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Impact of bacterial vaginosis on the reproductive outcomes of IVF: meta-analysis


Obstetrics & Gynecology International Journal
Santa María-Ortiz Johana Karin,1 Varillas Del Rio Carmen2

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Abstract

History: Bacterial vaginosis has been seen to have a negative impact on the reproductive outcomes of in vitro fertilization (IVF).

Aim: To determine its impact on the rates of biochemical pregnancy, clinical pregnancy, early spontaneous miscarriage and live newborns. Data source: Bibliographic search according to PRISMA guidelines in the MEDLINE, EMBASE, CINAHL and Cochrane Library databases.

Eligibility criteria for the studies: The process for identifying and selecting studies is shown in the PRISMA flowchart. Evidence was evaluated according to the GRADE method.

Subjects and interventions: Infertile women with IVF. Diagnosis of bacterial vaginosis according to Nugent or qPCR criteria.

Evaluation of studies and summary methods: Forest plot, sensitivity analysis, funnel plots and evaluation of evidence according to GRADE.

Results: A total of seven studies were included. We detected an overall statistically significant association with the rate of biochemical pregnancy (OR 0.55; 95%CI: 0.36-0.85; P=0.004) and rate of clinical pregnancy 0.43; 95%CI: 0.22-0.87; P=0.018). This was not the case for early spontaneous miscarriage (OR 1.13; 95%CI: 0.46-2.82; P=0.78) and rate of live newborns (OR 1.63; 95%CI: 0.61- 4.32; P=0.33).

Limitations: Observational studies with a small sample and significant heterogeneity between them. Conclusions: Bacterial vaginosis appears to have some impact on the rate of clinical and biochemical pregnancy achieved with IVF.

Keywords

abnormal vaginal flora, bacterial vaginosis, biochemical pregnancy, clinical pregnancy, early spontaneous miscarriage, infertility, in vitro fertilization, live newborns

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