Bacterial vaginosis in a subfertile population undergoing fertility treatments: a prospective cohort study

van den Tweel, Marjolein M.; van den Munckhof, Ellen H.A.; van der Zanden, Moniek; Molijn, Anco C.; van Lith, Jan M.M.; Le Cessie, Saskia; Boers, Kim E.

doi:10.1007/s10815-023-03000-w

Cited by 4 publications

(2 citation statements)

References 23 publications

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“…This decrease in Lactobacilli and negative change of microbiome status could have a negative effect on ongoing pregnancy rates. Another paper by this research group showed that samples with a consecutive miscarriage had 15% less Lactobacilli compared to samples with a consecutive ongoing pregnancy (however not significant) [13]. The numbers in this study were too low to calculate specific pregnancy outcomes for changing qPCR or microbiome status compared to persons with a stable microbiome.…”

Section: Discussioncontrasting

confidence: 56%

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The Vaginal Microbiome Changes During Various Fertility Treatments

van den Tweel,

van den Munckhof,

van der Zanden

et al. 2024

Reprod. Sci.

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This study aimed to investigate the influence of hormonal treatment on the vaginal microbiome during fertility treatments. Bacterial vaginosis (BV) could affect fecundity, particularly in the in vitro fertilization (IVF) population, where negative effects on pregnancy outcomes have been reported. It is hypothesized that the hormone treatment during fertility treatments could influence the abundance of Lactobacilli, with negative effects on the pregnancy results. A total of 53 couples attending a fertility clinic in the Netherlands between July 2019 and August 2022 were included in this prospective cohort study. Vaginal samples were collected at start of treatment, oocyte retrieval or insemination from subjects undergoing intra uterine insemination (IUI) with mild ovarian stimulation, and IVF or intra cytoplasmatic sperm injection (ICSI) with controlled ovarian hyperstimulation. AmpliSens® Florocenosis/Bacterial vaginosis-FRT qPCR and 16S rRNA gene-based amplicon sequencing were performed on all samples. In total, 140 swabs were analyzed, with a median of two swabs per person. 33 (24%) tested qPCR BV positive. Lactobacilli percentage decreased during fertility treatments, leading to changes in the vaginal microbiome. Shannon diversity index was not significantly different. Of the total of 53 persons, nine switched from qPCR BV negative to positive during treatment. The persons switching to qPCR BV positive had already a (not significant) higher Shannon diversity index at start of treatment. If the vaginal microbiome of persons deteriorates during fertility treatments, timing of following treatments, lifestyle modifications, or a freeze all strategy could be of possible benefit.

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Section: Discussioncontrasting

confidence: 56%

“…The 140 samples were also tested with the microbiota analysis (Supplemental figure 1). The details about the microbiome results and the comparison with qPCR are described in another paper [13].…”

Section: Microbiota Over Timementioning

confidence: 99%

The Vaginal Microbiome Changes During Various Fertility Treatments

van den Tweel,

van den Munckhof,

van der Zanden

et al. 2024

Reprod. Sci.

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Testing on bacterial vaginosis in a subfertile population and time to pregnancy: a prospective cohort study

van den Tweel,

van den Munckhof,

van der Zanden

et al. 2024

Arch Gynecol Obstet

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Purpose This study aimed to investigate the influence of bacterial vaginosis on time to pregnancy in subfertile couples. Methods Couples attending a teaching hospital in the Netherlands having an initial fertility assessment (IFA) between July 2019 and June 2022 were included in this prospective study, with follow-up of pregnancies until June 2023. Vaginal samples at IFA were analyzed on pH, qPCR BV, and 16S rRNA gene microbiome analysis of V1-V2 region. Main outcome measures were time from initial fertility assessment to ongoing pregnancy at 12 weeks and live birth, analyzed by Kaplan–Meier and Cox regression with adjustment for potential confounders. Results At IFA, 27% of 163 included participants tested positive for BV. BV status had no influence on time to ongoing pregnancy (HR 0.98, 0.60–1.61, aHR 0.97, 0.58–1.62). In persons with unexplained subfertility, positive BV status had a tendency of longer time to pregnancy. When persons had an indication for fertility treatment, positive BV status (HR 0.21, 0.05–0.88, aHR 0.19, 0.04–0.85) and microbiome community state type III and type IV had significant longer time to pregnancy. Conclusion This study indicates that BV may have a potential negative impact on time to live birth pregnancy in subfertile persons with an indication for fertility treatment. This study did not find an association between BV and time to live birth pregnancy in a general group of subfertile couples or in unexplained subfertility. More research should be done in persons with unexplained subfertility and if treatment improves time to pregnancy.

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Vaginal dysbiosis – the association with reproductive outcomes in IVF patients: a systematic review and meta-analysis

Maksimovic Celicanin,

Haahr,

Humaidan

et al. 2024

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of review To examine impact of vaginal dysbiosis (VD), including bacterial vaginosis (BV) and aerobic vaginitis (AV) on reproductive outcomes of in vitro fertilization (IVF) patients. Recent findings BV-bacteria (e.g. Gardnerella) and AV-bacteria (e.g. Streptococci and Enterococci) have been identified in the endometrium. However, there is inconclusive evidence whether IVF patients with VD have lower success rates. Summary The present systematic review and meta-analysis of PubMed/Medline, until December 2023 included 25 studies, involving 6835 IVF patients. Overall VD was defined as an approximation of community state type IV, including BV and AV-type dysbiosis based on either molecular or microscopy methods. Outcomes were live birth rate (LBR), early pregnancy loss (EPL), clinical pregnancy rate (CPR), and biochemical pregnancy rate (BPR). Vaginal dysbiosis prevalence was 19% [1271/6835, 95% confidence interval (CI) 18–20%]. Six studies examined AV-type dysbiosis with a prevalence of 4% (26/628, 95% CI 3–6%). Vaginal dysbiosis correlates with a higher EPL [relative risk (RR) = 1.49, 95% CI 1.15–1.94] and lower CPR (RR = 0.82, 95% CI 0.70–0.95). No statistically significant impact of VD, BV, or AV was found on LBR and BPR. Thus, the association between VD and reproductive outcome remains puzzling as it is difficult to explain how VD impacts CPR and EPL but not LBR and BPR.

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Bacterial vaginosis in a subfertile population undergoing fertility treatments: a prospective cohort study

Cited by 4 publications

References 23 publications

The Vaginal Microbiome Changes During Various Fertility Treatments

The Vaginal Microbiome Changes During Various Fertility Treatments

Testing on bacterial vaginosis in a subfertile population and time to pregnancy: a prospective cohort study

Vaginal dysbiosis – the association with reproductive outcomes in IVF patients: a systematic review and meta-analysis

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