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

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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.

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About the authors

Marina G. Avdeeva

Kuban State Medical University

Author for correspondence.
Email: avdeevam@mail.ru
ORCID iD: 0000-0002-4979-8768
SPIN-code: 2066-2690
Scopus Author ID: 6603810508
ResearcherId: AAM-4866-2020

MD, Dr. Sci. (Med.), Professor

Russian Federation, Krasnodar

Victoria A. Krutova

Kuban State Medical University; Clinic of Kuban State Medical University

Email: klinika@bagk-med.ru
ORCID iD: 0000-0002-9907-7491
SPIN-code: 1673-1155

MD, Dr. Sci. (Med.)

Russian Federation, Krasnodar; Krasnodar

Anna A. Konchakova

Kuban State Medical University; Clinic of Kuban State Medical University

Email: AAKK93@yandex.ru
ORCID iD: 0000-0002-2899-5084
SPIN-code: 7674-8090

MD, Cand. Sci. (Med.), Assistant Professor

Russian Federation, Krasnodar; Krasnodar

Anna V. Dudnikova

Clinic of Kuban State Medical University

Email: avdudnikova@yandex.ru
ORCID iD: 0000-0003-2601-7831
SPIN-code: 7480-1992

MD, Cand. Sci. (Med.)

Russian Federation, Krasnodar

Natalia S. Prosolupova

Clinic of Kuban State Medical University

Email: NatalyPro87@yandex.ru
ORCID iD: 0000-0003-1888-3991
SPIN-code: 1192-0437

MD

Russian Federation, Krasnodar

Ekaterina A. Konchakova

Kuban State Medical University

Email: konchakova01@mail.ru
ORCID iD: 0000-0002-5732-8328
SPIN-code: 1708-1267

Student

Russian Federation, Krasnodar

Alexander S. Omelchak

Kuban State Medical University

Email: omelchak.a00@mail.ru
ORCID iD: 0000-0003-2225-6210

Student

Russian Federation, Krasnodar

References

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Supplementary files

Supplementary Files
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2. Fig. 1. Scheme-design of the study.Note: ЭКО — in vitro fertilization; КНП — the number of required attempts to achieve a positive result in the form of a clinical pregnancy, culminating in the birth of a live child.

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3. Fig. 2. Age composition of patients of the general group, years.

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4. Fig. 3. Age composition of patients in groups with different outcomes of in vitro fertilization, years.

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5. Fig. 4. The average level of IgG titers to toxoplasma with a different number of required in vitro fertilization attempts (NRA) to obtain a positive result in the form of an urgent delivery with the birth of a healthy child. ЭКО — in vitro fertilization.

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6. Fig. 5. The average level of IgG titers to cytomegalovirus infection with a different number of required in vitro fertilization attempts to obtain a positive result in the form of an urgent delivery with the birth of a healthy child. ЭКО — in vitro fertilization.

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7. Fig. 6. The average level of IgG titers to herpetic infection with a different number of required in vitro fertilization attempts (NRA) to obtain a positive result in the form of an urgent delivery with the birth of a healthy child. ЭКО — in vitro fertilization.

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