Effect of Helicobacter pylori infection on pregnancy rates and early pregnancy loss after intracytoplasmic sperm injection

There is a need to elucidate what affects the implantation and early pregnancy
course in pregnancies conceived with assisted reproductive technology (ART) so that pregnancy
rates and outcomes can be improved. Our aim was to determine the role of maternal Helicobacter
pylori infection.
Material and methods: We did a prospective study of 187 infertile couples undergoing
intracytoplasmic sperm injection (ICSI) and segregated those according to underlying infertility
etiology. We assessed the status of H. pylori IgG antibodies and anti-CagA IgG antibodies by
ELISA assay. All pregnancies were followed for early pregnancy loss (EPL, first 12 weeks).
Results: The likelihood of H. pylori infection increased with age (1.01, 95% confidence interval
[CI]: 1.0–1.13; P = 0.040) but there was no association with EPL. Women infected with CagApositive
strains were more likely to have EPL (19.39, 95% CI: 1.8–208.4; P = 0.014). Women
with tubal factor or ovulatory disorder infertility were more likely to abort early (12.95, 95%
CI: 1.28–131.11; P = 0.030, 10.84, 95% CI: 1.47–80.03; P = 0.020, respectively). There was
no association between EPL and age, number of embryos formed or transferred, or number of
oocytes retrieved.
Conclusion: Our findings suggest that infection with CagA-positive H. pylori strains is linked
to an increase in women’s potential to abort early (possibly through increased release of inflammatory
cytokines). In addition, tubal factor and ovulatory disorder infertility are linked to EPL
after ICSI due to unknown mechanisms. Proposals to eradicate H. pylori infection prior to ICSI
could lead to a decrease in EPL after ART