Effect of Helicobacter pylori infection on pregnancy rates and early pregnancy loss after intracytoplasmic sperm injection.
Effect of Helicobacter pylori infection on pregnancy rates and early pregnancy loss after intracytoplasmic sperm injection.
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DOI：
10.2147/ijwh.s24424
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Saeedi V
中科院分区：
文献类型：
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作者：
Hajishafiha M;Ghasemi-Rad M;Memari A;Naji S;Mladkova N;Saeedi V
有必要阐明影响辅助生殖技术（ART）妊娠的着床和早期妊娠过程的因素，以提高妊娠率和结局。我们的目的是确定母体幽门螺杆菌感染的作用。我们对187对接受卵胞浆内单精子注射（ICSI）的不育夫妇进行了前瞻性研究，并根据潜在的不孕原因进行了分离。采用ELISA法检测幽门螺杆菌IgG抗体和抗caga IgG抗体的状态。对所有妊娠进行早期妊娠丢失（EPL，前12周）随访。幽门螺杆菌感染的可能性随着年龄的增长而增加（1.01,95%可信区间[CI]: 1.0 ~ 1.13; P = 0.040），但与EPL无关。感染caga阳性菌株的妇女更容易发生EPL （19.39, 95% CI: 1.8-208.4; P = 0.014）。输卵管因素或排卵障碍不孕的妇女更容易早期流产（12.95,95% CI: 1.28-131.11; P = 0.030, 10.84, 95% CI: 1.47-80.03; P = 0.020）。EPL与年龄、形成或移植的胚胎数量或取出的卵母细胞数量没有关系。我们的研究结果表明，感染caga阳性的幽门螺杆菌菌株与女性早期流产的可能性增加有关（可能是通过增加炎症细胞因子的释放）。此外，由于机制未知，输卵管因子和排卵障碍不孕与ICSI后EPL有关。在ICSI之前根除幽门螺杆菌感染的建议可能导致抗逆转录病毒治疗后EPL的降低。
There is a need to elucidate what affects the implantation and early pregnancy course in pregnancies conceived with assisted reproductive technology (ART) so that pregnancy rates and outcomes can be improved. Our aim was to determine the role of maternal Helicobacter pylori infection. We did a prospective study of 187 infertile couples undergoing intracytoplasmic sperm injection (ICSI) and segregated those according to underlying infertility etiology. We assessed the status of H. pylori IgG antibodies and anti-CagA IgG antibodies by ELISA assay. All pregnancies were followed for early pregnancy loss (EPL, first 12 weeks). The likelihood of H. pylori infection increased with age (1.01, 95% confidence interval [CI]: 1.0–1.13; P = 0.040) but there was no association with EPL. Women infected with CagA-positive strains were more likely to have EPL (19.39, 95% CI: 1.8–208.4; P = 0.014). Women with tubal factor or ovulatory disorder infertility were more likely to abort early (12.95, 95% CI: 1.28–131.11; P = 0.030, 10.84, 95% CI: 1.47–80.03; P = 0.020, respectively). There was no association between EPL and age, number of embryos formed or transferred, or number of oocytes retrieved. Our findings suggest that infection with CagA-positive H. pylori strains is linked to an increase in women’s potential to abort early (possibly through increased release of inflammatory cytokines). In addition, tubal factor and ovulatory disorder infertility are linked to EPL after ICSI due to unknown mechanisms. Proposals to eradicate H. pylori infection prior to ICSI could lead to a decrease in EPL after ART.