P-436 Colonization by genital Mycoplasmas at the time of embryo transfer and its impact on ICSI outcomes

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Abstract Study question Can commensal Mycoplasmas contaminate the embryo transfer catheter and what’s their potential effect on ICSI outcomes? Summary answer Contamination of transfer catheters by commensal Mycoplasmas is possible. It could have a negative impact on the ICSI outcomes. What is known already Female genital tract is frequently colonized by commensal Mycoplasmas species: Ureaplasma urealyticum (UU), Ureaplasma parvum (UP) and Mycoplasma hominis (MH). Ureaplasma spp can be detected in the cervix or vagina of 40-80% of sexually mature asymptomatic females whereas MH is found in only 20-50% of cases. The impact of these species on fertility has been widely studied but remains controversial. Mycoplasmas detection is frequently requested during fertility assessment, but the significance of positive results is often unclear. Study design, size, duration A prospective, longitudinal and analytical study that was performed from January 1st 2021 to September 30th 2023. It included 194 patients undergoing fresh or frozen embryo transfer. Contamination of the catheter tip by commensal mycoplasmas was assessed. Participants/materials, setting, methods Inclusion criteria were: negative detection of genital Mycoplasmas in vaginal samples within the last 12 months, at least one good quality embryo transferred and morphologically normal uterus. After embryo transfer,the tip of the catheter was collected and analyzed using a multiplex real time PCR (MH/UU/UP Multiplex PCR Kit®,GeneProof®). Classic culture was also done to identify catheter tips contaminated by micro-organisms other than Mycoplasmas. Main results and the role of chance The study included 194 patients. At least one species of Mycoplasma was detected in the catheter tip of 29 patients (13.8% of cases). UP was the most prevalent (22 patients) followed by UU (8 patients) and MH (2 patients). Contamination by two species at the same time was found in 3 patients. In two patients, negative detection of Mycoplasmas in the vaginal simple was done less than one month before the transfer and in four patients, less than six months. Catheters were contaminated by micro-organisms other than Mycoplasmas in 71 cases. Comparison between negative catheters (n = 112) and those contaminated by Mycoplasmas only showed lower pregnancy rates (32.1% vs 17.2%; p = 0.106) and live birth rates (20.4% vs 6.9%; p = 0.08) yet the differences were not statistically significant. Limitations, reasons for caution Other factors likely to influence ICSI results, such as the transfer operator and micro-organisms that cannot be detected by standard culture (anaerobes), have not been taken into account. Wider implications of the findings Colonization by genital mycoplasma is common and can contaminate the transfer catheter. However, negative detection in a previous vaginal sample is not sufficient to prevent this contamination. Antibiotic prophylaxis may be useful to improve the results of ICSI. Trial registration number No

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