Impact of detection of bacterial endotoxin in menstrual effluent on the pregnancy rate in in vitro fertilization and embryo transfer

Objective

To examine whether bacterial endotoxin is detectable in menstrual effluent and to analyze a possible association between endotoxin levels and a pregnancy rate after IVF-ET.

Design

Prospective observational study.

Setting

University hospital.

Patient(s)

Thirty-eight infertile women undergoing endotoxin assay and IVF-ET.

Intervention(s)

Endotoxin was assayed by the limulus amoebocyte lysate test.

Main outcome measure(s)

Levels of bacterial endotoxin and a pregnancy rate.

Result(s)

In 38 samples of menstrual effluent taken from 38 women, bacterial endotoxin was detected with a range of 7.1 to >1,000 pg/mL in 37 samples and was not detected in 1 sample. After IVF-ET, pregnancy occurred in 9 of the 38 women. The mean (± SD) endotoxin level in these 9 pregnant women was 71.3 ± 52.5 pg/mL and was significantly lower compared with >236.2 ± 333.6 pg/mL in the 29 nonpregnant women. All pregnancies occurred in 28 women with an endotoxin level of ≤200 pg/mL, whereas no pregnancies occurred in 10 women with an endotoxin level of >200 pg/mL, producing the significantly higher pregnancy rate in the former group than in the latter.

Conclusion(s)

Bacterial endotoxin was detectable in menstrual effluent from infertile women. The pregnancy rate after IVF-ET was significantly higher in women with an endotoxin level of ≤200 pg/mL than in women with an endotoxin level of >200.0 pg/mL.

Key words:  Bacterial endotoxin , menstrual effluent , IVF-ET outcome