Bacterial vaginosis and past chlamydial infection are strongly and independently associated with tubal infertility but do not affect in vitro fertilization success rates

Abstract

Objective: To determine the incidence of active vaginal infection in women undergoing IVF, relate it to the cause of infertility, and investigate a relation with the outcome of fresh ET.

Design: Cross-sectional study.

Setting: Tertiary care infertility referral center.

Patient(s): Two hundred eighty-six women who underwent 344 oocyte recovery procedures for IVF cycles between March 1997 and January 1998.

Intervention(s): High vaginal swab specimens and endocervical swab specimens were obtained and ELISA serology was performed for detection of Chlamydia species on samples taken immediately before oocyte recovery. The results were related to the cause of infertility and the outcome parameters.

Main outcome measure(s): Pregnancy rates.

Result(s): Seropositivity for Chlamydia species and the presence of bacterial vaginosis both were strongly and independently associated with tubal disease. There was no difference in pregnancy rates in any of the groups regardless of their serologic status for chlamydial infection or current infection with bacterial vaginosis.

Conclusion(s): This study provides further evidence of the pelvic pathogenicity of bacterial vaginosis. However, it shows that women who have bacterial vaginosis or who have been treated for chlamydial infection in the past achieve pregnancy rates with IVF treatment similar to those of women who have no evidence of such infections.