Luteal Fazda Vajinal Laktobasil Desteğinin IVF/ICSI Sikluslarında Taze Embriyo Transferi Uygulanan Hastalarda İmplantasyon Oranlarına Etkisi

Yıl 2020, , 177 - 180, 01.08.2020

Kiper Aslan , Işıl Kasapoğlu , Göktan Kuspinar , Berrin Avcı , Gürkan Uncu

https://doi.org/10.32708/uutfd.731738

Öz

Bu prospektif çalışmanın amacı IVF/ICSI sikluslarında taze embriyo transferi uygulanan infertil hastalarda luteal fazda vajinal laktobasil desteğinin implantasyon oranlarına etkisini araştırmaktır. Vajinal mikrobiyota ve infertilite ilişkisi günümüzde oldukça popüler bir araştırma konusudur ve yapılan çalışmalarda bozulmuş vajinal mikrobiyotanın infertil hastalarda gebelik sonuçlarını olumsuz olarak etkilediği bilinmektedir. Biz de bu sebeple çalışmamızda 88 infertil hastaya kontrollü ovaryan hiperstimülasyon sonrası oosit toplandığı gün vajinal 1x4 tablet vajinal laktobasil desteği sağlayarak, gebelik sonuçlarını laktobasil desteği uygulanmayan 88 kontrol hastası ile karşılaştırdık. Sonuçlarda grupların demografik verileri birbirine benzerdi. Ve çalışmanın birincil sonucu olan implantasyon oranları çalışma grubunda %38,6 kontrol grubunda %32,9 olarak bulundu. Sonuçlar kontrol grubunda daha yüksek olmasına rağmen istatistiksel olarak benzerdi. Çalışmanın sonucu olarak taze embriyo transferi yapılan infertil hastalarda luteal fazda laktobasil desteği sağlanmasının gebelik sonuçlarına etkisi gözlenmedi.

Anahtar Kelimeler

İnfertilite, Mikrobiyota, Laktobasil, Luteal Faz Desteği

Implantation Rates with Adding Vaginal Lactobacilli to Luteal Phase Support in Patients Undergoing Fresh Embryo Transfer in IVF/ICSI Cycles

Öz

This prospective study aims to clinically evaluate the effect of adding vaginal lactobacilli to luteal phase support implantation rates in patients undergoing fresh embryo transfer in IVF/ICSI cycles. The relationship between vaginal microbiota and infertility is a popular investigation field, and recent studies show that dysbiotic vaginal microbiota is related to poor pregnancy results in infertile patients. Thus, we enrolled 88 infertile patients who underwent ICSI procedure in the study group. We applied 1x4 tablets of lactobacillus through the vagina on the day of the oocyte pick up procedure. The pregnancy results were compared with the 88 patients who did not receive any lactobacillus support. The demographic parameters of the groups were comparable. Implantation rates were 38.6% in the study group and 32,9% percent in the control group. Although the implantation rate was higher in the study group, the difference was not statically significant. As a result, adding vaginal lactobacilli to luteal phase support does not improve implantation rates in patients undergoing fresh embryo transfer in IVF/ICSI cycles.

Anahtar Kelimeler

Infertility, Microbiota, Lactobacillus, Luteal Phase Support

Kaynakça

• 1. Lander ES, Linton LM, Birren B, Nusbaum C, Zody MC, Baldwin J, et al. Initial sequencing and analysis of the human genome. Nature. 2001 Feb 15;409(6822):860–921.
• 2. Turnbaugh PJ, Ley RE, Hamady M, Fraser-liggett C, Knight R, Gordon JI. The human microbiome project: exploring the microbial part of ourselves in a changing world. Nature. 2007;449(7164):804–10.
• 3. Mendling W. Vaginal microbiota. In: Advances in Experimental Medicine and Biology. Springer New York LLC; 2016. p. 83–93.
• 4. Hurley E, Mullins D, Barrett MP, O’Shea CA, Kinirons M, Ryan CA, et al. The microbiota of the mother at birth and its influence on the emerging infant oral microbiota from birth to 1 year of age: a cohort study. J Oral Microbiol. 2019 Jan 1;11(1).
• 5. Kervinen K, Kalliala I, Glazer-Livson S, Virtanen S, Nieminen P, Salonen A. Vaginal microbiota in pregnancy: Role in induction of labor and seeding the neonate’’s microbiota? Vol. 44, Journal of biosciences. NLM (Medline); 2019.
• 6. Haahr T, Jensen JS, Thomsen L, Duus L, Rygaard K HP. Abnormal Vaginal Microbiota May Be Associated With Poor Reproductive Outcomes: A Prospective Study in IVF Patients - PubMed. Hum Reprod. 2016;795–803.
• 7. Ravel J, Gajer P, Abdo Z, Schneider GM, Koenig SSK, McCulle SL, et al. Vaginal microbiome of reproductive-age women. Proc Natl Acad Sci U S A. 2011 Mar 15;108(SUPPL. 1):4680–7.
• 8. Tachedjian G, Aldunate M, Bradshaw CS, Cone RA. The role of lactic acid production by probiotic Lactobacillus species in vaginal health. Res Microbiol. 2017 Nov 1;168(9–10):782–92.
• 9. R Koedooder, M Singer , S Schoenmakers , P H M Savelkoul, S A Morré, J D de Jonge, L Poort, W J S S Cuypers, N G M Beckers, F J M Broekmans, B J Cohlen, J E den Hartog, K Fleischer, C B Lambalk, J M J S Smeenk, A E Budding JSEL. The Vaginal Microbiome as a Predictor for Outcome of in Vitro Fertilization With or Without Intracytoplasmic Sperm Injection: A Prospective Study - PubMed. Hum Reprod. 2019. p. 1042–54.
• 10. Mangot-Bertrand J, Fenollar F, Bretelle F, Gamerre M, Raoult D, Courbiere B. Molecular diagnosis of bacterial vaginosis: Impact on IVF outcome. Eur J Clin Microbiol Infect Dis. 2013 Apr;32(4):535–41.
• 11. Brabant G. Bacterial vaginosis and spontaneous preterm birth. J Gynecol Obstet Biol la Reprod. 2016 Dec 1;45(10):1247–60.
• 12. Kyono K, Hashimoto T, Kikuchi S, Nagai Y, Sakuraba Y. A pilot study and case reports on endometrial microbiota and pregnancy outcome: An analysis using 16S rRNA gene sequencing among IVF patients, and trial therapeutic intervention for dysbiotic endometrium. Reprod Med Biol. 2019 Jan 1;18(1):72–82.
• 13. Hyman RW, Herndon CN, Jiang H, Palm C, Fukushima M, Bernstein D, et al. The dynamics of the vaginal microbiome during infertility therapy with in vitro fertilization-embryo transfer. J Assist Reprod Genet. 2012 Feb;29(2):105–15.
• 14. Miles SM, Hardy BL, Merrell DS. Investigation of the microbiota of the reproductive tract in women undergoing a total hysterectomy and bilateral salpingo-oopherectomy. Fertil Steril. 2017 Mar 1;107(3):813-820.e1.
• 15. Moreno I, Codoñer FM, Vilella F, Valbuena D, Martinez-Blanch JF, Jimenez-Almazán J, et al. Evidence that the endometrial microbiota has an effect on implantation success or failure. In: American Journal of Obstetrics and Gynecology. Mosby Inc.; 2016. p. 684–703.
• 16. Moore DE, Soules MR, Klein NA, Fujimoto VY, Agnew KJ, Eschenbach DA. Bacteria in the transfer catheter tip influence the live-birth rate after in vitro fertilization. Fertil Steril. 2000;74(6):1118–24.
• 17. Selim SA, El Alfy SM, Aziz MHA, Mohamed HM, Alasbahi AA. Effective of metronidazole to bacterial flora in vagina and the impact of microbes on live birth rate during intracytoplasmic sperm injection (ICSI). Arch Gynecol Obstet. 2011 Dec;284(6):1449–53.