Influence of immunity intensity to opportunistic infections on in vitro fertilization efficiency

Abstract

BACKGROUND: The number of infertile couples and women seeking in vitro fertilization is on the rise worldwide. At the same time, the probability of pregnancy after one in vitro fertilization attempt is 25–40%. Among the various causes of in vitro fertilization failure, the impact of opportunistic infections remains underestimated.

AIMS: retrospective assessment of the dependence of the number of successful in vitro fertilization attempts on the intensity of immunity to opportunistic infections.

MATERIALS AND METHODS: On the basis of the Clinic of the Kuban State Medical University, from January 2020 to March 2021, 865 women aged 26 to 48 years with infertility, included in the assisted reproductive technology program, were observed. Before the in vitro fertilization procedure, all patients were examined by enzyme immunoassay (ELISA) and polymerase chain reaction for the presence of herpesvirus infections (herpes infection, cytomegalovirus infection) and toxoplasmosis. The study included 79 people with unexplained infertility with a history of one to four in vitro fertilization cycles and positive antibody titers [IgG (+), IgM (–)] to herpes simplex virus, cytomegalovirus, and toxoplasmosis. During the study, groups were formed depending on the presence of opportunistic infections and the number of unsuccessful in vitro fertilization attempts.

RESULTS: During the study, a dependense was established between the number of in vitro fertilization attempts and the level of the initial (before pregnancy) IgG to toxoplasma. A negative prognosis for the effectiveness of in vitro fertilization is most likely in the presence of high titers of IgG to toxoplasma (370.0±57.0 U/ml). In the case of herpes infection, there was a tendency to increase the number of necessary in vitro fertilization attempts to 3–4 in the group with higher herpes simplex virus IgG levels. The baseline IgG cytomegalovirus level was not directly related to the effectiveness of the in vitro fertilization procedure.

CONCLUSION: The study demonstrates the importance of determining the intensity of immunity to toxoplasma and herpes infection in preparation for in vitro fertilization, especially if there is a history of unsuccessful in vitro fertilization attempts or spontaneous abortion.

Keywords

cytomegalovirus / toxoplasmosis / herpes infection / in vitro fertilization / intracytoplasmic sperm injection-embryo transfer / pregnancy

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