Bacterial vaginosis and infertility: cause or association?

OBJECTIVES: To estimate the prevalence of bacterial vaginosis (BV) in infertile women and evaluate the effect of treatment of BV on the pregnancy rate in patients with polycystic ovarian disease (PCOD) and unexplained infertility. STUDY DESIGN: Cohort study conducted at the Department of Obstetrics and Gynecology in collaboration with the Microbiology Department of Sohag University Hospital, Egypt. All eligible women with female factor infertility (n=874) were enrolled and all asymptomatic fertile women (n=382) attending the family planning clinic of the study hospital were recruited as a control group. The study was in two phases: the first included screening all participants for BV after Gram-staining of the vaginal discharge. The second phase was concerned with evaluating the effect of treatment of BV on the cumulative pregnancy rate (CPP) in patients with PCOD (group I; n=278) and unexplained infertility (group II; n=170). Each group was divided into three sub-groups: groups Ia (n=129) and IIa (n=73) were BV positive and treated for BV; groups Ib (n=61) and IIb (n=49) were BV positive and did not receive treatment for BV, and groups Ic (n=88) and IIc (n=48) were BV negative. The prevalence of BV was compared using the Chi-square. The long rank test of Kaplan-Meier life table analysis was used to compare the CPR. A multivariate regression model was designed to define the most significant variable which affected the pregnancy rate in patients with PCOD. RESULTS: The prevalence of BV was significantly higher in infertile than fertile women (45.5% vs 15.4%). The highest prevalence was found in patients with PCOD (60.1%) and unexplained infertility (37.4%). The CPR in both patients with PCOD and unexplained infertility were significantly higher in the patients who were treated for BV. Regression model showed that BV was one of the significant factors interfering with pregnancy. CONCLUSIONS: BV is strongly implicated in female infertility and is probably an underestimated cause of unexplained infertility. Screening and treatment of BV in patients with PCOD and unexplained infertility improved the pregnancy rate considerably.

Bee-honey and yogurt: a novel mixture for treating patients with vulvovaginal candidiasis during pregnancy.

OBJECTIVE: To evaluate the clinical and mycological cure rates of a novel mixture consisting of Bee-honey and yogurt compared to local antifungal agents for treating patients with vulvo-vaginal candidiasis (VVC) during pregnancy. MATERIALS AND METHODS: This is a prospective comparative study which included 129 patients with VVC during pregnancy. The participants were allocated into study group (n = 82) who received a mixture of Bee-honey and yogurt vaginally and control group (n = 47) who received local anti-fungal agents. The Chi-square test was used to evaluate the clinical and mycological cure rates and the side-effects of both modes of therapy. RESULTS: The clinical cure rate was significantly higher in the study than the control group (87.8 vs. 72.3%, respectively) while the mycological cure rate was higher in the control than the study group (91.5 vs. 76.9%, respectively). Both types of therapy were favorably tolerated by most of the patients. Side effects were reported only in 24.3 and 29.7% of patients in group I and II, respectively (p < 0.05). CONCLUSIONS: The mixture of Bee-honey and yogurt produced a high clinical cure rate and a reasonable mycological cure rate. It can be used as a complementary or an alternative to antifungal agents especially in patients with VVC during pregnancy.