A pilot study and case reports on endometrial microbiota and pregnancy outcome: An analysis using 16S rRNA gene sequencing among IVF patients, and trial therapeutic intervention for dysbiotic endometrium. (25th October 2018)

• Record Type: Journal Article
• Authors: Kyono, Koichi; Hashimoto, Tomoko; Kikuchi, Suguru; Nagai, Yoko; Sakuraba, Yoshiyuki
• Is Part Of: Reproductive medicine and biology. Volume 18:Number 1(2019)
• Page Start: 72
• Page End: 82
• Publication Date: 2018-10-25
• Subjects: dysbiosis -- endometrium -- infertility -- prebiotics -- probiotics; Reproduction -- Periodicals; Reproductive health -- Periodicals; 612.6
• DOI: 10.1002/rmb2.12250
• Languages: English
• ISSNs: 1445-5781

Abstract

Abstract: Purpose: The present study aimed to analyze the pregnancy outcomes of IVF patients presenting Lactobacillus ‐dominated microbiota (LDM) or non‐ Lactobacillus ‐dominated microbiota (NLDM) of their endometrium and to report cases who were treated for NLDM concurrently with antibiotics and prebiotic/probiotic supplements in a Japanese infertile population. Methods: Ninety‐two IVF patients were recruited from August 2017 to March 2018. Endometrial fluid samples for sequencing were collected using an IUI catheter. The bacterial status of the endometrium and the pregnancy outcomes were analyzed. For cases with NLDM, antibiotics and prebiotics/probiotics were administered according to their individual microbial conditions. Results: Forty‐seven cases (51.1%) presented LDM and 45 cases (48.9%) presented NLDM at initial analysis. Nine Patients with NLDM were treated by antibiotics and prebiotics/probiotics, and successfully became Lactobacillus ‐dominant. Pregnancy rates by single vitrified‐warmed blastocyst transfers were higher in the LDM group (58.9% per patient and 36.3% per FBT) than in the NLDM group (47.2% per patient and 34.7% per FBT) but not significantly different. Conclusion: The results of this study could not necessarily prove the clear benefit of establishing Lactobacillus ‐dominated endometrium in terms of pregnancy outcome, but there is significance in searching for endometrial microbial status of infertile patients and recovering Lactobacillus ‐dominated endometrium might benefit implantation. Abstract : This is a follow‐up to the previous study, analyzing the endometrial microbiome of IVF patients and assessing the pregnancy outcome of patients with Lactobacillus ‐dominant or non‐ Lactobacillus ‐dominant endometrium, and we found that Lactobacillus dominancy may be beneficial for the pregnancy outcome of IVF patients. Also, we tried to establish a treatment strategy for recovering Lactobacillus ‐dominant endometrium, and this may be the first study reporting on a treatment for dysbiotic endometrium. We found that concurrent administration of antibiotics and prebiotics and/or probiotics was successful in recovering endometrium to a Lactobacillus ‐dominant condition.