Rates of bacterial vaginosis in women undergoing in vitro fertilisation for different types of infertility

Janet D Wilson, Janet Wilson, Ralph SG, Susan G. Ralph, Anthony J. Rutherford, Rutherford AJ
BJOG: An International Journal of Obstetrics & Gynaecology · 2002 · vol. 109(6) , pp. 714–717 · doi:10.1111/j.1471-0528.2002.01297.x · PMID:12118653 · W2008386494
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Women with tubal infertility were significantly more likely to have bacterial vaginosis (BV) compared to those with endometriosis, male factor, or unexplained infertility, and anovulation also showed increased BV rates.

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Abstract

OBJECTIVE: To assess whether the rate of bacterial vaginosis (BV) is higher in women with tubal factor infertility compared with those with other causes of infertility. DESIGN: Cross-sectional study. SETTING: Assisted conception unit of a teaching hospital in Leeds. POPULATION: Consecutive women undergoing in vitro fertilisation. METHODS: Women undergoing in vitro fertilisation (IVF) had a vaginal smear taken at the time of their egg collection. The smear was Gram-stained and graded as normal, intermediate or BV. MAIN OUTCOME MEASURES: The presence of bacterial vaginosis and the causes of infertility. RESULTS: A total of 749 women were included. The vaginal smears were normal in 63.6%, intermediate in 12.1%, and BV in 24.3%. The rates of BV in women with different types of infertility were 36.4% in tubal factor, 15.6% in male factor, 33.3% in anovulation, 12.5% in endometriosis and 18.9% in unexplained infertility. After controlling for the effects of age and smoking using a multivariate logistic regression model, women with tubal infertility were significantly more likely to have BV than women with endometriosis OR 3.63 (95% CI 1.52-8.67); male factor OR 2.98 (95% CI 1.80-4.90); and unexplained infertility OR 2.20 (95% CI 1.35-3.59). The adjusted figures for the increase of BV in women with anovulation were: endometriosis OR 3.77 (95% CI 1.28-11.08); male factor OR 3.09 (95% CI 1.37-6.96); and unexplained infertility OR 2.29 (95% CI 1.02-5.12). CONCLUSIONS: Women with tubal infertility were three times more likely to have BV than women with endometriosis, male factor or unexplained infertility. These findings support the association between BV, pelvic inflammatory disease (PID) and tubal damage but do not help distinguish between cause and effect. Women with anovulation were also three times more likely to have BV than women with endometriosis or male factor infertility, supporting suggestions of hormonal influence on vaginal flora.

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Condition tags

endometriosisinfertility

MeSH descriptors

Gardnerella vaginalis Infertility, Female Vaginosis, Bacterial Adult Adult Age Factors Age Factors Cross-Sectional Studies Cross-Sectional Studies Double-Blind Method Double-Blind Method Endometriosis Endometriosis Endometriosis Fallopian Tube Diseases Fallopian Tube Diseases Fallopian Tube Diseases Female Female Fertilization in Vitro

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