Ureaplasma urealyticum and Mycoplasma hominis detected by the polymerase chain reaction in the cervices of women undergoing in vitro fertilization: prevalence and consequences.

PURPOSE

The prevalence of Ureaplasma urealyticum and Mycoplasma hominis in the endocervix at the time of oocyte collection in women undergoing in vitro fertilization (IVF) was examined using the polymerase chain reaction (PCR).

METHODS

All women were treated with tetracycline following sample collection.

RESULTS

U. urealyticum was identified in 56 (17.2%) of 326 women while M. hominis was present in only 5 (2.1%) of 235 women. U. urealyticum was detected at a higher frequency (P = 0.01) in those women whose IVF cycle failed prior to embryo transfer. This organism was present in 8 of 19 (42.1%) women with either no fertilization or no embryo transfer, 19 of 148 (12.8%) who had no evidence of pregnancy following embryo transfer, 6 of 30 (20.0%) who had only a transient (biochemical) pregnancy, 5 of 14 (35.7%) with a spontaneous abortion, and 18 of 115 (15.6%) with a term birth. Of the eight women with U. urealyticum who had no embryos transferred, male factor was the cause of infertility in five cases, two women had tubal occlusions while in one woman the diagnosis was idiopathic. Therefore, poor sperm quality, and not a U. urealyticum infection, might explain the failure of most of these cases to proceed to the stage of embryo transfer. Analysis of all patients revealed no association between male factor infertility and U. urealyticum in the cervix.

CONCLUSIONS

U. urealyticum, but not M. hominis, is present in the cervices of many culture-negative women. Its presence, however, does not influence IVF outcome subsequent to embryo transfer in women treated with tetracycline after oocyte retrieval.