MICROBIAL-FLORA OF THE CERVIX ASSESSED AT THE TIME OF EMBRYO-TRANSFERADVERSELY AFFECTS IN-VITRO FERTILIZATION OUTCOME

Objective: To investigate whether the presence of cervical microorgani sms, as detected on catheters used for ET, alters the outcome of IVF-E T. Design: Prospective analysis. Setting: The assisted reproduction un it of a hospital in Clamart, France. Patient(s): Two hundred seventy-n ine controlled ovarian hyperstimulation (COH) cycles performed for IVF -ET. Inclusion criteria were a patient age of less than or equal to 38 years, a morphologically normal uterus, and greater than or equal to 2 good-quality embryos transferred. Intervention(s): The tips of cathe ters used for ruling out possible cervical obstruction before ET were subjected to quantitative (greater than or equal to 10 colonies = posi tive culture group; <10 colonies = negative culture group) and qualita tive microbial assessment. Main Outcome Measure(s): Pregnancy and impl antation rates. Result(s): In 143 (51%) of 279 ETs, cultures were posi tive, predominantly for Escherichia coli (64%) and Streptococcus speci es (8%). Although data on patients, COH, and embryology were similar i n both culture groups, clinical and ongoing pregnancy rates as well as implantation rates were significantly lower in the positive culture g roup than in the negative culture group (24% versus 37%; 17% versus 28 %; and 9% versus 16%, respectively). Conclusion(s): The presence of mi crobial flora of the cervix on ET catheters is associated with poor IV F-ET outcome. (Fertil Steril(R) 1998;70:866-70. (C) 1998 by American S ociety for Reproductive Medicine.).