P-439 Intimate hygiene practices and the correlation with abnormal vaginal microbiota in in vitro fertilization (IVF) patients – a cohort study in 1421 patients

Abstract Study question What are the intimate hygiene practices of women in IVF treatment and do they correlate with vaginal microbiota? Summary answer Hygiene practices, specific douching use soap significantly increased risk abnormal microbiota (AVM). is known already The normal acts as a defense system against infection. AVM molecularly defined dysbiosis, resembling bacterial vaginosis (BV) dominated by anaerobic bacteria such Gardnerella vaginalis. Importantly, associated an genital tract infections, poor outcomes, early miscarriage preterm labor. cause multifactorial may interrupt microbiota. Previous small studies suggested to be AVM. Few have investigated possible correlation between menstrual design, size, duration Observational cohort study, including total 1421 patients from four Danish fertility centers. inclusion period was 2017 January 2022. Participants/materials, setting, methods Patients aged 18-42 years undergoing their first, second or third stimulation cycle were eligible for inclusion. terms type soap, protection, probiotics, reported structured questionnaire 40 questions. Vaginal swabs obtained prior ovarian subsequently subjected quantitative PCR testing, targeting DNA dysbiotic bacteria. Main results role chance present 34 % (479/1421) women, 20% (272/1384) douching, which correlated (p < 0.01, OR = 1.62 [1.23-2.12]). Intimate used 39 (535/1384) patients, also ( P 0.04, 1.35 [1.08-1.69]). Water only 36% (492/1384), regular 27% (374/1384). No water detected. For protection 40% (433/1078) pads, followed tampons alone 25% (265/1078) combination 21% (230/1078), 14 (148/1078) cup. A trend when using tampons, 1.21 [0.91-1.62] seen whereas cup seemed lower AVM, 0.71 [0.48-1.04] Active smoking, higher BMI, drinking >7 units per week previous chlamydia infection p 0.04 0.01). Finally, 84% (1190/1421) gynecological symptoms discharge, dyspareunia fungal infection, but fishy odor Limitations, reasons caution To best our knowledge, this largest study investigating practice its population. As these describe Scandinavian population, differ other settings ethnicities. Wider implications findings Exploration cause-and-effect relations needed, requiring intervention-based prospective studies. This would lead evidence-based advice on prevention, possibly increasing live birth rates. unexpected high prevalence population needs further exploration. Trial registration number NCT03420859