Contaminação microbiológica em placas de cultivo de embriões humanos e a interferência no sucesso da reprodução assistida
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Data
2015-03-14
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Universidade Federal de Goiás
Resumo
Introduction: Human reproduction laboratories perform quality control
because procedures directly influence results and because certain materials,
such as the vagina, follicular fluid and semen cannot be sterilized. The
embryo culture dishes should be free of contamination to protect both the
mother and the fetuses. Objectives: To investigate the prevalence of
microbial contamination of human embryo culture dishes, identify the
microorganisms implicated and evaluate the impact of contamination on the
success of assisted reproduction. Methods: A total of 470 samples of culture
media were obtained from Goiânia, Goiás State after the embryos were
transferred to the mother’s uterus, between May 2009 and March 2014. The
culture medium was inoculated into BHI broth, and the positive samples were
isolated and identified. Data from medical records were collected and
analyzed, and regression analyses were performe during SPSS-17.0
software. Results: There was a 6.32% prevalence of contamination. The
main fungal pathogens, which resulted in live births, were Candida sp (20%),
and the bacterial pathogens, which did not result in live births, were Bacillus
sp (16%), E. coli (10%) and Staphylococcus sp (10%). The chance of not
getting pregnant was 2.57 (OR, p=0.043, CI=1.06-6.24) times higher in the
infected group, the group uncontaminated. Perinatal outcome of live births
was 2 (6.6%) in infected and 118 (27%) in uncontaminated, with a significant
difference in the logistic regression, p = 0.026, OR = 5.13, CI =1.39-18.97.
The infected group had 4.37 (OR, p=0.094, CI=1.58-12.04) times greater
chance of pregnancy loss than the group not contaminated. Female factors
were the most common infertility factors, and they differed significantly
between the contaminated and uncontaminated groups (p=0.02); tubal factor
infertility (p<0.001, OR=4.18, CI=1.94-9.01) showed a highly significant
difference between the contaminated and uncontaminated groups. A
significant difference in poor embryos (Grade C and D) was observed
between the groups (p=0.013, OR=3.54 and 95% CI). Conclusion:
Microbiological contamination increases the number of embryos poor and the
chance of pregnancy loss, and decreases pregnancy rates and perinatal
outcome of births.
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Palavras-chave
Reprodução , Contaminação , Microbiologia , Gravidez , Nascimento , Embriões , Reproduction , Contamination , Microbial , Pregnancy , Birth , Embryos
Citação
RIBEIRO, Barbara Rosa Foizer. Contaminação microbiológica em placas de cultivo de embriões humanos e a interferência no sucesso da reprodução assistida. 2015. 139 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2015.