Effect of the vaginal microbiome on the pregnancy rate in women receiving assisted reproductive treatment

Bernabéu, A; Lledó, Belén; Díaz, Ma Carmen; Lozano, F M; Ruíz, Vicente; Fuentes, A; López-Pineda, Adriana; Moliner, B.; Castillo, Juan Carlos; Ortíz, José Antonio; Ten, Jorge; Llácer, J.; Carratalá‐Munuera, Concepción; Orozco-Beltrán, Domingo; Quesada, José A.; Bernabéu, Rafael

doi:10.1007/s10815-019-01564-0

Cited by 61 publications

(72 citation statements)

References 25 publications

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“…Two studies were based on the same study population [ 5 , 29 ], and only the initial publication was included [ 5 ], but data on LBR was extracted from the later study [ 29 ]. A total of five studies [ 25 , 26 , 27 , 28 , 37 ] were included and added to the 12 studies [ 5 , 20 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 ] in the previous version of the present systematic review and meta-analysis [ 21 ]. Overall, the present meta-analysis included a total of 17 studies, comprising 3543 IVF patients.…”

Section: Resultsmentioning

confidence: 99%

“…This study defined an unfavorable microbiome profile by a relative Lactobacillus load <20%, relative load of L. jensenii >35%, presence of Gardnerella vaginalis or Proteobacteria >28% of total bacterial load. Finally, one study [ 25 ] used 16S rRNA gene sequencing without defining VD. As individual participant data was shared, identification of patients with VD was performed for the present meta-analysis according to the criteria defined by Koedooder et al listed above.…”

Section: Resultsmentioning

confidence: 99%

“…Through the last decade, studies have enabled a shift in the diagnostic methodology of the vaginal microbiota—from microscopy to molecular based approaches [ 25 , 26 , 27 , 28 , 29 ]. First, many groups validated qPCR diagnostic assays according to the Nugent score BV.…”

Section: Introductionmentioning

confidence: 99%

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The Association between Vaginal Dysbiosis and Reproductive Outcomes in Sub-Fertile Women Undergoing IVF-Treatment: A Systematic PRISMA Review and Meta-Analysis

et al. 2021

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Recent advances in molecular microbiology have enabled refined studies of the genital tract microbiota. This constitutes the basis of the present updated systematic review and meta-analysis which investigate vaginal dysbiosis (VD) as defined by either microscopy (e.g., Nugent score for bacterial vaginosis) or molecular methods (qPCR and Next Generation Sequencing) to evaluate the impact of VD on the reproductive outcomes in women undergoing IVF-treatment. A total of 17 studies were included, comprising 3543 patients and with a VD prevalence of 18% (95%CI 17–19). Across all methods, VD is a significant risk factor for early pregnancy loss in IVF (Relative risk (RR) = 1.71 95%CI 1.29–2.27). Moreover, a predefined sub-analysis of studies using molecular methods for VD diagnosis showed a significant reduction in the clinical pregnancy rate when compared to normal vaginal microbiota patients (RR = 0.55 95%CI 0.32–0.93). However, regardless of diagnostic methodology, VD did not significantly influence live birth rate (LBR). In conclusion, molecular tools have provided a more detailed insight into the vaginal microbiota, which may be the reason for the increased adverse effect estimates in IVF patients with molecularly defined VD. However, the quality of evidence was very low across all outcomes according to GRADE and thus, more studies are warranted to understand the impact of VD in IVF.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The Association between Vaginal Dysbiosis and Reproductive Outcomes in Sub-Fertile Women Undergoing IVF-Treatment: A Systematic PRISMA Review and Meta-Analysis

et al. 2021

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“…Hyman et al reported lower richness and diversity of species (Chao1 index and SDI – p=,001, respectively) in the group with live birth ( 44 ). Bernabeu et al revealed a lower richness of species (p=,04) in VM in patients who achieved pregnancy after SET (euploid embryos), but they found no differences in alpha or beta diversity (p=,09), maybe due to the small sample size ( 45 ).…”

Section: Resultsmentioning

confidence: 97%

The Impact of Female Genital Microbiota on Fertility and Assisted Reproductive Treatments

Brandão

Gonçalves-Henriques

2020

JFRH

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Objective: The preconception period is largely neglected, whereas it represents an opportunity to identify and modify clinical and behavioral risks, particularly in infertile women characterized by an unfavorable vascular burden. The present study was performed to strengthen previous findings and to increase the awareness of clinicians who should envision a broader preconception approach in infertile women, beyond their reproductive health. Materials and methods: In this cross-sectional study, we investigated 1003 Caucasian women, referred to the Internal Medicine Clinic at the Assisted Reproductive Technologies Center, Florence. Results: A high prevalence of dyslipidemia (57.4%), overweight/obesity (29.1%) and, smoking habit (26.6%) were found. We provided evidence of unhealthy lifestyle habits, represented by a closer adherence to the Mediterranean diet in the 9.5% only and by a sedentary behavior in 73%. A significant correlation between the Mediterranean Diet score and both anthropometric and metabolic parameters was found. We also observed a lower score adherence with both metabolic syndrome and diabetes (for both p=0.02), but not with hypertension. Conclusion: Before infertility treatment, the correction and the management of modifiable and non-modifiable cardiovascular risk factors are mandatory and represent the main goal for a safe pregnancy, and lifetime women’s health.

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“…was associated with significant decreases in implantation (60% vs. 23%), pregnancy (70% vs. 33%), ongoing pregnancy (59% vs. 13%) and live birth (59% vs. 7%) rates (43). Using a similar approach in a cohort of 31 women, Bernabeu et al showed that women achieving pregnancy after IVF (cryotransfer of a single embryo) showed a greater presence of Lactobacillus spp., while a trend toward higher alpha diversity in vaginal samples was found in patients who did not achieve pregnancy and no difference in beta diversity (132). In a recent large prospective cohort study, Koedooder et al, used a new technique "IS-PRO" (see section "Diagnostic Challenges") to examine microbial profiles of vaginal microbiota in 192 women undergoing IVF.…”

Section: Early Pregnancy (Infertility and Recurrent Miscarriage)mentioning

confidence: 99%

The Interplay Between Reproductive Tract Microbiota and Immunological System in Human Reproduction

et al. 2020

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In the last decade, the microbiota, i.e., combined populations of microorganisms living inside and on the surface of the human body, has increasingly attracted attention of researchers in the medical field. Indeed, since the completion of the Human Microbiome Project, insight and interest in the role of microbiota in health and disease, also through study of its combined genomes, the microbiome, has been steadily expanding. One less explored field of microbiome research has been the female reproductive tract. Research mainly from the past decade suggests that microbial communities residing in the reproductive tract represent a large proportion of the female microbial network and appear to be involved in reproductive failure and pregnancy complications. Microbiome research is facing technological and methodological challenges, as detection techniques and analysis methods are far from being standardized. A further hurdle is understanding the complex host-microbiota interaction and the confounding effect of a multitude of constitutional and environmental factors. A key regulator of this interaction is the maternal immune system that, during the peri-conceptional stage and even more so during pregnancy, undergoes considerable modulation. This review aims to summarize the current literature on reproductive tract microbiota describing the composition of microbiota in different anatomical locations (vagina, cervix, endometrium, and placenta). We also discuss putative mechanisms of interaction between such microbial communities and various aspects of the immune system, with a focus on the characteristic immunological changes during normal pregnancy. Furthermore, we discuss how abnormal microbiota composition, "dysbiosis," is linked to a spectrum of clinical disorders related to the female reproductive system and how the maternal immune system is involved. Finally, based on the data presented in this review, the future perspectives in diagnostic approaches, research directions and therapeutic opportunities are explored.

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Effect of the vaginal microbiome on the pregnancy rate in women receiving assisted reproductive treatment

Cited by 61 publications

References 25 publications

The Association between Vaginal Dysbiosis and Reproductive Outcomes in Sub-Fertile Women Undergoing IVF-Treatment: A Systematic PRISMA Review and Meta-Analysis

The Association between Vaginal Dysbiosis and Reproductive Outcomes in Sub-Fertile Women Undergoing IVF-Treatment: A Systematic PRISMA Review and Meta-Analysis

The Impact of Female Genital Microbiota on Fertility and Assisted Reproductive Treatments

The Interplay Between Reproductive Tract Microbiota and Immunological System in Human Reproduction

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