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. 2019 Dec;36(12):2471-2479.
doi: 10.1007/s10815-019-01630-7. Epub 2019 Nov 18.

Does dysbiotic endometrium affect blastocyst implantation in IVF patients?

Tomoko Hashimoto  1 , Koichi Kyono  2
Affiliations

Does dysbiotic endometrium affect blastocyst implantation in IVF patients?

Tomoko Hashimoto et al. J Assist Reprod Genet. 2019 Dec.

Abstract

Purpose: To analyze the pregnancy outcomes of IVF patients presenting eubiotic or dysbiotic endometrium at the time of embryo transfer and to analyze what bacterial profiles are suitable for embryo implantation.

Methods: Ninety-nine IVF patients under 40 years old undergoing vitrified-warmed blastocyst transfer in HRT cycle had concurrent endometrial microbiome analysis. Samples from the endometrium were taken from the participants at the time of mock transfer; the bacterial profiles at genus level and percentage of lactobacilli in the endometrium of the patients were analyzed.

Results: Thirty-one cases (31.3%) had dysbiotic endometrium. The background profiles, pregnancy rates per transfer (52.9% vs 54.8%), and miscarriage rates (11.1% vs 5.9%) were comparable between patients with eubiotic or dysbiotic endometrium. Major bacterial genera other than Lactobacillus detected in the dysbiotic endometrium were Atopobium, Gardnerella, and Streptococcus. Some patients achieved ongoing pregnancies with 0% Lactobacillus in the endometrium. The endometrial bacterial profiles of pregnant cases with dysbiotic endometrium were comparable with those of non-pregnant cases.

Conclusion: Analyzing microbiota at the species-level resolution may be necessary for identifying the true pathogenic bacteria of the endometrium and avoiding over-intervention against non-Lactobacillus microbiota. Further studies are necessary for analyzing the mechanism of how the pathogenic bacteria affect embryo implantation.

Keywords: Blastocyst; Embryo implantation; Endometrium; High-throughput nucleotide sequencing; Microbiota.

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Conflict of interest statement

These authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Bacterial profile of patients with dysbiotic endometrium achieving FBT pregnancy. The letters below the graph correspond to individual patients. Patients A to N have ongoing pregnancies beyond 15 weeks as of September 2, 2019. Patient Q had spontaneous miscarriage at 6 weeks
Fig. 2
Fig. 2
Bacterial profile of patients with dysbiotic endometrium who did not achieve FBT pregnancy. The letters below the graph correspond to individual patients
See this image and copyright information in PMC

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