Utility of culture and molecular methods using AllplexTM Bacterial Vaginosis Plus Assay (Seegene) as a tool for endometriosis, infertility and recurrent pregnancy loss diagnosis

Diagn Microbiol Infect Dis. 2024 Nov;110(3):116437. doi: 10.1016/j.diagmicrobio.2024.116437. Epub 2024 Jul 15.

Abstract

Endometriosis, infertility, or recurrent pregnancy loss (RPL) are entities characterised by a decrease in Lactobacillus spp. and an increase in bacterial vaginosis-associated bacteria, (BVAV) according with 16S rRNA sequencing studies. However, the use of nucleic acid amplification tests (NAAT) as a tool for diagnosis algorithms is unknown. Seventy-four patients were included, with a median age of 36.5 years old (IQR: 34-39) including infertility (n=31), endometriosis (n=25), or RPL (n=18), for culturing and NAAT using the Allplex™ Bacterial Vaginosis Plus (ABVP) assay (Seegene) with endometrial samples. The objective was determining the utility of ABVP assay for diagnosing the entities. Forty-six microorganisms were isolated from 31 out of 74 patients (41.9 %). Twenty-five endometrial samples (33.8 %) were positive for some targets included in the ABVP-assay, with median Ct value ∼37 (IQR: 31.3-37.1) and Qt value 1.43 Log10copies/reaction (IQR:1.1-2.6). For Lactobacillus species, sensitivity and specificity were 80 % and 84 %, respectively. Gardnerella vaginalis, 63.6 % and 95.7 %. No significant increase in BVAV was detected in any of the gynaecological entities. The ABVP and culture based algorithm did not show utility as a tool for endometriosis, infertility, or RPL diagnosis.

Keywords: Dysbiosis; Endometriosis; Endometritis; Hysteroscopy; Infertility; Miscarriage; PCR; Recurrent pregnancy loss; Seegene; Vaginosis.

MeSH terms

  • Abortion, Habitual* / diagnosis
  • Abortion, Habitual* / genetics
  • Abortion, Habitual* / microbiology
  • Adult
  • Endometriosis* / diagnosis
  • Endometriosis* / microbiology
  • Female
  • Humans
  • Infertility / diagnosis
  • Infertility / microbiology
  • Infertility, Female / diagnosis
  • Infertility, Female / microbiology
  • Molecular Diagnostic Techniques / methods
  • Nucleic Acid Amplification Techniques / methods
  • Pregnancy
  • RNA, Ribosomal, 16S / genetics
  • Sensitivity and Specificity
  • Vaginosis, Bacterial* / diagnosis
  • Vaginosis, Bacterial* / microbiology

Substances

  • RNA, Ribosomal, 16S