A-310 Infections Associated With Infertility and Success of In Vitro Fertilization
Authors: Bacarov N B , Nunes A V , Dias R , Resende C , Garcia L , Barbosa C , Soane M , Christofolini D 
Published: September 2023

Abstract

Background
Preimplantation genetic analysis aims selecting the best embryo to transfer increasing the chance of a successful pregnancy. However, failure in the implantation of euploid embryos is frequent in the practice of assisted human reproduction, observed in approximately 30 to 50% of transfers, with no cause found in most cases. Previous or active infectious may be associated with infertility, but this topic still lacks deeper studies. Our aim was to analyze the occurrence of sexually transmitted infections in women who underwent the transfer of euploid embryos with different gestational outcomes.

Methods
A prospective cohort study was carried out for which 36 plasma (EDTA) samples and 17 endocervical smears (Digene HC2 DNA Collection Device) were collected from patients who would be submitted to assisted reproduction cycles (using euploid blastocysts) shortly after the collections, at a private assisted reproduction center. The collections were performed on the 3rd day after the start of luteal phase support with progesterone (clinic protocol). After collection, the samples were placed in a freezer at -80°C until the time of analysis. Women with signs of cervicitis at the time of collection, deep endometriosis, patients over 40 years of age, cases of severe male factor, chronic pelvic pain, patients who would transfer more than one embryo, transfer of aneuploid embryos or with chromosomal mosaicism were also excluded. Samples were submitted to IIFT (EUROIMMUN) to diagnostic specific anti-IgG antibodies against Chlamydia trachomatis (MIF), Neisseria gonorrhoeae, Herpes simplex virus 1 and 2, Mycoplasma hominis, Ureaplasma urealyticum and Treponema pallidum. Active infection was verified by Microrray technic using EUROArray STI 11 kit (EUROIMMUN) to detect Chlamydia trachomatis, Neisseria gonorrhoeae, Herpes simplex virus 1 and 2, Haemophilus ducreyi, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum, Ureaplasma urealyticum, Treponema pallidum and Trichomonas vaginalis.

Results
From the 36 plasma samples analyzed for IgG antibodies presence, the following were seropositive: 30 anti-herpes simplex 1 and 2, 3 anti-Treponema pallidum, 10 anti-Chlamydia MIF and 32 anti-Mycoplasma hominis and anti-Ureaplasma urealyticum. From the 16 endocervical smears samples analyzed, Ureaplasma parvum was detected in 3 women, who failed to get pregnant. No other infectious agent was detected in the samples. For the statistical analysis of the descriptive results, Fisher's exact test was used, the qualitative variables were presented by absolute and relative frequency, the confidence interval level adopted was 95%. The P value was calculated using the statistical program Stata version 14.0, and no statistic difference was observed between the group got pregnant through IVF and the group didn't.

Conclusion
Although, a high prevalence of IST specific antibodies anti-IgG in this cohort and 3 patients with active infection was found, a statistical significant difference was no obtained between groups who have succeed on IVF and not, against to the bibliography. In another hand all the patients with active infection of Ureaplasma parvum didn't have success on IVF which suggests that infection increase the unsuccess IVF. On this context, a larger sampling will clarify the hypotheses of associations of STIs as a cause of failed IVF.