Department of Obstetrics and Gynecology, Sohag Faculty of Medicine, Sohag University Hospital, Egypt.
Eur J Obstet Gynecol Reprod Biol. 2013 Mar;167(1):59-63. doi: 10.1016/j.ejogrb.2012.10.031. Epub 2012 Nov 27.
To estimate the prevalence of bacterial vaginosis (BV) in infertile women and evaluate the effect of treatment of BV on the pregnancy rate in patients with polycystic ovarian disease (PCOD) and unexplained infertility.
Cohort study conducted at the Department of Obstetrics and Gynecology in collaboration with the Microbiology Department of Sohag University Hospital, Egypt. All eligible women with female factor infertility (n=874) were enrolled and all asymptomatic fertile women (n=382) attending the family planning clinic of the study hospital were recruited as a control group. The study was in two phases: the first included screening all participants for BV after Gram-staining of the vaginal discharge. The second phase was concerned with evaluating the effect of treatment of BV on the cumulative pregnancy rate (CPP) in patients with PCOD (group I; n=278) and unexplained infertility (group II; n=170). Each group was divided into three sub-groups: groups Ia (n=129) and IIa (n=73) were BV positive and treated for BV; groups Ib (n=61) and IIb (n=49) were BV positive and did not receive treatment for BV, and groups Ic (n=88) and IIc (n=48) were BV negative. The prevalence of BV was compared using the Chi-square. The long rank test of Kaplan-Meier life table analysis was used to compare the CPR. A multivariate regression model was designed to define the most significant variable which affected the pregnancy rate in patients with PCOD.
The prevalence of BV was significantly higher in infertile than fertile women (45.5% vs 15.4%). The highest prevalence was found in patients with PCOD (60.1%) and unexplained infertility (37.4%). The CPR in both patients with PCOD and unexplained infertility were significantly higher in the patients who were treated for BV. Regression model showed that BV was one of the significant factors interfering with pregnancy.
BV is strongly implicated in female infertility and is probably an underestimated cause of unexplained infertility. Screening and treatment of BV in patients with PCOD and unexplained infertility improved the pregnancy rate considerably.
评估细菌性阴道病（BV）在不孕女性中的患病率，并评估治疗 BV 对多囊卵巢疾病（PCOD）和不明原因不孕患者的妊娠率的影响。
在埃及索哈格大学医院妇产科与微生物学系合作进行的队列研究。所有符合条件的女性因素不孕患者（n=874）均被纳入研究，并招募所有无症状的健康生育女性（n=382）作为研究医院计划生育诊所的对照组。该研究分为两个阶段：第一阶段包括对所有参与者进行阴道分泌物革兰氏染色后的 BV 筛查。第二阶段评估治疗 BV 对 PCOD（第 I 组；n=278）和不明原因不孕（第 II 组；n=170）患者的累积妊娠率（CPP）的影响。每组分为三个亚组：第 Ia 组（n=129）和第 IIa 组（n=73）BV 阳性并接受 BV 治疗；第 Ib 组（n=61）和第 IIb 组（n=49）BV 阳性且未接受 BV 治疗，第 Ic 组（n=88）和第 IIc 组（n=48）BV 阴性。使用卡方检验比较 BV 的患病率。使用 Kaplan-Meier 生命表分析的长秩检验比较 CPR。设计了一个多元回归模型来确定影响 PCOD 患者妊娠率的最重要变量。
不孕女性的 BV 患病率明显高于健康生育女性（45.5% vs 15.4%）。在 PCOD 患者（60.1%）和不明原因不孕患者（37.4%）中，BV 的患病率最高。在接受 BV 治疗的患者中，PCOD 和不明原因不孕患者的 CPR 均显著升高。回归模型显示，BV 是影响妊娠的重要因素之一。
BV 与女性不孕密切相关，可能是不明原因不孕被低估的原因。对 PCOD 和不明原因不孕患者进行 BV 筛查和治疗可显著提高妊娠率。
