Assisted Reproductive Technology Results and Microorganism Contamination

Abstract

Objective: The uterine cervix plays an important role of gatekeeper, therefore microorganism presents in vagina seldom infects the uterine cavity in normal condition. While in Assisted Reproductive Technology (ART) procedures, we use transfer tube to put the gametes and zygotes through cervix into uterine cavity. These procedures carry a risk of uterine infection and may lead to a tragic pregnancy result. The purpose of this study is to explore the rate of contamination while put transfer tube into uterine cavity, and the impact of contamination on pregnancy rate.Methods: We did the bacteria workup for the ART cases, including embryo transfer (ET) and intrauterine insemination (IUI), at Sin-Lau hospital from January 2006 to July 2006. Before transfer procedure, the cervix was copiously irrigated with warmed normal saline. During and after the transfer procedure, the transfer tip was kept away from touching vagina wall. The transfer tip was cut and collected with sterile scissor and send to the microorganism laboratory immediately. We also perform the PCR test for detection of C. trachomatis and N. gonorrhoeae.Results: In our data, none of our cases was positive for C. trachomatis and N. gonorrhoeae. In the IUI and IVF-ET cases, the bacteria culture positive rate was 79 % (38/48) and 65% (13/20) respectively. The pregnancy rate was 14.5% (7/48) in IUI group and 35% (7120) in IVF group. The abortion rate was 14% (1/7) in IUI group and 0% in IVF group. In the pregnancy cases of IUI and IVF-E T, the bacteria culture positive rate was 85% (6/7) (p=0.54) and 71% (5/7) (p=0.02l) respectively. There is no statistic difference between contamination and non-contamination group in the pregnancy rate. But in IVF cases, the contamination group has higher pregnancy rate than non-contamination group in IUI group. Most of the cultured bacteria were normal vagina bacteria flora such as coagulase negative staphylococcus (non-staphylococcus saprophyticas), gram (+) Bacillus, etc. In rare condition, we found some infection bacterial like Group B streptococcus (9.3 %) and Candia albicans (3%). One abortion case pregnant by IUI has contaminated by candida albicans.Conclusions: Although we find high positive culture rate on transfer tip in our ART cases. But it did not decrease our pregnancy outcome or increase abortion rate. The high positive culture rate alarms us to clean the cervix more thoroughly to decrease contamination.