Impact of the Female Genital Microbiota on Outcomes of Assisted Reproductive Techniques

Abstract

The female genital microbiota plays a critical role in reproductive health and has recently emerged as a key factor influencing the outcomes of Assisted Reproductive Techniques (ARTs). Beyond traditional concerns about vaginal dysbiosis and infections such as bacterial vaginosis or mycoses, recent evidence highlights the broader impact of genital microbial communities, including the vaginal, cervical, and endometrial niches, on ART success rates. New findings suggest that specific bacterial profiles, as well as shifts in the virome and mycobiome, can significantly affect implantation and pregnancy outcomes. Non-invasive biomarkers such as menstrual blood have also been proposed for assessing endometrial receptivity. Furthermore, growing attention has been directed towards methodological challenges such as contamination risks during microbiota sampling which may influence study reliability. This review synthesizes the latest data on the relationship between the female genital microbiota and ART outcomes, with a focus on standardized microbiological analysis techniques and specific patient populations such as those experiencing recurrent implantation to optimize ART success based on microbiota profiling.

Keywords: ART; assisted reproductive techniques; bacteria; endometrial microbiota; fertility; genital microbiota; vaginal microbiota.