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Observational Study
. 2024 Feb;41(2):441-450.
doi: 10.1007/s10815-023-03000-w. Epub 2023 Dec 13.

Bacterial vaginosis in a subfertile population undergoing fertility treatments: a prospective cohort study

Marjolein M van den Tweel  1   2 , Ellen H A van den Munckhof  3 , Moniek van der Zanden  2 , Anco C Molijn  4 , Jan M M van Lith  1 , Saskia Le Cessie  5   6 , Kim E Boers  7
Affiliations
Observational Study

Bacterial vaginosis in a subfertile population undergoing fertility treatments: a prospective cohort study

Marjolein M van den Tweel et al. J Assist Reprod Genet. 2024 Feb.

Abstract

Purpose: This study investigates the role of bacterial vaginosis (BV) on pregnancy rates during various fertility treatments. BV is known to influence several obstetric outcomes, such as preterm delivery and endometritis. Only few studies investigated the effect of BV in subfertile women, and studies found a negative effect on fecundity especially in the in vitro fertilisation population.

Methods: Observational prospective study, 76 couples attending a fertility clinic in the Netherlands between July 2019 and June 2022, undergoing a total of 133 attempts of intra uterine insemination, in vitro fertilization or intra cytoplasmatic sperm injection. Vaginal samples taken at oocyte retrieval or insemination were analysed on qPCR BV and 16S rRNA gene microbiota analysis of V1-V2 region. Logistic regression with a Generalized Estimated Equations analysis was used to account for multiple observations per couples.

Results: A total of 26% of the 133 samples tested positive for BV. No significant differences were observed in ongoing pregnancy or live birth rates based on BV status (OR 0.50 (0.16-1.59), aOR 0.32 (0.09-1.23)) or microbiome community state type. There was a tendency of more miscarriages based on positive BV status (OR 4.22 (1.10-16.21), aOR 4.28 (0.65-28.11)) or community state type group III and IV. On baseline qPCR positive participants had significantly higher body mass index and smoked more often. Odds ratios were adjusted for smoking status, body mass index, and socioeconomic status.

Conclusion: Bacterial vaginosis does not significantly impact ongoing pregnancy rates but could affect miscarriage rates.

Keywords: Bacterial vaginosis; IUI; IVF; Microbiome; Subfertility.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of included participants
Fig. 2
Fig. 2
Overview of microbiota of swabbed attempts arranged on non-pregnant vs pregnant
Fig. 3
Fig. 3
Overview of microbiota of swabbed attempts arranged in ongoing pregnant vs miscarriage
See this image and copyright information in PMC

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