Influence of opportunistic infections on in vitro fertilization efficiency in women with various types of infertility

Background. Today, according to the WHO, in Russia 15% of couples do not have children. Opportunistic infections in adults are pathological processes that occur and develop against the background of a reduced immune response and often cause infertility.

Aim. To study the ratio of opportunistic infection markers in women with various types of infertility who are treated with IVF to create a model for predicting treatment outcomes.

Materials and methods. The main sample consisted of 711 patients, aged 20 to 46 years, who were treated for infertility with IVF methods at the Clinic of the Kuban State Medical University from 2016 to 2018. The study group consisted of 431 patients with pregnancy according to ultrasound. Depending on the outcome of pregnancy, two groups were considered: group 1 - 167 women with preterm birth or termination of pregnancy at different gestational periods; Group 2 - 264 women who gave birth to healthy children on time. The first and second groups were divided into subgroups depending on the type of infertility: primary and secondary. Before pregnancy planning (IVF), all women were examined for opportunistic infections by ELISA and PCR. Antibodies to herpetic infection (At HSV IgM and G), cytomegalovirus infection (At CMV IgM and IgG) and toxoplasmosis (At TOXO IgM and IgG) were determined.

Results. Among the studied group of women with signs of a latent course of opportunistic infections, positive IVF results were noted in 40%. Upon successful completion of IVF with an urgent delivery, there are more often markers for only herpes viruses of type I-II, and less often markers for cytomegalovirus infection are recorded. In contrast, with premature birth or miscarriage, infection markers by several opportunists are determined. In secondary infertility in the group with failed IVF outcomes, infection with several opportunistic infections was detected in 87.7 ± 3.85% of cases.

Conclusion. The combination of several opportunistic infections, including those with a latent course, can have a negative impact on the effectiveness of IVF, leading to a decrease in the percentage of positive results. Secondary infertility is characterized by the presence of markers of several opportunistic infections. Screening for opportunistic infections is a necessary part of preparing a woman for an IVF procedure.