Infertility Treatment and Oral Health
Study suggests that the chronic bacterial infections found in
periodontal diseases may affect reproduction success and the outcome
of infertility treatment
CHICAGO – June 22, 2004 – Researchers found that women
undergoing ovulation induction for infertility treatment for more
than three menstrual cycles experience higher gingival inflammation,
bleeding and gingival crevicular fluid (GCF). This study appeared
in the recent issue of the Journal of Periodontology (Study Abstract*).
In this study, the gingival inflammation levels of women undergoing
infertility treatment and subjected to ovulation induction were
investigated and compared with women who were not using these
drugs. It found that despite similar plaque levels, women who
received ovulation induction medications for more than three menstrual
cycles had higher levels of gingival inflammation, bleeding and
GCF. GCF is a fluid that contains enzymes and tissue breakdown
products that have been examined as potential markers for the
progression of periodontitis.
"These effects are presumably correlated with the increased
levels of progesterone and estrogen," explains Dr. Cenk M.
Haytac, Cukurova University, Adana, Turkey. "Gingiva is a
target tissue for estrogen since it contains specific high-affinity
estrogen receptors."
Several studies provided evidence that the presence of infection
is associated with unsuccessful embryo development and implantation
failure in in vitro fertilization patients. Since periodontal
diseases are chronic bacterial infections, the study suggests
that periodontal status may also affect reproduction success and
the outcome of infertility treatment.
"It is reasonable to assume that if low levels of plaque
are established and maintained during the infertility treatment,
gingival inflammation would not effect the success of infertility
treatment," said Dr. Michael P. Rethman, DDS, MS, and president
of the American Academy of Periodontology. "This would require
meticulous oral hygiene and routine professional cleanings, perhaps
at the beginning of each menstrual cycle to ensure the presence
of healthy gums."
Periodontal diseases are risk factors for several systemic conditions
including preterm low birthweight babies. "It will be interesting
to see if further intervention studies will determine the effects
of periodontal status and the periodontal therapy on the outcome
of infertility treatment," said Rethman.
"A woman undergoing infertility treatment is often given
drugs to stimulate the ovaries to produce as many healthy follicles
as possible to increase the chances of conception," said
Haytac. "This method has been used worldwide for more than
30 years, and the World Health Organization estimates that approximately
8% to 10% of couples worldwide experience some form of fertility
problem."