Role of vulvovaginal candidiasis infection in infertility: systematic review and meta-analysis

Objective: To evaluate the relationship between fungal infection in the female genital tract and infertility. Data sources: A systematic review was carried out, and the search was conducted in Medline, Embase, Web of Science, Google Scholar, and Cochrane Library databases until August 2022. The search strategy used standardized keywords such as “candidiasis” and “infertility,” combined with their respective synonyms. The search was limited to human studies, with no language restrictions. Study eligibility criteria: Primary articles that evaluated women of reproductive age with and without infertility and related to the presence or absence of candidiasis were included. Study appraisal and synthesis methods: For the analyses, the odds ratio association measure was used with a confidence interval of 95% using RevMan software (version 5.4). Results: Eight studies, published between 1995 and 2021 in different countries around the world, were included in this systematic review. Two studies were excluded after sensitivity analysis. A total of 909 participants were included in the group of infertile women and 2363 women in the control group. The age of the evaluated women varied between 18 and 50 years. The random effect model was used and showed no significant difference when comparing candidiasis between fertile and infertile women (odds ratio: 1.44; 95% confidence interval 0.86, 2.41 p= 0.17). Conclusions: There was no association between candidiasis and female sterility.