The Influence of Vaginal Dysbiosis on Intracytoplasmic Sperm Injection Outcome

In women of reproductive age, vaginal infection is a gynaecological condition with various health consequences. Bacterial vaginosis, vulvovaginal candidiasis, and aerobic vaginitis are the most prevalent types of infection. Although reproductive tract infections are known to impact human fertility, no consensus guidelines on microbial control in infertile couples undergoing in vitro fertilization therapy are currently available. This study aimed to determine the effect of asymptomatic vaginal infections on the outcome of intracytoplasmic sperm injection in infertile Iraqi couples. Forty-six asymptomatic infertile Iraqi women were evaluated for genital tract infections by taking a vaginal sample on ovum pick-up for microbiological culture during their intracytoplasmic sperm injection treatment cycle. Based on the acquired results, a multi-microbial community colonized the participant's female lower reproductive tract, and only ۱۳ women achieved pregnancy compared to ۳۳ who did not. Candida albicans was found in ۴۳.۵% of the cases, ۳۹.۱% Streptococcus agalactiae, ۱۹.۶% Enterobacter species, ۱۳.۰% Lactobacillus, ۸.۷% Escherichia coli, ۸.۷% Staphylococcus aureus, ۴.۳% Klebsiella, and ۲.۲% Neisseria gonorrhoeae. However, no statistically significant effect was observed on the pregnancy rate except for Enterobacter spp. and Lactobacilli. In conclusion, the majority of patients had a genital tract infection; Enterobacter spp. had a substantial negative influence on the pregnancy rate, and lactobacilli were highly related to positive outcomes in participating females.