Cinsel Yolla Bulaşan Çeşitli Patojenlerin İnfertil Çiftlerdeki Prevalansı ve İn Vitro Fertilizasyon Başarısı Üzerine Etkisi
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2019
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info:eu-repo/semantics/openAccess
Özet
Öz: Giriş: Cinsel yolla bulaşan infeksiyonlar kadın ve erkek genital sisteminde oluşturduğu doku hasarı ve fonksiyon kayıpları ile infertilite, ektopik gebelik ve abortus gibi sorunlara neden olabilmektedir. İnfertilite etyopatogenezinde bakteriyel ajanların rolü iyi bilinmesine karşılık, cinsel ilişki ile bulaşabilen bazı viral etkenlerin infertilite ile olan ilişkileri göreceli olarak daha az bilinmektedir. Bu çalışmada in vitro fertilizasyon (IVF) programına alınan infertil hastalarda sitomegalovirüs (CMV), insan papillomavirüs (HPV), herpes simpleks virüs (HSV 1 ve HSV 2), insan immünyetmezlik virüsü (HIV), hepatit B virüsü (HBV), hepatit C virüsü (HCV) ve Chlamydia trachomatis sıklığının araştırılması amaçlanmıştır. Materyal ve Metod: Yaklaşık bir yıllık sürede 149 infertil çiftten semen ve servikal örnekler alındı ve polimeraz zincir reaksiyonu (PCR) yöntemiyle etkenlerin varlığı araştırıldı. Bu etkenlerin IVF tedavi başarısı üzerine etkisi değerlendirildi. Bulgular: Toplam 149 IVF tedavisine alınan infertil çiftin %8.1 (12/149)’inin CMV ile infekte olduğu görülmüş, sperm örneklerinde %2 (3/149), servikal örneklerde ise %6 (9/149) oranında CMV-DNA pozitifliği saptanmıştır. Çiftlerin her ikisinde birlikte CMV infeksiyonuna rastlanmamıştır. Çiftlerin %9.4 (14/149)’ünde HPV infeksiyonu olduğu görülmüş ve bunların sperm örneklerinde %5.4 (8/149), servikal örneklerde ise %7.4 (11/149) oranında HPV-DNA varlığı gösterilmiştir. Sperm örneklerindeki onkojenik yüksek riskli HPV (HR HPV) genotip oranı %37.5 (3/8), en sık saptanan genotipler sırayla HPV 18, 35 ve 39 iken, servikal örneklerdeki HR HPV genotip oranı %63.6 (7/11), en sık saptanan genotipler ise HPV 35, 16, 18, 45 ve 53 olarak bulunmuştur. Çiftlerin her ikisinde birden %3.4 (5/149) oranında HPV-DNA pozitifliği bulunurken, HPV genotipleri için çiftler arası uyum %40 (2/5) olarak saptanmıştır. HPV veya CMV pozitifliğinin erkeklerde sperm parametreleri, IVF tedavisi ile elde edilen oosit, embriyo sayısı ve gebelik ve canlı doğum parametreleri üzerinde istatistiksel olarak anlamlı bir etkisi olmadığı görülmüştür. Çiftlere ait sperm ve servikal örneklerin hiçbirinde C. trachomatis, HSV-1/2, HBV, HCV ve HIV tespit edilmemiştir. Sonuç: İnfertil hastalarda olası etkenlerin araştırıldığı daha kapsamlı çalışmalara gereksinim vardır. Bu konudaki epidemiyolojik veri eksiğinin giderilmesi için de öncelikle IVF kliniklerine başvuran hastalar gibi ulaşılması daha kolay hasta gruplarına ve özellikle ülkemizde endemik olarak görülen bakteriyel/viral etkenlere öncelik tanınması yararlı olacaktır.
Abstract: Introduction: Sexually transmitted infections can cause problems such as infertility, ectopic pregnancy and miscarriage due to tissue damage and function loss in female and male genital system. Although the role of bacterial agents in the etiopathogenesis of infertility is well known, the association of some viral agents that can be transmitted by sexual intercourse with infertility is relatively little known. The aim of this study was to investigate the presence of cytomegalovirus (CMV), human papillomavirus (HPV), herpes simplex virus (HSV 1 and HSV 2), human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and Chlamydia trachomatis in infertile patients undergoing in vitro fertilization (IVF) treatment. Materials and Methods: Semen and cervical samples were taken from 149 infertile couples during one year, and the presence of agents was investigated with polymerase chain reaction (PCR). The effect of these agents on in vitro fertilization (IVF) treatment success was evaluated. Results: It was found that 8.1% (12/149) of the 149 infertile couples receiving IVF treatments were infected with CMV, and CMV-DNA positivity was found as 2% (3/149) in sperm samples and 6% (9/149) in cervical samples. CMV infection was not observed in both pairs. HPV infection was observed in 9.4% (14/149) of the couples and HPV-DNA was found to be 5.4% (8/149) in sperm samples and 7.4% (11/149) in cervical samples. The oncogenic high-risk HPV (HR-HPV) genotype ratio in sperm samples was 37.5% (3/8) and the most common genotypes were HPV 18, 35 and 39, respectively. HR-HPV genotype ratio in cervical samples was 63.6% (7/11) and HPV 35, 16, 18, 45 and 53 were the most common genotypes. While HPV-DNA was found to be positive in 3.4% (5/149) in both of the pairs, interpair consistency was 40% (2/5) for HPV genotypes. HPV or CMV positivity did not have a statistically significant effect on sperm parameters, number of oocytes, embryos, and clinical pregnancy and live birth rate after IVF. C. trachomatis, HSV-1/2, HBV, HCV and HIV viruses were not detected in any of the sperm and cervical samples of the couples. Conclusion: More extensive studies are needed to investigate the possible agents in infertile patients. In order to eliminate the lack of epidemiological data on this subject, it would be useful to give priority to patients admitted to IVF clinics that are easier to reach first and to bacterial/viral factors that are seen endemic in our country, especially.
Abstract: Introduction: Sexually transmitted infections can cause problems such as infertility, ectopic pregnancy and miscarriage due to tissue damage and function loss in female and male genital system. Although the role of bacterial agents in the etiopathogenesis of infertility is well known, the association of some viral agents that can be transmitted by sexual intercourse with infertility is relatively little known. The aim of this study was to investigate the presence of cytomegalovirus (CMV), human papillomavirus (HPV), herpes simplex virus (HSV 1 and HSV 2), human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and Chlamydia trachomatis in infertile patients undergoing in vitro fertilization (IVF) treatment. Materials and Methods: Semen and cervical samples were taken from 149 infertile couples during one year, and the presence of agents was investigated with polymerase chain reaction (PCR). The effect of these agents on in vitro fertilization (IVF) treatment success was evaluated. Results: It was found that 8.1% (12/149) of the 149 infertile couples receiving IVF treatments were infected with CMV, and CMV-DNA positivity was found as 2% (3/149) in sperm samples and 6% (9/149) in cervical samples. CMV infection was not observed in both pairs. HPV infection was observed in 9.4% (14/149) of the couples and HPV-DNA was found to be 5.4% (8/149) in sperm samples and 7.4% (11/149) in cervical samples. The oncogenic high-risk HPV (HR-HPV) genotype ratio in sperm samples was 37.5% (3/8) and the most common genotypes were HPV 18, 35 and 39, respectively. HR-HPV genotype ratio in cervical samples was 63.6% (7/11) and HPV 35, 16, 18, 45 and 53 were the most common genotypes. While HPV-DNA was found to be positive in 3.4% (5/149) in both of the pairs, interpair consistency was 40% (2/5) for HPV genotypes. HPV or CMV positivity did not have a statistically significant effect on sperm parameters, number of oocytes, embryos, and clinical pregnancy and live birth rate after IVF. C. trachomatis, HSV-1/2, HBV, HCV and HIV viruses were not detected in any of the sperm and cervical samples of the couples. Conclusion: More extensive studies are needed to investigate the possible agents in infertile patients. In order to eliminate the lack of epidemiological data on this subject, it would be useful to give priority to patients admitted to IVF clinics that are easier to reach first and to bacterial/viral factors that are seen endemic in our country, especially.
Açıklama
Anahtar Kelimeler
Kaynak
Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
24
Sayı
3
Künye
GÜRSOY N. C,TUNCAY G,KARAER A,TECELLİOĞLU A. N,YİĞİT H,YAKUPOĞULLARI Y,OTLU B (2019). Cinsel Yolla Bulaşan Çeşitli Patojenlerin İnfertil Çiftlerdeki Prevalansı ve İn Vitro Fertilizasyon Başarısı Üzerine Etkisi. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi, 24(3), 215 - 226.
