Microbiology of Human Follicular Fluid and the Vagina and Its Impact on in Vitro Fertilization Outcomes

Su Mi Kim, Kyu Hee Won, Yeon Hee Hong, Seul Ki Kim, Jung Ryeol Lee, Byung Chul Jee, Chang Suk Suh

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: The present study aimed to identify microorganisms in follicular fluids and to investigate their association with in vitro fertilization (IVF) outcomes. Materials and Methods: This study was conducted as a prospective study of 49 infertile females undergoing IVF/intracytoplasmic sperm injection cycles between 2013 and 2016. Paired follicular fluid and vaginal secretions were collected on the day of ovum pick up and were cultured to detect microorganisms. Results: Fifteen women (30.6%) had no microorganisms in follicular fluid or vaginal swabs, 23 (46.9%) had microorganisms on vaginal swab alone, 3 (6.1%) had microorganisms in follicular fluid alone, and 8 (16.3%) had microorganisms in both follicular fluid and vaginal swabs. The same microorganisms were detected in both the follicular fluid and vaginal swabs of three women, while different microorganisms were detected between follicular fluid and vaginal swabs in five women. Follicular fluid microorganisms were not associated with embryo quality or clinical pregnancy rates during IVF cycles. However, significantly decreased implantation rates (9.1% vs. 29.4%, p=0.031) and clinical pregnancy rates on embryo transfer day 5 (0% vs. 83.3%, p=0.048) were observed in the group that was positive for vaginal pathogens. Conclusion: Follicular fluid contains microorganisms that can differ from those in the vagina of the same women; however, they do not appear to be associated with embryo quality or clinical pregnancy rates in IVF cycles. In contrast, vaginal pathogens were found to be associated with worse implantation rates and clinical pregnancy rates in IVF cycles.

Original languageEnglish
Pages (from-to)941-947
Number of pages7
JournalYonsei Medical Journal
Volume63
Issue number10
DOIs
StatePublished - Oct 2022

Keywords

  • Follicular fluid
  • in vitro fertilization
  • microorganisms
  • pregnancy rate
  • vagina

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