Bacterial vaginosis and its association with infertility, endometritis, and pelvic inflammatory disease

Ravel, Jacques; Moreno, Inmaculada; Simón, Carlos

doi:10.1016/j.ajog.2020.10.019

Cited by 176 publications

(153 citation statements)

References 76 publications

(76 reference statements)

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“…BV is associated with adverse reproductive health outcomes, such as sexually transmitted infections (STIs) and pelvic inflammatory disease (PID) (Unemo et al, 2017;Ravel et al, 2021). Moreover, preterm birth (PTB) (Hillier et al, 1995), low birthweight (Svare et al, 2006), miscarriage (Leitich and Kiss, 2007), and other adverse obstetric outcomes are also linked to BV.…”

Section: Bv-associated Diseasesmentioning

confidence: 99%

The Female Vaginal Microbiome in Health and Bacterial Vaginosis

Chen

et al. 2021

Front. Cell. Infect. Microbiol.

181

118

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The vaginal microbiome is an intricate and dynamic microecosystem that constantly undergoes fluctuations during the female menstrual cycle and the woman’s entire life. A healthy vaginal microbiome is dominated by Lactobacillus which produce various antimicrobial compounds. Bacterial vaginosis (BV) is characterized by the loss or sharp decline in the total number of Lactobacillus and a corresponding marked increase in the concentration of anaerobic microbes. BV is a highly prevalent disorder of the vaginal microbiota among women of reproductive age globally. BV is confirmed to be associated with adverse gynecologic and obstetric outcomes, such as sexually transmitted infections, pelvic inflammatory disease, and preterm birth. Gardnerella vaginalis is the most common microorganism identified from BV. It is the predominant microbe in polymicrobial biofilms that could shelter G. vaginalis and other BV-associated microbes from adverse host environments. Many efforts have been made to increase our understanding of the vaginal microbiome in health and BV. Thus, improved novel and accurate diagnosis and therapeutic strategies for BV have been developed. This review covers the features of vaginal microbiome, BV, BV-associated diseases, and various strategies of diagnosis and treatment of BV, with an emphasis on recent research progresses.

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Section: Bv-associated Diseasesmentioning

confidence: 99%

The Female Vaginal Microbiome in Health and Bacterial Vaginosis

Chen

et al. 2021

Front. Cell. Infect. Microbiol.

181

118

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“…The presence of different microorganisms in the female and male reproductive tracts might influence reproductive function (Franasiak and Scott 2015;Koedooder, Mackens, et al 2019;Ravel, Moreno, and Simón 2020). Recent studies indicate that the chance of becoming pregnant before the start of an in vitro fertilisation (IVF) treatment is stratified based on the vaginal microbiota composition, as women with a low percentage of Lactobacillus in their vaginal sample are less likely to have a successful embryo implantation (Koedooder, Singer, et al 2019).…”

Section: Introductionmentioning

confidence: 99%

Endometrial microbiota composition is associated with reproductive outcome in infertile patients

Moreno

García-Grau

Pérez-Villaroya

et al. 2021

Preprint

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Background: Previous evidence indicates associations between the female reproductive tract microbiome composition and reproductive outcome in infertile patients undergoing assisted reproduction. We aimed to determine whether the endometrial microbiota composition is associated with reproductive outcomes of live birth, biochemical pregnancy, clinical miscarriage, or no pregnancy. Methods: Here we present a multicentre prospective observational study using 16S rRNA gene sequencing to analyse endometrial fluid and biopsy samples before embryo transfer in a cohort of 342 infertile patients asymptomatic for infection undergoing assisted reproductive treatments. Results: A dysbiotic endometrial microbiota profile composed of Atopobium, Bifidobacterium, Chryseobacterium, Gardnerella, Haemophilus, Klebsiella, Neisseria, Staphylococcus and Streptococcus was associated with unsuccessful outcomes. In contrast, Lactobacillus was consistently enriched in patients with live birth outcomes. Conclusions: Our findings indicate that endometrial microbiota composition before embryo transfer is a useful biomarker to predict reproductive outcome, offering an opportunity to further improve diagnosis and treatment strategies.

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“…BV is a high-recurrence vaginal disease that occurs in 20%–40% of sampled women [54] , [30] depending on cohorts surveyed. It is associated with genital tract infections and many pregnancy complications [3] , [49] , [53] , [60] , [76] , including pelvic inflammatory disease [6] , [72] , premature rupture of membranes [12] , intrauterine growth restriction, intrauterine fetal demise [9] , chorioamnionitis [21] , endometritis, preterm labor and delivery [29] , [33] , [71] , [74] , postpartum infection, ectopic pregnancy [72] , and tubal factor infertility [15] . BV is also an independent risk factor for the acquisition and transmission of STDs (sexually-transmitted diseases) and HIV [36] , [64] , [73] .…”

Section: Introductionmentioning

confidence: 99%