Assessment of the microbiome of a married couple by the RT-PCR method, including the woman’s cervical canal, the urethra and ejaculate of a man

Abstract

Introduction. When assessing the urogenital tract microbiome in both men and women, modern clinical guidelines suggest using the real-time polymerase chain reaction method, which allows qualitatively and quantitatively identifying the microbiota of sexual partners. The urogenital tract microbiome of a married couple remains poorly understood. The impact of the urogenital tract microbiota of sexual partners and the possibility of transmitting it to each other also remains open. To date, there are no clear recommendations on which of the biotopes in men to choose primarily for verification of microorganisms, while one of the possible biotopes is most often examined. In our previously published works, we noted that the biotopes of the urethra, prostate secretion and ejaculate in men have a low level of concordance among themselves, and the biotopes of the urogenital tracts of sexual partners in most cases do not coincide, which calls into question the daily practice of prescribing treatment to both spouses at the same time, having data from only one of them. The role of male factors in the development of bacterial vaginosis in the spouse remains debatable to this day. Modern advances in molecular diagnostics have made it possible to consider bacterial vaginosis as a probable sexually transmitted infection, including the spouse. Material and methods: а survey of 127 married couples who sought help for pre-conception preparation, infertility or miscarriage was conducted, and then divided into two groups. The first group, «Normocenosis», consisted of 67 married couples in whom the proportion of Lactobacillus spp. was determined to be 80-100% of the cervical canal microflora. The second group, «Dysbiosis», consisted of 60 couples in whom the proportion of Lactobacillus spp. was determined to be lower than 80% of the total cervical canal microflora, which corresponded to the diagnosis of BV. The biotopes of the cervical canal of women, the urethra and ejaculate of men were analyzed by the PCR real-time method using the «Androflor®» and «Femoflor®» reagent kits («DNATechnology TS», Russia). Results. The biotope of the ejaculate had statistically lower values of the total bacterial mass, compared with the urethra and cervical canal. In the biotope of the cervical canal, Gardnerella vaginalis/Prevotella bivia/ Porphyromonas spp. and Ureaplasma spp. were found significantly more often compared with the biotope of both the urethra and the ejaculate of men. In the urethra of men, Staphylococcus spp., Streptococcus spp., Eubacterium spp. and Peptostreptococcus spp. were identified more often than the cervical canal. Eubacterium spp. were determined significantly more often in the ejaculate, compared with the cervical canal. The occurrence of Enterobacteriaceae/Enterococcus spp. in the urethra and in the sperm was reliably higher compared with the cervical canal. The concordance for all bacteria detected in the compared biotopes of the spouses did not exceed 34%. The concordance for Gardnerella vaginalis and Ureaplasma spp. was significantly higher between the biotopes of the cervical canal and urethra, compared with the concordance between the cervical canal and ejaculate. In the «Normocenosis» group, Ureaplasma spp. and Enterobacteriaceae spp. were encountered significantly less frequently in the cervical canal compared with the «Dysbiosis» group. In men, Staphylococcus spp. and Gardnerella vaginalis were detected significantly more often in the ejaculate of the «Dysbiosis» group compared with the «Normocenosis» group. In the ejaculate of men from the «Dysbiosis» group, an increase in the total bacterial mass was encountered significantly more often compared with the «Normocenosis» group. Conclusion. In our opinion, in men with infertility and/or miscarriage, it is necessary to evaluate the biotope of both the urethra and the ejaculate, because the biotopes of the spouse’s cervical canal, urethra and ejaculate have a low percentage of concordance, which must be taken into account when diagnosing and treating urogenital tract infections of sexual partners.