Risks associated with bacterial vaginosis in infertility patients: a systematic review and meta-analysis

Oostrum, Noortje Van; Sutter, Petra De; Meys, Joris; Verstraelen, Hans

doi:10.1093/humrep/det096

Cited by 216 publications

(184 citation statements)

References 4 publications

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“…This microbially mediated vaginal acidity provides an important barrier that restricts the colonization of potential pathogens (Boskey et al, 1999). Perturbations to the composition of the human vaginal microbiome are often associated with diseased states, including bacterial vaginosis (BV) (Fredricks et al, 2005;Oakley et al, 2008;Marrazzo et al, 2010;Srinivasan et al, 2010), susceptibility to sexually transmitted infectious diseases (Sewankambo et al, 1997;Wiesenfeld et al, 2003), tubal infertility (Wiesenfeld et al, 2012;van Oostrum et al, 2013) and adverse pregnancy outcomes (White et al, 2011;Ganu et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Primate vaginal microbiomes exhibit species specificity without universal Lactobacillus dominance

et al. 2014

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Bacterial communities colonizing the reproductive tracts of primates (including humans) impact the health, survival and fitness of the host, and thereby the evolution of the host species. Despite their importance, we currently have a poor understanding of primate microbiomes. The composition and structure of microbial communities vary considerably depending on the host and environmental factors. We conducted comparative analyses of the primate vaginal microbiome using pyrosequencing of the 16S rRNA genes of a phylogenetically broad range of primates to test for factors affecting the diversity of primate vaginal ecosystems. The nine primate species included: humans (Homo sapiens), yellow baboons (Papio cynocephalus), olive baboons (Papio anubis), lemurs (Propithecus diadema), howler monkeys (Alouatta pigra), red colobus (Piliocolobus rufomitratus), vervets (Chlorocebus aethiops), mangabeys (Cercocebus atys) and chimpanzees (Pan troglodytes). Our results indicated that all primates exhibited host-specific vaginal microbiota and that humans were distinct from other primates in both microbiome composition and diversity. In contrast to the gut microbiome, the vaginal microbiome showed limited congruence with host phylogeny, and neither captivity nor diet elicited substantial effects on the vaginal microbiomes of primates. Permutational multivariate analysis of variance and Wilcoxon tests revealed correlations among vaginal microbiota and host species-specific socioecological factors, particularly related to sexuality, including: female promiscuity, baculum length, gestation time, mating group size and neonatal birth weight. The proportion of unclassified taxa observed in nonhuman primate samples increased with phylogenetic distance from humans, indicative of the existence of previously unrecognized microbial taxa. These findings contribute to our understanding of host-microbe variation and coevolution, microbial biogeography, and disease risk, and have important implications for the use of animal models in studies of human sexual and reproductive diseases.

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Section: Introductionmentioning

confidence: 99%

Primate vaginal microbiomes exhibit species specificity without universal Lactobacillus dominance

et al. 2014

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“…4–5 BV is highly persistent and recurrent after treatment. 6 However, the etiology of BV is not clear.…”

Section: Introductionmentioning

confidence: 99%

A blinded, randomized controlled trial of high-dose vitamin D supplementation to reduce recurrence of bacterial vaginosis

Turner

Reese

Fields

et al. 2014

American Journal of Obstetrics and Gynecology

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Objective Low serum vitamin D levels have been associated with increased prevalence of the reproductive tract condition bacterial vaginosis (BV). The objective of this trial was to evaluate the effect of high-dose vitamin D supplementation on BV recurrence. Study design This randomized, placebo-controlled, double-blinded trial enrolled 118 women with symptomatic BV from an urban STD clinic (clinicaltrials.gov registration NCT01450462). All participants received 500mg oral metronidazole twice daily for seven days. Intervention participants (n=59) also received nine doses of 50,000 international units of cholecalciferol (vitamin D3) over 24 weeks; control women (n=59) received matching placebo. Recurrent BV was assessed via Nugent scoring after 4, 12 and 24 weeks. We assessed the effect of the intervention using an intention-to-treat approach, fitting Cox proportional hazards models to evaluate recurrent BV over the follow-up period. Results Most participants (74%) were black, with a median age of 26 years. Median presupplementation serum 25-hydroxyvitamin D [25(OH)D] was similar across randomization arms: 16.6 ng/mL in the vitamin D arm and 15.8 ng/mL in the control arm. At trial completion, median 25(OH)D among women receiving vitamin D was 30.5 ng/mL, vs 17.8 ng/mL in control women; 16% of women receiving vitamin D and 57% receiving placebo remained vitamin D deficient (<20 ng/mL). BV prevalence among women randomized to vitamin D was very similar to those randomized to placebo at the 4- and 12-week visits, but by the 24-week visit, BV prevalence was 65% among women in the vitamin D arm and 48% among control women. BV recurrence was not reduced by vitamin D supplementation (intention-to-treat hazard ratio, 1.11; 95% confidence interval, 0.68-1.81). Among women experiencing recurrent BV, median time to recurrence was 13.7 weeks in the vitamin D arm and 14.3 weeks in the control arm. Conclusions Women receiving vitamin D experienced significant increases in serum 25(OH)D, but this increase was not associated with decreased BV recurrence in this high-risk STD clinic population.

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“…Its prevalence in UI was 37.4% which is more or less similar to our results (42.5%). In a recent systematic review and a meta-analysis, 28 it was concluded that all studies on infertility in relation to BV included had a cross-sectional design and, therefore, do not allow for causal inferences. Our study and others 27 would support the concept of definite correlation between UI and BV.…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic and bacteriologic evidence of bacterial vaginosis in unexplained infertility

Darwish

Abdel-Aleem

2015

Int J Reprod Contracept Obstet Gynecol

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Risks associated with bacterial vaginosis in infertility patients: a systematic review and meta-analysis

Cited by 216 publications

References 4 publications

Primate vaginal microbiomes exhibit species specificity without universal Lactobacillus dominance

Primate vaginal microbiomes exhibit species specificity without universal Lactobacillus dominance

A blinded, randomized controlled trial of high-dose vitamin D supplementation to reduce recurrence of bacterial vaginosis

Laparoscopic and bacteriologic evidence of bacterial vaginosis in unexplained infertility

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