Witkin S S, Kligman I, Grifo J A, Rosenwaks Z
Department of Obstetrics and Gynecology, Cornell University Medical College, New York, NY 10021, USA.
J Assist Reprod Genet. 1995 Oct;12(9):610-4. doi: 10.1007/BF02212584.
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).
All women were treated with tetracycline following sample collection.
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.
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.
采用聚合酶链反应（PCR）检测接受体外受精（IVF）的女性在卵母细胞采集时宫颈内解脲脲原体和人型支原体的感染率。
所有女性在样本采集后均接受四环素治疗。
326名女性中有56名（17.2%）检测出解脲脲原体，而235名女性中只有5名（2.1%）检测出人型支原体。在胚胎移植前IVF周期失败的女性中，解脲脲原体的检出频率更高（P = 0.01）。在19名未受精或未进行胚胎移植的女性中有8名（42.1%）存在该病原体，在胚胎移植后未妊娠的148名女性中有19名（12.8%），仅出现短暂（生化）妊娠的30名女性中有6名（20.0%），自然流产的14名女性中有5名（35.7%），足月分娩的115名女性中有18名（15.6%）。在8名未进行胚胎移植且感染了解脲脲原体的女性中，5例不孕原因是男性因素，2例女性输卵管堵塞，1例女性诊断为特发性不孕。因此，精子质量差而非解脲脲原体感染可能解释了这些病例中大多数未能进入胚胎移植阶段的原因。对所有患者的分析显示，男性因素不孕与宫颈解脲脲原体感染之间无关联。
许多培养阴性的女性宫颈中存在解脲脲原体，但不存在人型支原体。然而，在卵母细胞采集后接受四环素治疗的女性中，解脲脲原体的存在并不影响胚胎移植后的IVF结局。
