Does seminal fluid bacterial isolate(s) affect in vitro fertilization — embryo transfer outcome?

Abstract

Background The chance of achieving a successful pregnancy through in vitro fertilization and embryo transfer (IVF-ET) is limited despite recent scientific advances in this field due to several factors that are known to affect the outcome. There are studies linking the presence of bacteria in the male genital tract to poor semen parameters and IVF-ET outcomes. Results are, however, contradictory. The finding of confirmed genital tract infection warrants treatment, especially when dealing with infertile couples, but treating asymptomatic bacteriospermia is controversial. This study assessed the prevalence and effects of seminal fluid bacterial isolates on semen quality and rates of fertilization and biochemical and clinical pregnancies in IVF-ET. Methodology This is an analytical cross-sectional study conducted at the IVF Center of National Hospital Abuja, Nigeria. Due to the low turnout of clients, we enrolled all consecutive consenting eligible male partners of women undergoing the procedure during the study period to obtain a sample size of 242. Participants observed sterile techniques to prevent contamination of the seminal fluid during collection. Growth of bacteria > 10,000 colony-forming units (CFU)/ml was considered significant and tested for sensitivity to a panel of antibiotics. We determined the influence of positive bacterial isolates on fertilization, biochemical pregnancy, clinical pregnancy (primary outcome), and multiple pregnancies. Data were analyzed using SPSS version 22. Student’s t-test, chi-square test, and Fisher’s exact tests were employed as appropriate. p-value < 0.05 at a 95% confidence interval was regarded as statistically significant. Results Seminal fluid culture was positive in 57 patients (47.11%). Staphylococcus aureus was the predominant organism cultured (43.90%), followed by Streptococci spp. (21.05%), Escherichia coli (17.54%), Klebsiella spp. (8.77%), Pseudomonas aeruginosa (5.26%), Staphylococcus saprophyticus (1.75%), mixed Staphylococcus aureus, and Streptococcus spp. organisms (1.75%). The fertilization rate was 95.4%, the biochemical pregnancy rate was 42.2%, the clinical pregnancy rate was 38%, and the multiple pregnancy rate was 16.53%. Significant factors found to be associated with positive clinical pregnancy were primary infertility (p-value = 0.001) and negative seminal fluid culture result (p-value = 0.033). Conclusion The prevalence of bacteriospermia was relatively high, and the presence of bacterial isolates adversely affected fertilization and clinical pregnancy rates among couples undergoing the IVF-ET program.