Implication of infectious agents in infertility

Infertility is characterized by the inability to achieve a successful pregnancy, taking into account the patient's medical, sexual, and reproductive history, age, physical findings, diagnostic tests, or a combination of these factors. Primary infertility refers to the inability to conceive a first pregnancy, while secondary infertility refers to the inability to conceive a subsequent pregnancy after having previously conceived. Infertility is a multifactorial condition that can originate from both male and female factors. In many cases, medical intervention is necessary for the couple to achieve pregnancy. One of the potentially treatable causes is female genital infectious pathology. Currently, various infectious agents are known, among which Ureaplasma parvum and Mycoplasma hominis are two agents whose treatment could benefit patients in achieving pregnancy OBJETIVE: To analyze the effect of antibiotic treatment (AMT) in women that are looking for pregnancy and our main outcome is the achievement of the pregnancy after this antibiotic treatment.

In total we collected data from 174 patients who were attended in the fertility consultation of our Gynecology and Obstetrics Department during the period February/2020-November/2021. The variables we analyzed were: type of infertility (primary or secondary), previous births, previous miscarriages, previous ectopic pregnancies, suspected causes of infertility, prior contraceptive use, time since discontinuation of contraceptives, antibiotic treatment, type of antibiotic administered, and achievement of pregnancy.

174 patients Median age = 35 years (IQR 32, 38 years; minimum 25, maximum 47) Primary infertility (78.7%), 26.9% without apparent cause Several possible causes of infertility in 21.2% Microbiological study performed in 96 cases (55.1%) Vaginal exudate (91.2%), Endometrial biopsy (6.3%), Endocervical exudate (1.9%) 60.4% positive microbiological result (Microbiological isolates in Figure 2) Median time in search of pregnancy = 18 months (IQR 9, 30 months) 47.1% received AMT, in 44% of them pregnancy was confirmed 52.8% not received AMT, in 50% of them pregnancy was confirmed 51.2% previously use of contraceptives

More studies are necessary to assess the implication of microbiological isolates and antibiotic treatment in women who do not achieve pregnancy.