Introduction
Materials and methods
Study design
Sample size and statistical power
Inclusion criteria
Exclusion criteria
Data collection and analysis
Operational definitions
Data management and statistical analysis
Ethics approval and consent to participate
Results
Sociodemographic and clinical description of the cases and controls
Parameters | Total | Tubal factor infertility | |||||
---|---|---|---|---|---|---|---|
Cases (37.9%) | Controls (62.1%) | ||||||
n(%) 137(100) | BV+ 32(61.5) | BV - 20(38.5) | p | BV + 26(30.6) | BV - 59(69.4) | p | |
Age | 0.258* | 0.421* | |||||
<25 years | 6(4.4) | 1(33.3) | 2(66.7) | 0(0) | 3(100) | ||
25-29 years | 36(26.3) | 9(60) | 6(40) | 9(42.9) | 12(57.1) | ||
30-34 years | 44(32.1) | 14(77.8) | 4(22.2) | 8(30.8) | 18(69.2) | ||
≥35 years | 51(37.2) | 8(50.0) | 8(50.0) | 9(25.7) | 26(74.3) | ||
Menarches | 0.375 | 0.472 | |||||
<13 years | 58(42.3) | 20(66.7) | 10(33.3) | 10(35.7) | 18(64.3) | ||
≥13 years | 79(57.7) | 12(54.5) | 10(45.5) | 16(28.1) | 41(71.9) | ||
BMI | 0.074 | 0.224 | |||||
18-24 kg/m2 | 38(27.7) | 8(44.4) | 10(55.6) | 8(40.0) | 12(60.0) | ||
25-29 kg/m2 | 52(37.9) | 8(57.1) | 6(42.9) | 8(21.1) | 30(78.9) | ||
≥30 kg/m2 | 47(34.4) | 16(80) | 4(20) | 10(38.46) | 17(28.8) | ||
Education level | 0.013* | 0.129 | |||||
Primary level | 8(5.8) | 0(0) | 4(100) | 3(75.0) | 1(25.0) | ||
Secondary level | 43(31.4) | 14(77.8) | 4(22.2) | 6(24.0) | 19(76.0) | ||
Higher education | 86(62.8) | 18(60.0) | 12(40.0) | 17(30.4) | 39(69.7) | ||
Occupation | 0.005* | 0.249* | |||||
No | 54(39.4) | 20(83.3) | 4(16.7) | 13(43.3) | 17(56.7) | ||
Schoolgirl/student | 4(2.9) | 2(100) | 0(0) | 0(0) | 2(100) | ||
Independent | 34(24.8) | 4(40.0) | 6(60.0) | 7(29.2) | 17(70.8) | ||
Employee | 45(32.8) | 6(37.5) | 10(62.5) | 6(20.7) | 23(79.3) | ||
Monthly income | *0.592 | 0.966 | |||||
<500$ | 20(14.6) | 6(60.0) | 4(40.0) | 3(30.0) | 7(70.0) | ||
≥500$ | 117(85.4) | 26(61.9) | 16(38.1) | 23(30.7) | 52(69.3) |
Parameters | Total | Tubal factor infertility | |||||
---|---|---|---|---|---|---|---|
Cases 52(37.9%) | Controls 85(62.1%) | ||||||
n(%) 137(100) | BV+ 32(61.5) | BV - 20(38.5) | p | BV + 26(30.6) | BV - 59(69.4) | p | |
Type of infertility | 0.111 | 0.039 | |||||
Primary infertility | 45(32.9) | 9(47.4) | 10(52.6) | 12(46.2) | 14(53.8) | ||
Secondary infertility | 92(67.1) | 23(69.7) | 10(30.3) | 14(23.7) | 45(76.3) | ||
Duration of infertility | 0.482 | 0.458 | |||||
<24 months | 55(40.2) | 16(66.7) | 8(33.3) | 11(35.5) | 20(64.5) | ||
≥24 months | 82(59.8) | 16(57.1) | 12(42.9) | 15(27.8) | 39(72.2) | ||
SI frequency | 0.634* | 0.551* | |||||
1-2/week | 15(19.9) | 2(50.0) | 2(50.0) | 3(27.3) | 8(72.7) | ||
>2/week | 122(89.1) | 30(62.5) | 18(37.5) | 23(31.1) | 51(68.9) | ||
Irregulars cycles | 0.283* | 0.386 | |||||
Yes | 28(20.4) | 8(80) | 2(20) | 4(22.2) | 14(77.8) | ||
No | 109(79.6) | 24(57.2) | 18(42.8) | 22(32.8) | 45(67.2) | ||
DOR | 0.071* | 0.149 | |||||
Yes | 24(17.5) | 6(100) | 0(0) | 3(16.7) | 15(83.3) | ||
No | 113(82.5) | 26(56.5) | 20(43.5) | 23(34.3) | 44(65.7) | ||
PCOS | 0.374 | 0.528 | |||||
Yes | 33(24.3) | 10(71.4) | 4(28.6) | 7(36.8) | 12(63.2) | ||
No | 103(75.7) | 22(57.9) | 16(42.1) | 19(29.2) | 46(70.7) | ||
C. trachomatis | 32(23.4) | 25(48.1) | 7(8.2) | <0.001 |
Prevalence of BV and C. trachomatis infection
Association of VB, C. trachomatis infection and TFI
Parameters | TFI prevalence (n=52) | OR (95%CI) | p | aOR (95%CI) | p |
---|---|---|---|---|---|
BV | |||||
yes | 32/58 | 4(1.89-8.43) | <0.001 | 3.77(1.61-8.83) | 0.002 |
no | 20/79 | 1 | |||
C. trachomatis Infection | |||||
yes | 25/32 | 14.4(5.00-41.44) | <0.001 | 13.77(4.59-41.27) | <0.001 |
no | 27/105 | 1 | |||
Type of infertility | 0.473 | ||||
Primary infertility | 19/45 | 1 | |||
Secondary infertility | 33/92 | 0.76(0.36-1.59) | |||
Education level | 0.574* | ||||
Primary level | 4/8 | 1 | |||
Secondary level | 18/43 | 0.72(0.16-3.27) | |||
Higher education | 30/86 | 0.54(0.16-2.29) | |||
Occupation | 0.495 | ||||
No | 24/54 | 1 | |||
Schoolgirl/student | 2/2 | 1.25(0.16-9.54) | |||
Independent | 10/34 | 0.52(0.21-1.29) | |||
Employee | 16/45 | 0.69(0.31-1.55) |
Discussion
General and clinical characteristics of study population
Prevalence of BV and C. trachomatis infection
Country (City) | Prevalence | Diagnosis |
---|---|---|
Africa | ||
Egypt (Ismailia) [35] | 36.6% (26/71) | Nugent score |
Egypt (Sohag) [36] | 45.5% (398/874) | Spiegel criteria |
Egypt (Alexandria) [41] | 25% (10/40) | Nugent score |
Rwanda (Kigali) [37] | 52% (158/312) | Nugent score |
D.R. of Congo (Bukavu) (current study) | 42.3% (58/137) | Nugent score |
Europe | ||
Denmark (Copenhagen) [42] | 21% (27/130)-28% (36/130) | qPCR-Nugent |
Spain (Barcelona) [43] | 23.3% (35/150) | qPCR |
Spain (Catania) [44] | 6.5% (2/31) | 16S rRNA |
France (Marseille) [45] | 9.4% (3/23) | qPCR-Nugent |
Greece (Athens) [46] | 36.9% (41/111) | Nugent score |
Netherlands (Utrecht) [47] | 8.6% (17/198) | Nugent score |
Netherlands (Maastricht) [48] | 17.7% (34/192) | IS-proTM |
United Kingdom (Leeds) [49] | 24.3% (182/749) | Hay et al |
Ireland (Dublin) [50] | 10% (12/120) | Nugent score |
United Kingdom (London) [51] | 18.5% (37/199) | Nugent score |
United Kingdom (Leeds) [52] | 24.6% (190/771) | Hay et al |
United Kingdom (Bristol) [53] | 25.6% (77/301) | Hay et al |
United Kingdom (Glasgow) [18] | 16.3% (40/331) | Amsel criteria and Gram stain |
Asia | ||
India (Mumbai) [20] | 25.9% (29/112) | Nugent score |
Iran (Tehran) [54] | 7.3% (29/399) | Nugent score |
Japan (Tokyo) [55] | 44.3% (44/79) | 16S rRNA |
Turkey (Ankara) [56] | 37.8% (45/120) | Nugent score |
America | ||
United States (New York) [21] | 4.2% (14/331) | Nugent score |
United States (Seattle) [57] | 11% (10/91) | Nugent score |
United States (Washington) [58] | 13.2% (12/91) | Nugent score |