A new study suggests that the chronic bacterial infections found in periodontal diseases may affect reproduction success and the outcome of infertility treatment.
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 a recent issue of the Journal of Periodontology.
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. The study 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 affect the success of infertility treatment," said 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 Dr. 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 Dr. Haytac. "This method has been used worldwide for more than 30 years, and the World Health Organization estimates that approximately 8 to 10 percent of couples worldwide experience some form of fertility problem."
A free brochure titled "Women and Periodontal Disease" is available by calling (800) FLOSS-EM or using the AAP's online request form. The AAP's Web site (www.perio.org) can provide more information and a referral to a nearby periodontist.
The AAP was established in 1914 and focuses on the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth and in the placement and maintenance of dental implants.
Editor's note:A copy of the report published in the Journal of Periodontology titled "The Effects of Ovulation Induction During Infertility Treatment on Gingival Inflammation" is available by calling Amy Duff at (312) 573-3244.