Contaminação microbiológica em placas de cultivo de embriões humanos e a interferência no sucesso da reprodução assistida

• Autor(a) principal: Ribeiro, Barbara Rosa Foizer
• Data de Publicação: 2015
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UFG
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tede/4691
• topic: Reprodução; Contaminação; Microbiologia; Gravidez; Nascimento; Embriões; Embryos; Reproduction; Contamination; Microbial; Pregnancy; Birth; CIENCIAS DA SAUDE::MEDICINA

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.