Impact of asymptomatic bacterial genital tract infections on intracytoplasmic sperm injection (ICSI)

Background: Assisted reproduction techniques (ART) have gained widespread use globally. However, genital infections pose a significant challenge in this field. Infections can disrupt the reproductive process and negatively impact the success of ART. The study aimed to explore factors influencing ICSI outcomes. Methods: Both vaginal and endocervical swabs of 220 infertile women were subjected to standard bacteriological culture to detect and identify potential genital pathogens. Real-time PCR was used to specifically detect and identify Ureaplasma urealyticum and Mycoplasma hominis in the collected samples. Then pregnancy test was conducted to identify the ICSI outcome. Results: The infection rate was lower in the ICSI positive group (82.1%) compared to the ICSI negative group (90.7%). The Lactobacilli spp. was more prevalent in the ICSI positive group (43.3%) than the ICSI negative group (37.2%). Three organisms were associated with the least ICSI success rates (Enterococci spp. and/or M. hominis and/or U. urealyticum). Conclusion: Definite bacterial pathogens were associated with reduced levels of vaginal lactobacilli. The presence of E. faecalis and/or U. urealyticum and/or M. hominis in genital samples of infertile women was predictive for a negative outcome of ICSI.