The dynamics of the vaginal microbiome during infertility therapy with in vitro fertilization-embryo transfer

Hyman, Richard W.; Herndon, Christopher N.; Jiang, Hui; Palm, Curtis J.; Fukushima, Marilyn; Bernstein, D.; Vo, Kim Chi; Zelenko, Zara; Davis, Ronald W.; Giudice, Linda C.

doi:10.1007/s10815-011-9694-6

Cited by 133 publications

(140 citation statements)

References 28 publications

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“…These findings are consistent with a recently published cross-sectional study of the microbiota of the cervix, posterior fornix and vaginal canal in a limited number (n = 5) of samples collected postpartum42. This dynamism provides evidence that oestrogen is likely an important factor in shaping the composition of the vaginal microbiome, particularly during pregnancy4344. During pregnancy, placental production of oestrogen causes circulating concentrations to rise dramatically4546.…”

Section: Discussionsupporting

confidence: 90%

The vaginal microbiome during pregnancy and the postpartum period in a European population

MacIntyre

Chandiramani

Lee

et al. 2015

Sci Rep

453

429

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The composition and structure of the pregnancy vaginal microbiome may influence susceptibility to adverse pregnancy outcomes. Studies on the pregnant vaginal microbiome have largely been limited to Northern American populations. Using MiSeq sequencing of 16S rRNA gene amplicons, we characterised the vaginal microbiota of a mixed British cohort of women (n = 42) who experienced uncomplicated term delivery and who were sampled longitudinally throughout pregnancy (8–12, 20–22, 28–30 and 34–36 weeks gestation) and 6 weeks postpartum. We show that vaginal microbiome composition dramatically changes postpartum to become less Lactobacillus spp. dominant with increased alpha-diversity irrespective of the community structure during pregnancy and independent of ethnicity. While the pregnancy vaginal microbiome was characteristically dominated by Lactobacillus spp. and low alpha-diversity, unlike Northern American populations, a significant number of pregnant women this British population had a L. jensenii-dominated microbiome characterised by low alpha-diversity. L. jensenii was predominantly observed in women of Asian and Caucasian ethnicity whereas L. gasseri was absent in samples from Black women. This study reveals new insights into biogeographical and ethnic effects upon the pregnancy and postpartum vaginal microbiome and has important implications for future studies exploring relationships between the vaginal microbiome, host health and pregnancy outcomes.

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Section: Discussionsupporting

confidence: 90%

The vaginal microbiome during pregnancy and the postpartum period in a European population

MacIntyre

Chandiramani

Lee

et al. 2015

Sci Rep

453

429

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show abstract

“…Finally, a lactobacilli-dominated VMB was associated with a reduced risk of pre-term birth, a higher likelihood of IVF resulting in a live birth, and a reduced risk of vaginal dryness in postmenopausal women in one study each [49], [69], [78].…”

Section: Resultsmentioning

confidence: 84%

The Vaginal Microbiota: What Have We Learned after a Decade of Molecular Characterization?

et al. 2014

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We conducted a systematic review of the Medline database (U.S. National Library of Medicine, National Institutes of Health, Bethesda, MD, U.S.A) to determine if consistent molecular vaginal microbiota (VMB) composition patterns can be discerned after a decade of molecular testing, and to evaluate demographic, behavioral and clinical determinants of VMB compositions. Studies were eligible when published between 1 January 2008 and 15 November 2013, and if at least one molecular technique (sequencing, PCR, DNA fingerprinting, or DNA hybridization) was used to characterize the VMB. Sixty three eligible studies were identified. These studies have now conclusively shown that lactobacilli-dominated VMB are associated with a healthy vaginal micro-environment and that bacterial vaginosis (BV) is best described as a polybacterial dysbiosis. The extent of dysbiosis correlates well with Nugent score and vaginal pH but not with the other Amsel criteria. Lactobacillus crispatus is more beneficial than L. iners. Longitudinal studies have shown that a L. crispatus-dominated VMB is more likely to shift to a L. iners-dominated or mixed lactobacilli VMB than to full dysbiosis. Data on VMB determinants are scarce and inconsistent, but dysbiosis is consistently associated with HIV, human papillomavirus (HPV), and Trichomonas vaginalis infection. In contrast, vaginal colonization with Candida spp. is more common in women with a lactobacilli-dominated VMB than in women with dysbiosis. Cervicovaginal mucosal immune responses to molecular VMB compositions have not yet been properly characterized. Molecular techniques have now become more affordable, and we make a case for incorporating them into larger epidemiological studies to address knowledge gaps in etiology and pathogenesis of dysbiosis, associations of different dysbiotic states with clinical outcomes, and to evaluate interventions aimed at restoring and maintaining a lactobacilli-dominated VMB.

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“…This community level change may be indicative of severe, active endometriosis and provide further explanation for decreased rates of pregnancy in these women. Indeed, it has been shown that within the vagina, this shift in microorganisms has been linked to decreases in pregnancy as a result of IVF [33], thus a more thorough, detailed characterization of these communities through time is warranted. Examining the cervical bacterial community of the stage III patient upon follow up visits, we showed that the bacterial community was similar to the DOS two weeks post-surgery, but at the four month post-surgery visit, the cervical bacterial community was 97% Lactobacillus sp.…”

Section: Discussionmentioning

confidence: 99%

Reproductive Microbiomes: Using the Microbiome as a Novel Diagnostic Tool for Endometriosis

Cregger¹,

Lenz²,

Leary³

et al. 2017

Reproductive Immunol Open Acc

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The dynamics of the vaginal microbiome during infertility therapy with in vitro fertilization-embryo transfer

Cited by 133 publications

References 28 publications

The vaginal microbiome during pregnancy and the postpartum period in a European population

The vaginal microbiome during pregnancy and the postpartum period in a European population

The Vaginal Microbiota: What Have We Learned after a Decade of Molecular Characterization?

Reproductive Microbiomes: Using the Microbiome as a Novel Diagnostic Tool for Endometriosis

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