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The Relationship Between Mycoplasma Hominis and Ureaplasma Urealyticum Bacterial Infections and Infertility in Women of Reproductive Age Couples

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The Relationship Between Mycoplasma Hominis and Ureaplasma Urealyticum Bacterial Infections and Infertility in Women of Reproductive Age Couples International Journal of Research and Review Vol.7; Issue: 8; August 2020 Website: www.ijrrjournal.com Original Research Article E-ISSN: 2349-9788; P-ISSN: 2454-2237 The Relationship between Mycoplasma hominis and Ureaplasma urealyticum Bacterial Infections and Infertility in Women of Reproductive Age Couples Lili Fitriati Rahmah1, Elizabeth Bahar2, Fika Tri Anggraini3, Andani Eka Putra2 1Magister of Midwifery, 2Department of Microbiology, 3Department of Physiology, Faculty of Medicine, Andalas University, Padang, Indonesia Corresponding Author: Andani Eka Putra ABSTRACT Keywords: Infertile, M. hominis, U. urealyticum, Women of Reproductive Age Infertility is a failure to raise children after Couples having approximately 12 months of regular marital contact without using contraception. INTRODUCTION One of the factors that influence infertility is Infertility is defined as a failure to infections including infections of M. hominis raise children after having approximately 12 and U. urealyticum bacteria. This study aimed to months of regular marital contact without determine the relation between M. hominis and using contraception1. Infertility is divided U. urealyticum bacterial infections and infertility in women of reproductive age into two, namely primary infertility, a couples. husband and wife have never had children This research was analytic with case control previously; and secondary infertile, a design of endocervical swab on infertile women husband and wife have had a previous child of reproductive age couples and 33 fertile or wife has been pregnant but abortion, women of reproductive age couple. This ectopic pregnancy, and intra-uterine fetal research was conducted in the Laboratory of death (IUFD) occured2 . Microbiology, Faculty of Medicine, University Globally, in infertility cases of Andalas from March 2019 to April 2020. according to WHO (2012), there were about Then, the sample was tested molecularly. M. 50-80 million couples with infertility. Of hominis and U. urealyticum bacterial infections (30%) were found in developing countries were examined by using PCR with a length of M. hominis product of 509 bp and U. and only (5-8%) in developed countries urealyticum of 429 bp. Data processing was (Masoumi et al., 2013). The prevalence of analyzed statistically by using the chi-square infertility in Asia is (30.8%) Cambodia, test. (10%) Kazakhtan, (43.7%) Turkmenistan, The results showed that in infertile and fertile and (21.3%) Indonesia1. women of reproductive age couples, M. hominis Based on the data from the National was not found, but U. urealyticum was found in Population and Family Planning Agency, infertile and fertile women, but there was no the prevalence of reproductive age couples statistical relation with the infertility in women who do not have children is (9.2%) out of of reproductive age couples, p = 0.091 and OR 11 Districts located in Padang, North value = 0.313. Padang District ranks the highest in The conclusion of this study is that there is no statistical relation between M. hominis and U. reproductive age couples who do not have children at (11, 5%), but the total infertility urealyticum bacterial infections and infertility in 3 women of reproductive age couples data was not found . Factors causing infertility that occur in women include age with an age range of 20-29 years old International Journal of Research and Review (ijrrjournal.com) 15 Vol.7; Issue: 8; August 2020 Lili Fitriati Rahmah et.al. The relationship between mycoplasma hominis and ureaplasma urealyticum bacterial infections and infertility in women of reproductive age couples (64.5%) higher than age of 30-39 years old (2009); Du and Zhang, (2010) showed that (20%) and age of 40-49 years old (11.8%), cases of M. hominis bacterial infections in whereas over 50 years (3.7%), menstrual infertile women in Iran were (3.14%), India disorders (20%), tubal disorders (27.4%), (6%) and China (45%). Furthermore, the uterine disorders (9.1%), ovarian disorders results of a study conducted by Michou et al (3.6%), endometrial disease (5%) and (2013) reported that M. hominis bacterium unknown (24.5%) (Roupa et al., 2009; was found in menstrual tissue (13.7%) and Sa'adah and Purnomo, 2016). In addition, cervical mucus (19.5%). While the results of there is (57%) influenced by disorders from the study reported by Sleha et al (2019) women, (17.5%) disorders from men, cases of M. hominis bacterial infection were (4.5%) disorders from men and women and accompanied by U. urealyticum bacterial (21%) unknown cause4 . infection (5.4%)8. M. hominis bacterial Infection of the genitals increases infection is associated with various other the risk of infertility such as viral, fungal, urogenital infections such as bacterial and bacterial infections. Besides consuming vaginosis (BV) and non-specific genital alcohol, Body Mass Index (BMI), and stress infections (IGNS). Cases of M. hominis also affect someone's fertility (Dechanet et bacterial infection in women with BV in al., 2010; Irene, 2010). Infertility is caused Portugal were (30%) and (20%) without by an infection in the reproductive organs BV, Poland were (9.1%) and (59.1%) caused by bacteria Mycoplasma hominis (M. whereas in Papua New Guinea were (7%) hominis), Ureaplasma urealyticum (U. and ( 20%) (Zdrodowska-Stefanow et al., urealyticum), Neisseria gonorrhoeae dan 2006; Dominingues et al., 2003; Clegg et Chlamydia trachomatis5.6 al., 1997). In Indonesia, cases of M. hominis M. hominis and U. urealyticum bacterial infection of 20-30% are the cause bacteria are Mycoplasma sp bacterium of non-gonorrhea urethritis9. The negative found in the human genital tract and their impact of M. hominis bacterial infection on growth increases with the onset of sexual the female reproductive tract which was activity. Mycoplasma sp is a bacterium that firstly identified by Mardh in 1976 in does not have cell walls and belongs to Baczynska et al (2007) with organ culture in gram-positive bacteria. Data on the vitro revealed swelling in the epithelial cells prevalence of M. hominis and U. of the tubal cilia. This resulted in ovum cells urealyticum bacterial infections in abnormal unable to reach the fallopian tubes and meet vaginal secretions in Indonesia is sperm10 tremendously limited. In particular, in M. The mechanism of U. urealyticum hominis bacterial infection, its main risk is bacterium in infecting needs urea as the high-risk sexual behavior which has more energy source. The virulence of U. than one sexual partner, initiating early sex urealyticum bacterium is mediated by IgA and not using condoms (Tibaldi et al., protease, adhesin, urease, phospholipase and 2009). This causes acute urethritis, hemolysin. In vitro, U. urealyticum vaginosis, pelvic inflammatory disease and bacterium is able to form biofilms. Biofilms infertility7. M. hominis bacterium is on high can adhere strongly and resist friction vaginal hydrogen (pH) potential. Normal repeatedly and can increase bacterial low vaginal pH levels turn out to be high immunity so that the body's immune system because the bacterium produces ammonia. is unable to reach the bacteria. The Ammonia is a nutrient for the growth and existence of this biofilm causes chronic propagation of pathogenic microbes. infection because in addition to being Ammonia production by this bacterium difficult to be eliminated by the body, causes a fishy odor in the vagina6 . biofilm is also difficult to be penetrated by The research results reported by anitimicrobial11. Seifoleslami et al (2015); Gupta et al International Journal of Research and Review (ijrrjournal.com) 16 Vol.7; Issue: 8; August 2020 Lili Fitriati Rahmah et.al. The relationship between mycoplasma hominis and ureaplasma urealyticum bacterial infections and infertility in women of reproductive age couples U. urealyticum bacterium infects contraceptive protection in less than 12 during sexual intercourse and moves months15. Secondary infertility is a woman towards the upper reproductive tract. This who has previously been pregnant but bacterium can be carried along with sperm abortion or ectopic pregnancy occurs and into the uterus and fallopian tubes and then cannot get pregnant anymore despite having attach to the fallopian tube epithelium, tried for 1 year or more having sexual causing swelling of the cilia and detachment intercourse regularly without contraceptive of the cilia from the epithelium. This protection16. bacterium can avoid the flow of blood by attaching themselves to the surface of the Etiology of Infertility tissue12 Causes of infertility in women can U. urealyticum bacterial infection is be classified into three groups, namely: 25% as a cause of Non Gonococcal Uretritis ovulation disorders, hormonal disorders, (UNG) and often coincides with Chlamydia blockages, local factors17. Risk factors for trachomatis infection. Infection by U. infertility in women include ovulation urealyticum bacterium causes symptoms in disorders, polycystic ovary syndrome, tubal the form of flour albus (43.3%), burning and problems, uterine problems, cervical factors, itching (18.9%), dysuria (10.8%) and no vaginal problems, reproductive organ symptoms (8.1%) (Zdrodowska-Stefanow et infections, sexually transmitted diseases al., 2006). Other studies also report that U. (STDs), hormones, unexplained infertility, urealyticum bacterial infections are in and factors risk of infertility due to infertile (42.5%) and fertile women lifestyle18. For infertile factors in men, (17.4%)13. infertility can also be caused by male,
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