Catheter contamination during embryo transfer: impact on outcomes of in vitro fertilization

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Objective: To evaluate the impact of embryo transfer catheter contamination on in vitro fertilization outcomes. Design: Prospective analytical observational study conducted over a period of 2 years and 9 months (from January 2021 to September 2023). Subjects: Women aged ≤42 years with a sonographically normal uterus, undergoing fresh or frozen embryo transfer with good-quality embryos. Exposure: Microbial contamination of the embryo transfer catheter was assessed by culture and real-time polymerase chain reaction. Vaginal and cervical samples were also analyzed by culture. Main Outcome Measures: Embryo transfer catheter contamination rate and its association with in vitro fertilization outcomes (pregnancy and live birth rates). Results: and urogenital mycoplasmas in 31.9% and 13.8% of patients, respectively. Overall, when all methods were combined, catheter contamination was observed in 58.1% of cases; it was 6 times higher in women with bacterial vaginosis. In multivariate analysis, a positive catheter culture was the only independent factor associated with failure to achieve pregnancy and live birth. Conclusion: species, constitutes an independent factor associated with in vitro fertilization failure. Guidelines for infertility management should be updated to include both clinical and microbiological parameters to enhance assisted reproductive technologies' diagnostic and therapeutic strategies.

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