Abstract
To compare the clinical outcomes of infertile patients with and without syphilis after in vitro fertilization and embryo transfer (IVF-ET), in this case-control study, 320 infertile couples were enrolled and divided into syphilis (n = 160) and control groups (n = 160). The primary IVF outcomes were the clinical pregnancy rate and the birth of a healthy baby. All syphilis patients received the standard anti-syphilis treatment before undergoing IVF/ICSI. Our results showed that the endometrial thickness of the syphilis group was greater than that of the control group following hCG injection (16.9±5.4 vs. 13.0±4.7 mm, P<0.001). The numbers of normally fertilized eggs and normally cleaved fertilized eggs and the implantation rate were 6.8±4.8, 6.3±4.7 and 24.2%, respectively, for the syphilis group and 8.3±4.6, 8.1±4.6 and 34.4%, respectively, for the control group, and these values were significantly different between the groups. The clinical pregnancy rate was lower in the syphilis group compared with that in the control group (43.8% vs. 55.6%, P = 0.03). Lower offspring birth weight was observed in the infected male group compared with those in the infected female (2.7±0.4 vs. 3.0±0.4 kg, P = 0.01) and infected couple groups (2.7±0.4 vs. 3.1±0.5 kg, P = 0.007). Therefore, syphilis infection reduces the clinical pregnancy rate after IVF/ICSI.
Highlights
Syphilis is a sexually transmitted disease (STD) caused by Treponema pallidum, and it is primarily spread through sexual intercourse[1,2], blood transfusion[3] or maternal-neonatal transmission[4]
Endometrial thickness on the human chorionic gonadotropin (hCG) injection day was significantly higher for the syphilis group compared with the control group (16.9±5.4 vs. 13.0 ±4.7 mm, P
The clinical pregnancy rate was significantly lower in the syphilis group compared with the control group (43.8% vs. 55.6%, P = 0.03), and the biochemical pregnancy rate was higher in the syphilis group (7.5% vs. 0.6%, P = 0.002) (Table 2)
Summary
Syphilis is a sexually transmitted disease (STD) caused by Treponema pallidum, and it is primarily spread through sexual intercourse[1,2], blood transfusion[3] or maternal-neonatal transmission[4]. The incidence rate of syphilis has risen rapidly in China since 1978[5,6], and it has become the most common STD in economically developed regions[7]. Syphilis infection of the reproductive tract[8]can cause inflammatory disease and infertility[9]. Reproductive tract infection and inflammation cause 8% and 35% of all cases of male infertility, respectively [10]. In women, it can result in fallopian tube obstruction[11,12] and endometritis.
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