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. 2019 Dec 10;7(1):ofz525.
doi: 10.1093/ofid/ofz525. eCollection 2020 Jan.

Differential Composition of Vaginal Microbiome, but Not of Seminal Microbiome, Is Associated With Successful Intrauterine Insemination in Couples With Idiopathic Infertility: A Prospective Observational Study

Virginia Amato  1 , Enrico Papaleo  2 , Renée Pasciuta  3 , Paola Viganò  4 , Roberto Ferrarese  3 , Nicola Clementi  1 , Ana Maria Sanchez  4 , Lavinia Quaranta  2 , Roberto Burioni  1 , Alessandro Ambrosi  5 , Andrea Salonia  6 , Massimo Clementi  1   3 , Massimo Candiani  2   7 , Nicasio Mancini  1   3
Affiliations

Differential Composition of Vaginal Microbiome, but Not of Seminal Microbiome, Is Associated With Successful Intrauterine Insemination in Couples With Idiopathic Infertility: A Prospective Observational Study

Virginia Amato et al. Open Forum Infect Dis. .

Abstract

Background: Vaginal and seminal microbiomes have gained increasing interest for their involvement in reproductive health and fertility. However, their role in reproductive outcome is not fully understood yet. In this study, we aimed to correlate the vaginal and the seminal microbiome of 23 couples with idiopathic infertility to the clinical pregnancy rate after intrauterine insemination (IUI).

Methods: Vaginal swabs and seminal fluids were collected on the day of IUI procedure and analyzed through polymerase chain reaction amplification of variable regions 3 and 4 (V3-V4) of 16S ribosomal ribonucleic acid genes and Illumina MiSeq sequencing. The taxonomic data were then correlated to IUI success.

Results: Idiopathic infertile women showed a different average composition of vaginal microbiome compared with control sequences, whereas for seminal counterpart no relevant differences were observed. Furthermore, among idiopathic infertile women, different patterns of Lactobacillus species dominations were observed, with a predominance either of Lactobacillus crispatus, a marker of a healthy vaginal ecosystem, or of Lactobacillus iners and Lactobacillus gasseri, associated with a more dysbiosis-prone environment. More important, considering all investigated variables, vaginal L crispatus domination was the only factor strongly associated to IUI success (P = .0002).

Conclusions: Our results strengthen the potential role of L crispatus in promoting a favorable environment for pregnancy and suggest that microbiome characterization could be useful, together with standard clinical and laboratory assessments, in the pre-IUI evaluation of infertile couples.

Keywords: idiopathic infertility; intrauterine insemination (IUI) success; seminal microbiome; vaginal lactobacilli; vaginal microbiome.

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Figures

Figure 1.
Figure 1.
Study design. BMI, body mass index; IUI, intrauterine insemination.
Figure 2.
Figure 2.
Vaginal microbiome taxonomic profile at family level. Comparison between women with idiopathic infertility, stratified by intrauterine insemination (IUI) outcome, and controls.
Figure 3.
Figure 3.
Seminal microbiome taxonomic profile at family level. Comparison between men with idiopathic infertility, stratified by intrauterine insemination (IUI) outcome, and controls.
Figure 4.
Figure 4.
Vaginal microbiome taxonomic profile at species level. Comparison between women with idiopathic infertility, stratified by intrauterine insemination (IUI) outcome, and controls.
Figure 5.
Figure 5.
Heatmap of the relative abundance of Lactobacillus species found in the vaginal microbiome of 23 women with idiopathic infertility. Color key is indicated in the upper left corner. The dashed-black box identifies the cluster relative to intrauterine insemination (IUI) success group (P = .0117).
See this image and copyright information in PMC

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