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. 2024 Jun;31(6):1593-1600.
doi: 10.1007/s43032-024-01484-0. Epub 2024 Feb 20.

The Vaginal Microbiome Changes During Various Fertility Treatments

M M van den Tweel  1   2 , E H A van den Munckhof  3 , M van der Zanden  2 , A Molijn  4 , J M M van Lith  1 , K E Boers  5
Affiliations

The Vaginal Microbiome Changes During Various Fertility Treatments

M M van den Tweel et al. Reprod Sci. 2024 Jun.

Abstract

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.

Keywords: Bacterial vaginosis; Hormone treatment; IUI; IVF; Microbiome.

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Conflict of interest statement

The authors have stated explicitly that they have no conflict of interest in connection with this article.

Figures

Fig. 1
Fig. 1
Flow diagram of included participants
Fig. 2
Fig. 2
Decrease of Lactobacilli during fertility treatment (*p = 0.01)
Fig. 3
Fig. 3
The microbiome of 27 persons with a more than 10% change in Lactobacilli, Gardnerella, or Atopobium/Fannyhessiae over time. Samples are arranged per person, categorized on community state type microbiome on basis of the first sample at intake
See this image and copyright information in PMC

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