Alejandro González: Vaginal Microbiome and Assisted Reproduction
Alejandro González, Gynecologist at INEBIR – Institute for the Study of Human Reproductive Biology, shared on LinkedIn:
“Vaginal microbiome and assisted reproduction: not all lactobacilli are created equal.
This systematic review and network meta-analysis included 12 longitudinal studies and 2,289 women undergoing IVF/ICSI or artificial insemination.
Against a microbiome dominated by Lactobacillus crispatus, profiles dominated by L. jensenii and communities with few lactobacilli were associated with lower odds of pregnancy.
No significant differences were observed for L. gasseri or L. iners.
The finding calls into question the simplification that any microbiome dominated by lactobacilli is necessarily favorable. However, association does not imply causality: observational studies predominate, there is methodological heterogeneity, and only five studies reported live births, with only 57 events.
Conclusion: Interesting results to generate hypotheses, but insufficient to routinely incorporate CST profiling into clinical practice or to indicate microbiome-targeted treatments.
We need standardized prospective studies that assess live birth and demonstrate that modifying the microbiome actually improves reproductive outcomes.”
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