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Is it Worthwhile to Test IVF Patients for Ureaplasma?
Hi everyone. Dr. DiMattina here to discuss the clinical issue of ureaplasma in infertility patients undergoing in vitro fertilization (IVF).
Studies show that this organism is often found on the cervix of 17 to 25% of patients with infertility. Cervical testing may be limited in detecting the presence of ureaplasma and many patients also have the bacterium present in the endometrial cavity regardless of whether or not it is present or detected on cervical testing. Detection of ureaplasma in the endometrial cavity is limited. Data from many studies suggest that untreated cervical or endometrial ureaplasma may lead to implantation failure or possibly spontaneous abortion but admittedly, much of the data comes from older literature.
Given the high prevalence of the bacterium in the female reproductive tract, virtually all IVF centers routinely treat patients with antibiotics (usually tetracycline, ciprofloxin or erythromycin) prior to and after the embryo transfer regardless of the results of the cervical/endometrial testing.
A report just released in January, 2014, studied the IVF outcomes of patients whose partner had ureaplasma present in the male reproductive tract. The authors concluded that infection in the male reproductive tract does not significantly affect the rates of IVF fertilization, oocyte cleavage, clinical pregnancy rates or abortion.
At Dominion Fertility, we have stopped testing for ureaplasma, instead routinely treating all IVF patients with doxycycline prior to and just after their embryo transfer. The patients’ male partner is no longer tested unless clinical symptoms exist. Because the injudicious use of antibiotics can be harmful and patients may require more than one embryo transfer to achieve pregnancy, we limit the duration of their antibiotic prophylaxis to five total doses. All IVF programs have their own antibiotic “cocktail” that they use for their patients.