Bacterial vaginosis and influence on pregnancy in fertility treatments

Bacterial vaginosis is defined as a dysbiosis of the vaginal microbiome.
Bacterial vaginosis (BV) is known to influence some obstetric outcomes, such as
preterm delivery. Only few studies investigated the effect of BV on pregnancy
among subfertile women, and a few found a negative effect on fecundity.

This study is conducted to discover if bacterial vaginosis is related to the
pregnancy rate in couples undergoing assisted reproduction.

This will be a prospective cohort study, patients starting with fertility
treatment will be included.
Before starting the treatment a PCR-swab and pH measurement of the vagina will
be done, to assess the vaginal flora. Groups will be divided in BV positive and
negative.
At time of insemination/oocyte collection a second swab will be done. Pregnancy
outcomes are monitored, also when it becomes a miscarriage. If patients are not
pregnant or having a miscarriage after the first treatment, a swab will be done
at every insemination/oocyte collection/embryo transfer until the patient is
pregnant. All patients have a blood hcg test two weeks after insemination or
embryo transfer to confirm pregnancy.

Duration of this study is two years, with a follow-up period until live birth.
After inclusion information about the medical history, fertility treatment
(months/cycles of treatment until pregnancy) and relevant information about the
pregnancy will be collected (miscarriage, preterm delivery, live birth).

When participating patients are symptomatic for BV they will be treated with
clindamycin. After treatment a second swab will be done to assess vaginal flora
at the next doctors appointment. This subgroup of symptomatic patients will be
analysed within the study as well as separately.

Data will be collected in the data management system Castor. Data will be
collected by the investigator van den Tweel or a research student.

not applicable