Vaginal Fungal Infection and Its Influencing Factors during In Vitro Fertilization-embryo Transfer Cycles:A Multicenter Open-label Study

  Objective  To explore the incidence of vaginal fungal infection and its influencing factors during in vitro fertilization and embryo transfer(IVF-ET)cycles.

  Methods  In this multicenter open-label clinical trial, 301 patients who underwent IVF-ET due to tubal factors from January 2006 to December 2006 were enrolled.Vaginal fungal cultures were performed before the commencement of ovarian stimulation, on the day of human chorionic gonadotropin(HCG)injection and on the day of embryo transfer.The possible influencing factors of vaginal fungal infections including age, body mass index(BMI), type and duration of infertility, dosage of ovarian-stimulating drug, follicle numbers, oocyte numbers, estrogen levels, and use of antibiotics were analyzed using Logistic regression analysis.

  Results  Vaginal fungal cultures showed negative results before the commencement of ovarian stimulation in all patients.However, 32 cases(10.6%)had positive vaginal swab on HCG injection day and 22 cases(7.3%)on ET day.The average age of patients were(32.23±3.86)years.BMI(21.54±2.73)kg/m².Sterile period(5.32±3.23)years, usage of total gonadotropin(35.45±14.08)ampous, average numbers of follicles(13.26±7.01), retrieved oocytes(12.77±7.47), and estradiol levels(2520.69±1686.04)pg/ml.Antibiotics were used in 66.78% of the patients after ovulation.Multiple factor Logistic regression analysis that factors such as age, BMI, type and duration of infertility, ovarian stimulation, and the use of antibiotics after oocyte retrieval were not significantly correlated with vaginal fungal infection(P> 0.05), which estradiol levels, follicle numbers, and oocyte numbers significantly influenced the incidence of vaginal fungal infection(P < 0.05).

  Conclusions  The incidence of vaginal fungal infections is low during IVF-ET treatment.Age, type and duration of infertility, drug dosage, use or not of antibiotics after oocyte retrieval has little effect on vaginal fungal infection, while larger number of follicles/oocyte numbers and the higher levels of estrogen may increase the incidence of vagina fungal infection.