Microbiology Section, Botany Department, Faculty of Science, Suez Canal University, P.O. 41522 Ismailia, Egypt.
Arch Gynecol Obstet. 2011 Dec;284(6):1449-53. doi: 10.1007/s00404-011-1857-2. Epub 2011 Feb 18.
The aim of this study was to investigate the impact of bacterial vaginal flora on life-birth rate during ICSI and influence of metronidazole as antibiotic treatment course before ICSI.
We enrolled 71 women who were undergoing ICSI. At embryo transfer (ET), all of the women had quantitative vaginal culture, ET catheter-tip culture, and vaginal Gram stain scored for bacterial vaginosis.
The overall live birth rate (LBR) was 36.6% (26/71), and the rate of early pregnancy loss was 13% (4/30). In women with bacterial vaginosis, intermediate flora and normal flora, the conception rates were 35% (9/26), 42% (14/33) and 58% (7/12), respectively (p = 0.06 for trend). Metronidazole effect to bacterial flora in vaginal. The predominant species isolated from the tip of the embryo transfer catheter in negative pregnancy was Staphylococcus epidermidis (7 vs. 15.2%), and Streptococcus viridians (11 vs. 24%).
Woman with bacterial vaginosis and with a decreased vaginal concentration of hydrogen peroxide-producing lactobacilli may have decreased conception rates and increased rates of failed pregnancy. A larger prospective treatment trial designed to evaluate the impact on ICSI outcomes of optimizing the vaginal flora prior to ICSI may be warranted.
本研究旨在探讨细菌性阴道菌群对 ICSI 期间活产率的影响，以及 ICSI 前使用甲硝唑作为抗生素治疗方案的影响。
我们纳入了 71 名接受 ICSI 的女性。在胚胎移植（ET）时，所有女性均进行了定量阴道培养、ET 导管尖端培养和阴道革兰氏染色评分，以评估细菌性阴道病。
总活产率（LBR）为 36.6%（26/71），早期妊娠丢失率为 13%（4/30）。在细菌性阴道病、中间菌群和正常菌群的女性中，受孕率分别为 35%（9/26）、42%（14/33）和 58%（7/12）（趋势检验 p=0.06）。甲硝唑对阴道菌群有影响。在妊娠阴性的胚胎移植导管尖端分离出的主要菌种为表皮葡萄球菌（7 株比 15.2%）和草绿色链球菌（11 株比 24%）。
细菌性阴道病且阴道中产生过氧化氢的乳酸杆菌浓度降低的女性受孕率可能降低，妊娠失败率可能增加。可能需要进行更大规模的前瞻性治疗试验，以评估在 ICSI 前优化阴道菌群对 ICSI 结局的影响。
