Semin Reprod Med 2014; 32(01): 035-042
DOI: 10.1055/s-0033-1361821
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Potential Influence of the Microbiome on Infertility and Assisted Reproductive Technology

Ido Sirota
1  Department of Obstetrics and Gynecology, St. Luke's-Roosevelt Hospital Center, New York, New York
,
Shvetha M. Zarek
2  Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
,
James H. Segars
2  Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
› Author Affiliations
Further Information

Publication History

Publication Date:
03 January 2014 (online)

Abstract

Although an altered vaginal microbiota has been demonstrated to affect parturition, its role in assisted reproductive technologies is uncertain. Nevertheless, the effect of known pathogens such as Mycoplasma tuberculosis, Chlamydia trachomatis, and Neisseria gonorrhoeae is clear, causing subclinical changes thought to be risk factors in subfertility. The Human Microbiome Project (HMP) has allowed for metagenomic studies to aid in characterizing normal vaginal flora. Recent findings from the HMP demonstrate that many different species of Lactobacillus are present in the vaginal tract, with a few that predominate. Studies that characterize the vaginal microbiome in assisted reproductive technology support the hypothesis that colonizing the transfer-catheter tip with Lactobacillus crispatus at the time of embryo transfer may increase the rates of implantation and live birth rate while decreasing the rate of infection. In addition, there is some evidence that a progesterone-resistant endometrium might increase the risk of an abnormal vaginal microbiome.

Note

The views expressed in this article are those of the authors and do not reflect the official policy or position of the U.S. Government.