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Review
. 2024 Jan 3;25(1):622.
doi: 10.3390/ijms25010622.

Clinical Relevance of Vaginal and Endometrial Microbiome Investigation in Women with Repeated Implantation Failure and Recurrent Pregnancy Loss

Xushan Gao  1 , Yvonne V Louwers  1 , Joop S E Laven  1 , Sam Schoenmakers  2
Affiliations
Review

Clinical Relevance of Vaginal and Endometrial Microbiome Investigation in Women with Repeated Implantation Failure and Recurrent Pregnancy Loss

Xushan Gao et al. Int J Mol Sci. .

Abstract

Recent studies have investigated if and how the vaginal and endometrial microbiome might affect endometrial receptivity and reproductive health. Although there is no consensus on the existence of a core uterine microbiome yet, evidence shows that the dominance of Lactobacillus spp. in the female reproductive tract is generally associated with eubiosis and improved chances of successful implantation and an ongoing pregnancy. Conversely, vaginal and endometrial dysbiosis can cause local inflammation and an increase of pro-inflammatory cytokines, compromising the integrity and receptivity of the endometrial mucosa and potentially hampering successful embryonic implantation. This review provides a critical appraisal of the influence of the vaginal and endometrial microbiome as parts of the female reproductive tract on fertility outcomes, focusing on repeated implantation failure (RIF) and recurrent pregnancy loss (RPL). It seems that RIF as well as RPL are both associated with an increase in microbiome diversity and a loss of Lactobacillus dominance in the lower female reproductive system.

Keywords: embryo implantation; endometrial microbiome; pregnancy; recurrent miscarriage; recurrent pregnancy loss; repeated implantation failure; vaginal microbiome.

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Conflict of interest statement

X.G., Y.V.L. and S.S. have nothing to declare. J.S.E.L. reports unrestricted research grants from Ansh Labs (Webster, TX, USA), from Ferring (Hoofddorp, The Netherlands), from Dutch Heart Association (Utrecht, The Netherlands), from Zon MW (Amsterdam, The Netherlands), from Roche Diagnostics (Rothkreuz, Switzerland), and consultancy fees from Ferring (Hoofddorp, The Netherlands), from Titus Healthcare (Hoofddorp, The Netherlands), from Gedeon Richter (Groot-Bijgaarden, Belgium), and is an unpaid board member and president of the AE-PCOS Society, outside the submitted work.

Figures

Figure 1
Figure 1
Eubiotic vaginal and endrometrial microbiota.
Figure 2
Figure 2
Alterations of the vaginal and endometrial microbiota in women with RIF.
Figure 3
Figure 3
Alterations of the vaginal and endometrial microbiota in women with RPL.
See this image and copyright information in PMC

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