The Associations of The Microbial Presence in Follicular Fluid of
Infertile Women with IVF Outcomes: a Systematic Review and Meta-analysis
Abstract
Background Although studies have shown that the microbial presence of
follicular fluid (FF) can lead to poor IVF outcomes, there is still a
lack of consensus. Objective The aim of the study was to synthesize
these disparate studies to comprehensively investigate the potential
impact of the microbial presence in the FF of infertile women on IVF
outcomes. Search strategy Following preliminary searches to find Medical
Subject Heading (MeSH) terms plus free terms, a systematic search was
performed in PubMed in July 2022. Selection criteria The population was
infertile women undergoing IVF treatment. The exposure was the
microbiota of FF. The positivity of FF was defined according to the
original studies. Primary outcomes included the clinical pregnancy rate
and fertilization rate Data Collection and Analysis Data collected for
each study were analyzed using RevMan 5.4 software available on the
Cochrane website. Main results The FFs of 285 women were detected
positively by nonspecific flora detection and specific flora detection.
The clinical pregnancy rate of the FF-positive group was significantly
lower than that of the FF-negative group in the microbial culture and
identification group (OR:0.61, 95% CI:0.21-1.71) and in the ELISA test
group (OR:0.41, 95% CI:0.21-0.80). In the IPA test group, which
included only one study, the pregnancy rate in the FF-positive group was
higher than that in the FF-negative group, but the results were low
quality. Conclusions Currently, there is still a lack of evidence for
the associations of the presence of microorganisms in FF with IVF
outcomes.