Changes in the microbiocenosis of the genital tract in pregnant women after pregnancy preparation before the program of assisted reproductive technologies

Abstract

Purpose - to investigate changes in the genital tract microbiocenosis in pregnant women with a history of sexually transmitted infections (STIs) after pre-vitro preparation before cycles of assisted reproductive technology (ART).

Materials and methods. A total of 247 women with a history of STIs and who planned pregnancy under the ART program were examined: 115 women received our proposed pre-pregnancy preparation, of whom 56 ended in pregnancy (the Group 2) and they received the proposed therapeutic and preventive measures; 132 women received standard pre-pregnancy preparation, of whom 55 ended in pregnancy (the Group 2) and they received the standard therapeutic and preventive measures. The control group comprised 30 pregnant women without a period of infertility, who became pregnant on their own. Statistical processing of the study results was carried out using standard Microsoft Excel 5.0 and Statistica 8.0 software.

Results. The state of the genital tract microbiocenosis in women of the Group 1 with a history of STIs, after pregravid preparation before the ART program, compared with pregnant women of the Group 2, is characterized by a significantly higher number of lactobacilli during the gestational period (I half of pregnancy: 49 (87.5%) vs. 38 (69.1%) cases, p<0.05; II half of pregnancy: 35 (68.6%) vs. 20 (44.4%) cases, p<0.001), bifidobacteria (I half of pregnancy: 42 (75.0%) vs. 31 (56.4%) cases, p<0.05; II half of pregnancy: 38 (74.5%) vs. 17 (37.7%) cases, p<0.001), lactic acid streptococci (I half of pregnancy: 29 (51.8%) vs. 18 (32.7%) cases, p<0.05; II half of pregnancy: 19 (37.2%) vs. 12 (26.6%) cases, p<0.05) against the background of a simultaneous significant decrease in the level of staphylococcus strains (I half of pregnancy: 9 (18.0%) vs. 20 (36.4%) cases, p<0.05; II half of pregnancy: 14 (27.4%) vs. 39 (86.6%) cases, p<0.05) and other microorganisms (urea and mycoplasma, chlamydia, escherichia and proteus).

Conclusions. The results of these studies show that in women with a history of STIs after pre-pregnancy preparation prior to the АRT programme, the vaginal microbiocenosis during pregnancy almost matches that of a physiological pregnancy, which positively affects the obstetric and perinatal outcomes of delivery in this group of pregnant women.

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.

No conflict of interests was declared by the author.