The Implication of The Vaginal Microbiome in Female Infertility and Assisted Conception Outcomes.

Abstract

The rise in infertility rates has prompted research into the impact of vaginal microbiota on female fertility and assisted reproduction technology (ART) success. Our study compares the vaginal microbiome of fertile and infertile women and explores its influence on ART outcomes. We analyzed vaginal secretions from 194 infertile women and 100 healthy controls at Shanghai Changzheng Hospital using polymerase chain reaction (PCR) to amplify the 16S rRNA V3-V4 region. A machine learning model predicted infertility based on genus abundances, and the PICRUSt algorithm predicted metabolic pathways related to infertility and ART outcome. The results showed women with infertility exhibited a significantly different vaginal microbial composition compared to healthy women, with the infertility group showing higher microbial diversity. Burkholderia, Pseudomonas, and Prevotella levels were significantly elevated in the vaginal microbiota of the infertility group, while Bifidobacterium and Lactobacillus abundances were reduced. Recurrent implantation failure (RIF) within the infertile population showed even higher diversity of vaginal microbiota, with specific genera such as Mobiluncus, Peptoniphilus, Prevotella, and Varibaculum being more abundant. Eleven metabolic pathways were associated with RIF and infertility, with Prevotella demonstrating stronger correlations. The present study provides insights into the differences in vaginal microbiome between healthy and infertile women, offering a new understanding of how vaginal microbiota may impact infertility and ART outcomes. Our findings underscore the significance of specific microbial taxa in women with RIF, suggesting avenues for targeted interventions to enhance embryo transplantation success rates.