Bacterial vaginosis (BV), also called Gardnerella vaginosis, arises from overgrowth of a bacteria that is normal flora of the vagina, but now has begun to proliferate. It is characterized by a white, malodorous vaginal discharge that is more noticeable after intercourse. Physicians do not routinely screen for BV unless the patient and doctor are concerned.
Diagnosis is usually made by a microscopic swab in the office where clue cells are found. The medicine of choice is Flagyl and is often started without microscopic confirmation. Treating sexual partners is controversial and usually not done because BV is contained within the female.
Enough shop talk, what can BV do? BV has been associated with an increased incidence of preterm labor. It is also more often found in women with tubal infertility, that is, in women with blocked or partially blocked fallopian tubes.
In a review of twelve different studies, the estimated prevalence of BV in infertile women was 19%, which was 3 times more prevalent than in the non-pregnant women of the same population. BV was not associated with lower conception rates in general, or in vitro fertilization. Surprisingly, there was a twofold higher risk of first trimester miscarriage. One separate study (Salah, RM 2013) noted the prevalence of BV at 46% in infertile women versus 15% in fertile women.
Unfortunately, BV can return after treatment. Recurrent symptoms would prompt re-evaluation.
We conclude that BV is strongly implicated in female infertility. Screening and treatment with Flagyl may also improve and lower miscarriage rates considerably.