Reproductive outcome of patients undergoing in vitro fertilization treatment and diagnosed with bacterial vaginosis or abnormal vaginal microbiota: a systematic PRISMA review and meta-analysis

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisReviewForskningpeer review

DOI

  • Thor Haahr
  • Jane Zacho, Department of Clinical Medicine, Aarhus University, Denmark and the Fertility Clinic Skive, Skive Regional Hospital, Denmark., Merethe Bräuner, Department of Clinical Medicine, Aarhus University, Denmark and the Fertility Clinic Skive, Skive Regional Hospital, Denmark.,
  • K Shathmigha
  • Jørgen Skov Jensen, Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark.,
  • Peter Humaidan

BACKGROUND: Despite recent efforts, the risks associated with bacterial vaginosis (BV) or abnormal vaginal microbiota in IVF patients are not well-established.

OBJECTIVES: We aimed to evaluate the risks associated with BV in IVF patients using meta-analysis.

SEARCH STRATEGY: Following preliminary searches in order to find relevant key words and MeSH terms, a systematic search was performed in Pubmed (Medline) September 2017.

SELECTION CRITERIA: The population was infertile women attending IVF treatment. The exposure was BV or abnormal vaginal microbiota. Outcomes included live birth rate, early spontaneous abortion rate and clinical pregnancy rate.

DATA COLLECTION AND ANALYSIS: Data were collected for each study and for each outcome using a summary of findings table. If appropriate, data was quantitatively assessed using meta-analysis. Sensitivity analysis, Funnel plots and GRADE evidence assessment were performed for the abovementioned outcomes.

MAIN RESULTS: A total of 12 studies were eligible comprising a total of 2980 patients. The prevalence of BV was 16% (95% CI 15-18%) in the general study population and tubal factor infertility was highly prevalent in patients diagnosed with BV compared to normal vaginal microbiota patients, P=0.001. Despite a significant association with early spontaneous abortion (RR 1.68; 95% CI 1.24, 2.27), BV did not significantly impact the live birth rate (RR 1.47; 95% CI 0.96, 1.57) or the clinical pregnancy rate (RR 0.93; 95% CI 0.75, 1.15).

CONCLUSIONS: BV is associated with tubal factor infertility and early spontaneous abortion. However, the quality of evidence was very low and the equivocal results justify the need for further research. This article is protected by copyright. All rights reserved.

OriginalsprogEngelsk
TidsskriftBJOG: An International Journal of Obstetrics and Gynaecology
Vol/bind126
Sider (fra-til)200-207
ISSN1470-0328
DOI
StatusUdgivet - 2019

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