Mohammad Hossein Nasr-Esfahani Corresponding Author
1- Embryology Department, Royan Institute, Iranian Academic Center for Education, Culture & Research (ACECR), Tehran, Iran
2- Isfahan Fertility and Infertility Center, Tehran, Iran
Seyyed Ali Fazeli
- Department of Bacteriology & Virology. Faculty of Medicine, Isfahan University of Medical Science, Isfahan, Iran
Fariborz Kianpoor
- Department of Microbiology, Clinical Laboratory, Al-zahra Hospital, Faculty of Medicine, Isfahan University of Medical Science, Isfahan, Iran
Seyyed Akbar Tabibian
- Department of Bacteriology & Virology. Faculty of Medicine, Isfahan University of Medical Science, Isfahan, Iran
Seyyed Mehdi Ahmadi
- Isfahan Fertility and Infertility Center, Isfahan, Iran
Seyyed Asadollah Kalantari
- Isfahan Fertility and Infertility Center, Isfahan, Iran

Received: 10/1/2003 Accepted: 10/1/2003 - Publisher : Avicenna Research Institute

Related Articles


Other Format



In spite of advances in the filed of assisted reproductive techniques including in vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI), the pregnancy rate remained low. One of the major events in fertility is implantation process. Researchers believe that introduction of cervical bacteria into uterus during embryo transfer might have an inhibitory effect on implantation and thereby pregnancy rate. The reason for performing this study was the contradictory reports in this field and lack of regional information. In this cross-sectional study, endo-cervical samples from one hundred women who were undergoing intra-cytoplasmic sperm injection (ICSI) were prepared by using embryo transfer catheter tips. Catheters tips were transferred to selective culture media and after incubation in special conditions by using current bacteriological methods, bacteria in the samples were isolated and characterized. Implantation was confirmed by measurement of β- hCG in serum. Analysis of the results were carried out by chi-square. The overall implantation rate per transfer was 17 %. Positive cultures in the successful and unsuccessful implantation groups were 29.4% and 49.4%, respectively. In other words, implantation rates in patients with and without cervical infection were 10.8% and 22.2%, respectively. Our study showed that, potentially pathogenic bacteria in endo-cervix of women with unsuccessful implantation is more prevalent than those with successful implantation (p0.05). Therefore, the results of this study imply the negative effects of cervical bacteria on the implantation process.

Keywords: Infertility, ICSI, Implantation, Bacterial flora of the cervix, In Vitro fertilization, Embryo transfer

To cite this article:


  1. Paulson R.J., Sauer M.V., Lobo R.A. Factors affecting embryo implantation after human in vitro fertilization: a hypothesis. Am J Obstet Gynecol.1990;163:2020-23.
  2. Fanchin R., Harmas A., Benaoudia F., Lundkvist U., Olivennes F., Frydman R. Microbial flora of cervix assessed at the time of embryo transfer adversely effects in vitro fertilization outcome. Fertil Steril.1998;70:866-870.
  3. Egbase P.E., al-Sharhan M., al-Othman S., al-Mutawa M., Udo E.E., Grudzinskas J.G. Incidence of microbial growth from the tip of the embryo transfer catheter after embryo transfer in relation to clinical pregnancy
  4. Ralph S.G., Rutherford A.J., Wilson J.D. Influence of bacterial vaginosis on conception and miscarriage in the first trimester: cohort study. BMJ.1999;319(7204):220-223.
  5. Faro S. Chlamydia trachomatis: female pelvic infection. Am J Obstet Gynecol.1991;164: 1767-70.
  6. Witkin S.S., Sultan K.M., Neal G.S., Jeremias J., Grifo J.A., Rosenwaks Z. Unsuspected Chlamydia trachomatis infection and in vitro fertilization outcome. Am J Obstet Gynecol.1994; 171(5):1208-1214.
  7. Bartlett J.G., Moon N.E., Goldstein P.R., Goren B., Onderdonk A.B., Polk B.F. Cervical and vaginal bacterial flora: ecologic niches in the female lower genital tract. Am J Obstet Gynecol. 1978; 130(6):658-661.
  8. Nishikawa Y. Adherence of Escherichia coli in pathogensis of endometritis and effects of estradiol examined by scanning electron microscopy. Infect Immun.1985;47(1):318-21.
  9. Drbohlav P., Halkova E., Masata J., Rezacova J., Cerny V., Rossova D. The effect of endometrial infection on embryo implantation in the IVF and ET program. Ceska Gynekol. 1998; 63(3):181-5.
  10. Salim R., Ben-Shlomo I., Colodner R., Keness Y., Shalev E. Bacterial colonization of the uterine cervix and success rate in assisted reproduction: esults of a prospective survey. Hum Reprod. 2002;17(2):337-340.
  11. Bailey & Scott`s Diagnostic microbiology. 8th Edition.1990;323-558.
  12. Mackie & McCartney Practical medical microbiology.13 th Edition.1989;303-583.
  13. Czernobilsky B. Endometritis and infertility. Fertil Steril.1978;30(2):119-30.
  14. Tabibzadeh S., Babaknia A. The signals and molecular pathways involved in implantation, a symbiotic interaction between blastocyst and endometrium involving adhesion and tissue invasion. Hum Reprod.1995;10(6):1579-1602.
  15. Lessey B.A., Damjanovich L., Coutifaris C., Castelbaum A., Albelda S.M., Buck C.A. Integrin adhesion molecules in the human endometrium. Correlation with normal and abnormal menstrual cycle. J Clin Invest.1992:90:188-195.
  16. Winberg J., Herthelius- Elman M., Mollby R., Nord CE. Pathogenesis of urinary tract infection experimental studies of vaginal resistance to colonization. Pediatr Nephrol.1993;7:509-14.


Home | About Us | Current Issue | Past Issues | Submit a Manuscript | Instructions for Authors | Subscribe | Search | Contact Us

"Journal of Reproduction & Infertility" is owned, published, and managed by Avicenna Research Institute .
Creative Commons License

This work is licensed under a Creative Commons Attribution –NonCommercial 4.0 International License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

Journal of Reproductoin and Infertility (JRI) is a member of COMMITTEE ON PUBLICATION ETHICS . Verify here .

©2024 - eISSN : 2251-676X, ISSN : 2228-5482, For any comments and questions please contact us.