Association of opportunistic bacterial pathogens with female infertility: A case–control study

Aim

Infertility affects a significant proportion of women worldwide, and the colonization of certain vaginal pathogens has been suggested as a possible contributing factor. To explore the relationship between bacterial pathogens and female infertility, a case–control study was conducted involving 55 infertile women as cases and 5 fertile women as controls.

Method

Conventional culture-based techniques and biochemical assays followed by 16S rDNA sequence analysis were employed for the identification of vaginal isolates from the two groups. The strength of association between the isolated bacterium and infecundity was derived by odds ratio calculation.

Results

The investigation revealed the presence of bacteria including Enterococcus faecalis, Escherichia coli, Bacillus spp., Acinetobacter baumannii, Pseudomonas spp., Micrococcus luteus, Staphylococcus aureus, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus capitis, Staphylococcus epidermidis, and Staphylococcus saprophyticus in the vaginal swabs of infertile women. Of these, the odds ratios for Staphylococcus aureus, Klebsiella pneumoniae, E. faecalis, and E. coli were 5.43 (95% CI = 0.28, 103.49), 4.59 (95% CI = 0.24, 87.93), 2.25 (95% CI = 0.11, 44.16), and 1.70 (95% CI = 0.09, 34.01), respectively, displaying an association with infertility. Moreover, vaginal colonization of these four bacterial species was also dominant in cases that were diagnosed with pelvic inflammatory disease and idiopathic infertility by laparoscopic examination.

Conclusion

Overall, the findings of this study indicate a probable association between specific pathogenic microorganisms and women's barrenness, emphasizing the significant role of these disease-causing agents in hindering conception. This highlights the significance of a complete understanding of the vaginal microbiome and emphasizes further research in this area.