Background Although studies have shown that the microbial presence of follicular fluid (FF) can lead to poor IVF outcomes, there is still a lack of consensus. Objective The aim of the study was to synthesize these disparate studies to comprehensively investigate the potential impact of the microbial presence in the FF of infertile women on IVF outcomes. Search strategy Following preliminary searches to find Medical Subject Heading (MeSH) terms plus free terms, a systematic search was performed in PubMed in July 2022. Selection criteria The population was infertile women undergoing IVF treatment. The exposure was the microbiota of FF. The positivity of FF was defined according to the original studies. Primary outcomes included the clinical pregnancy rate and fertilization rate Data Collection and Analysis Data collected for each study were analyzed using RevMan 5.4 software available on the Cochrane website. Main results The FFs of 285 women were detected positively by nonspecific flora detection and specific flora detection. The clinical pregnancy rate of the FF-positive group was significantly lower than that of the FF-negative group in the microbial culture and identification group (OR:0.61, 95% CI:0.21-1.71) and in the ELISA test group (OR:0.41, 95% CI:0.21-0.80). In the IPA test group, which included only one study, the pregnancy rate in the FF-positive group was higher than that in the FF-negative group, but the results were low quality. Conclusions Currently, there is still a lack of evidence for the associations of the presence of microorganisms in FF with IVF outcomes.