Division of Assisted Reproduction, Department of Obstetrics and Gynaecology, Semmelweis University, Baross U. 27., 1088, Budapest, Hungary.
J Med Case Rep. 2024 May 15;18(1):247. doi: 10.1186/s13256-024-04521-3.
Bacterial infection of embryo culture medium is rare but may be detrimental. The main source of embryo culture contamination is semen. Assisted reproduction centers currently lack consensus regarding the methods for preventing and managing embryo culture infection. In our recent case, a successful pregnancy was achieved with intracytoplasmic sperm injection after failed conventional in vitro fertilization owing to bacterial contamination.
We present a case report of two consecutive in vitro fertilization-intracytoplasmic sperm injection cycles with photo and video documentation of the bacterial growth. A 36-year-old Hungarian woman and her 37-year-old Hungarian partner came to our department. They had two normal births followed by 2 years of infertility. The major causes of infertility were a closed fallopian tube and asthenozoospermia. Bacterial infection of the embryo culture medium was observed during in vitro fertilization and all oocytes degenerated. The source was found to be the semen. To prevent contamination, intracytoplasmic sperm injection was used for fertilization in the subsequent cycle. Intracytoplasmic bacterial proliferation was observed in one of the three fertilized eggs, but two good-quality embryos were successfully obtained. The transfer of one embryo resulted in a successful pregnancy and a healthy newborn was delivered.
Intracytoplasmic sperm injection may be offered to couples who fail conventional in vitro fertilization treatment owing to bacteriospermia, as it seems to prevent infection of the embryo culture. Even if bacterial contamination appears, our case encourages us to continue treatment. Nevertheless, the development of new management guidelines for the prevention and management of bacterial contamination is essential.
胚胎培养液中的细菌感染较为罕见，但可能会造成损害。胚胎培养液污染的主要来源是精液。辅助生殖中心目前对于胚胎培养液感染的预防和处理方法尚未达成共识。在我们最近的病例中，由于细菌污染，常规体外受精失败后，采用卵胞浆内单精子注射成功妊娠。
我们报告了一例连续两次体外受精-卵胞浆内单精子注射周期的病例，其中有细菌生长的照片和视频记录。一名 36 岁的匈牙利女性和她 37 岁的匈牙利伴侣前来就诊。他们育有两个正常的孩子，随后经历了 2 年的不孕。不孕的主要原因是输卵管堵塞和弱精症。在体外受精过程中观察到胚胎培养液中的细菌感染，所有卵子均退化。来源被发现是精液。为了防止污染，在随后的周期中采用卵胞浆内单精子注射进行受精。在三个受精的卵子中，有一个观察到卵胞浆内细菌增殖，但成功获得了两个优质胚胎。移植一个胚胎后成功妊娠，并分娩了一个健康的新生儿。
对于因菌精症导致常规体外受精治疗失败的夫妇，可以提供卵胞浆内单精子注射，因为它似乎可以防止胚胎培养液感染。即使出现细菌污染，我们的病例也鼓励我们继续治疗。然而，制定新的预防和处理细菌污染的管理指南至关重要。
