Impact of detection of bacterial endotoxin in menstrual effluent on the pregnancy rate in in vitro fertilization and embryo transfer
Received 8 September 2003; received in revised form 5 January 2004; accepted 5 January 2004.
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.
Department of Obstetrics and Gynecology, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
Reprint requests: Koji Kanazawa, M.D., Ph.D., Department of Obstetrics and Gynecology, Faculty of Medicine, University of the Ryukyus, 207 Uehara Nishihara-Machi, Nakagami-Gun, Okinawa, Japan (FAX: 81-098-895-1426
ABSTRACT