The presence of microorganisms in follicular fluid and its effect on the outcome of in vitro fertilization-embryo transfer (IVF-ET) treatment cycles

Abstract

Objectives To determine if the presence of microorganisms in follicular fluid of women undergoing in vitro fertilization-embryo transfer (IVF-ET) adversely affects the outcome of the treatment cycles. Methods Follicular fluid was collected from 86 women enrolled for IVF-ET at the National Hospital, Abuja from June 1, 2018 to December 1, 2018. Microscopy imaging and cultures were performed to identify bacteria and fungi in the follicular fluid and the vagina. Women with follicular fluid microorganisms were the test group while the controls were those without follicular fluid microorganisms. Fertilization and pregnancy rates were subsequently determined and their association with the presence of follicular fluid microorganisms was assessed using univariable and multivariable logistic regression modelling. Results The mean age and mean Body Mass Index (BMI) of the participants were 35(± 3.5) years and 28(± 4.9) kg/m2 respectively. Bacteria and fungi were isolated in 17% of the follicular fluid samples collected (n = 15/86). Most common isolates were Streptococcus spp. (n = 4/15), Staphylococcus aureus (n = 7/15), Enterococcus spp. (n = 4/15), Lactobacillus species (n = 2/15) and Candida albicans (n = 2/15). There was no statistically significant difference in the fertilization rates (adjusted odds ratio [AdjOR] 0.55, 95% confidence interval [CI] 0.04–7.34; P = 0.10) and pregnancy rates (AdjOR 4.02, 95% CI 0.56–28.92; P = 0.19) between the group of women with positive follicular fluid bacterial /fungal colonization as compared against those with negative follicular fluid colonization. Conclusion Isolation of microorganisms from follicular fluid did not adversely affect fertilization and pregnancy rates following IVF-ET treatment cycles at the fertility centre of National Hospital, Abuja.

Characterization of the follicular fluid microbiota based on culturomics and sequencing analysis

“…and Staphylococcus spp. [8,11] could be isolated from human follicular fluid samples under different media and atmospheric conditions; Staphylococcus aureus was identified in follicular fluid samples collected from post-slaughter dairy cows [14]. Our results were partly in line with the previous studies on bacteria in follicular fluid collected from humans and animals.…”

“…and Lactobacillus spp. have been cultured from follicular fluid samples in previous reports [9,11,12]. Follicular fluid samples were cultured under aerobic and anaerobic conditions for 20 days, which allowed the isolation of 23 and 33 species, respectively (Fig.…”

Association between follicular fluid bacteria with inflammatory markers of the complete blood count and the outcomes of assisted reproductive technology in women with endometriosis: A case–control study

“…17 Contradictorily, based on another study that aimed to investigate the effect of microorganisms present in follicular fluid on IVF outcomes, bacterial colonization of follicular fluid had no effect on the number of retrieved oocytes, fertilization and pregnancy rates, and IVF outcomes. 29 Based on another research that was performed to identify and compare the microorganisms present in follicular fluid and their influence on IVF/ICSI outcomes, there was no relationship between the microorganisms present in follicular fluid and the embryo quality and the rate of pregnancy in IVF/ICSI cycles. 14 In the interpretation of the above contradictory findings, it is important to point out that currently the effect of bacteria on the oocyte is not well known and there are relatively few studies have been performed on the microorganisms present in the follicular fluid that might play a potential role in women's fertility.…”

“…Based on a study that aimed to investigate the influence of the microbial colonization of follicular fluid on ART outcomes, bacterial colonization in follicular fluid was associated with a decrease in the fertility rate and viable embryos in ART cycles, especially in women with endometriosis 17 . Contradictorily, based on another study that aimed to investigate the effect of microorganisms present in follicular fluid on IVF outcomes, bacterial colonization of follicular fluid had no effect on the number of retrieved oocytes, fertilization and pregnancy rates, and IVF outcomes 29 . Based on another research that was performed to identify and compare the microorganisms present in follicular fluid and their influence on IVF/ICSI outcomes, there was no relationship between the microorganisms present in follicular fluid and the embryo quality and the rate of pregnancy in IVF/ICSI cycles 14 …”

The Upper Reproductive System Microbiome: Evidence beyond the Uterus

“…57 Different bacterial species have been detected in colonized follicular fluids, including Lactobacillus spp., Staphylococcus spp., and Streptococcus spp. [58][59][60] Enterococcus, 58,59 Peptostreptococcus spp., E. coli, 58,61 Mycobacterium hominis, Ureaplasma urealyticum, G. vaginalis, 60 Actinomyces spp., Propionibacterium spp., and Bifidobacterium spp. 58 A recent study identified via culturomics Streptococcus, Finegoldia, and Peptoniphilus in follicular fluid from patients undergoing IVF treatment.…”