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. 2024 Jul 9:15:1380187.
doi: 10.3389/fendo.2024.1380187. eCollection 2024.

Assessing vaginal microbiome through Vaginal Microecology Evaluation System as a predictor for in vitro fertilization outcomes: a retrospective study

Quan Tian #  1   2 , Shengxi Jin #  1 , Guangmin Zhang  1 , Yujie Liu  2 , Jianxin Liu  2 , Xiuming Tang  2 , Yufeng Li  2 , Jiane Liu  1   2 , Yifei Liu  3 , Zheng Wang  1   2
Affiliations

Assessing vaginal microbiome through Vaginal Microecology Evaluation System as a predictor for in vitro fertilization outcomes: a retrospective study

Quan Tian et al. Front Endocrinol (Lausanne). .

Abstract

Objective: This study aims to evaluate the effectiveness of the Vaginal Microecology Evaluation System (VMES) in assessing the dynamics of the vaginal microbiome (VM) throughout the process of in vitro fertilization and embryo transfer (IVF-ET). Furthermore, it seeks to explore the potential correlation between distinct types of VM ecology and the success rate of IVF-ET.

Methods: This study employed VMES to ascertain the composition of the VM. Data were collected from infertile women who underwent their initial IVF-ET treatment for tubal factor between January 2018 and December 2021. A retrospective analysis of pregnancy outcomes resulting from their fresh embryo transfer was conducted to determine the predictive significance of the vaginal microenvironment.

Results: We demonstrate that VMES is able to predict IVF-ET outcomes in patients diagnosed with Bacterial Vaginosis (BV). Notably, a discernible shift in the VM was observed in a decent subset of patients following Controlled Ovarian Stimulation (COS), though this phenomenon was not universal across all participants. Specifically, there was a noteworthy increase in the proportion of patients exhibiting BV and uncharacterized dysbiosis subsequent to COS. Furthermore, our investigation revealed a significant correlation between VM and both the live birth rate and early miscarriage rate. Employing a multivariable logistic regression model, we identified that VM status pre-COS, VM status post-COS, patient age, and the number of embryos transferred emerged as independent predictors of the live birth rate.

Conclusion: Our study suggests that, during IVF-ET treatment, the VMES can effectively detect changes in the VM, which are strongly correlated with the pregnancy outcome of IVF-ET procedures.

Keywords: IVF; dysbiosis; infertility; pregnancy outcomes; vaginal microecology.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The timeline of the stimulus program and specimen acquisition. The study followed a Gonadotropin-Releasing Hormone agonist (GnRH-a) prolonged protocol within the ART procedures. On day 2 of the menstrual cycle, a 3.75 mg dose of GnRH-a was administered. Subsequently, recombinant Follicle-Stimulating Hormone (rFSH) was administered daily in doses ranging from 75 to 300 IU after confirming down-regulation through ultrasound scans and serum hormone level assessments. Upon reaching a mean diameter of 18 mm for the two leading follicles, a trigger for ovulation was induced using 6000–10,000 IU of Human Chorionic Gonadotropin (HCG). Transvaginal oocyte retrieval was performed 36–37 hours post-trigger. Fertilization was achieved through standard IVF or intracytoplasmic sperm injection (ICSI) methods. Embryo transfer took place on either day 3 or day 5 after fertilization. Specimen 1 was obtained 30 days ahead of pituitary downregulation, and Specimen 2 was obtained on the trigger day.
Figure 2
Figure 2
Morphological analyses of Gram-stained vaginal smears for (A) NVM (B) VVC (C) BV (D) Intermediate BV patients.
Figure 3
Figure 3
Pregnancy outcomes of post-COS NVM and post-COS BV patients. Pregnancy outcomes include IR, BPR, CPR, EMR and LBR.
Figure 4
Figure 4
Pregnancy outcomes of NVM and AVM patients. The Pre refers to pre-COS analysis and Post to post-COS analysis. Pregnancy outcomes include IR, BPR, CPR, EMR and LBR.
Figure 5
Figure 5
Pregnancy outcomes of post-COS NVM and post-COS AVM patients. Pregnancy outcomes include IR, BPR, CPR, EMR and LBR.
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References

    1. Alqawasmeh O, Fok E, Yim H, Li T, Chung J, Chan D. The microbiome and male infertility: looking into the past to move forward. Hum Fertil (Camb). (2023) 26:450–62. doi: 10.1080/14647273.2022.2098540 - DOI - PubMed
    1. Chambers GM, Dyer S, Zegers-Hochschild F, de Mouzon J, Ishihara O, Banker M, et al. . International Committee for Monitoring Assisted Reproductive Technologies world report: assisted reproductive technology, 2014†. Hum Reprod. (2021) 36:2921–34. doi: 10.1093/humrep/deab198 - DOI - PubMed
    1. De Geyter C. Assisted reproductive technology: Impact on society and need for surveillance. Best Pract Res Clin Endocrinol Metab. (2019) 33:3–8. doi: 10.1016/j.beem.2019.01.004 - DOI - PubMed
    1. Costello EK, Stagaman K, Dethlefsen L, Bohannan BJ, Relman DA. The application of ecological theory toward an understanding of the human microbiome. Science. (2012) 336:1255–62. doi: 10.1126/science.1224203 - DOI - PMC - PubMed
    1. Haahr T, Zacho J, Bräuner M, Shathmigha K, Skov Jensen J, Humaidan P. Reproductive outcome of patients undergoing in vitro fertilisation treatment and diagnosed with bacterial vaginosis or abnormal vaginal microbiota: a systematic PRISMA review and meta-analysis. Bjog. (2019) 126:200–7. doi: 10.1111/1471-0528.15178 - DOI - PubMed

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