Vaginal microbiota are associated with in vitro fertilization during female infertility

Abstract

The vaginal microbiome plays an essential role in the reproductive health of human females. As infertility increases worldwide, understanding the roles that the vaginal microbiome may have in infertility and in vitro fertilization (IVF) treatment outcomes is critical. To determine the vaginal microbiome composition of 1411 individuals (1255 undergoing embryo transplantation) and their associations with reproductive outcomes, clinical and biochemical features are measured, and vaginal samples are 16S rRNA sequenced. Our results suggest that both too high and too low abundance of Lactobacillus is not beneficial for pregnancy; a moderate abundance is more beneficial. A moderate abundance of Lactobacillus crispatus and Lactobacillus iners (~80%) (with a pregnancy rate of I‐B: 54.35% and III‐B: 57.73%) is found beneficial for pregnancy outcomes compared with a higher abundance (>90%) of Lactobacillus (I‐A: 44.81% and III‐A: 51.06%, respectively). The community state type (CST) IV‐B (contains a high to moderate relative abundance of Gardnerella vaginalis) shows a similar pregnant ratio (48.09%) with I‐A and III‐A, and the pregnant women in this CST have a higher abundance of Lactobacillus species. Metagenome analysis of 71 samples shows that nonpregnant women are detected with more antibiotic‐resistance genes, and Proteobacteria and Firmicutes are the main hosts. The inherent differences within and between women in different infertility groups suggest that vaginal microbes might be used to detect infertility and potentially improve IVF outcomes.

Abstract

The vaginal microbiome is crucial for reproductive health, and as global infertility rates rise, understanding its impact on in vitro fertilization (IVF) is vital. Here, we analyzed the microbiome of 1411 individuals (1255 undergoing embryo transplantation) and revealed that a moderate abundance of Lactobacillus (~80%) is most beneficial for pregnancy (pregnancy rates were 54.35% and 57.73% for community state types [CST] I‐B and III‐B respectively), outperforming higher abundances (>90%) seen in I‐A (44.81%) and III‐A (51.06%). Metagenomic analysis of 71 samples indicates more antibiotic‐resistance genes in nonpregnant women, with Proteobacteria and Firmicutes as predominant hosts. Variations among infertility groups suggest potential applications for detecting infertility and enhancing IVF outcomes using vaginal microbes. AMH, antimullerian hormones; BMI, body mass index; E2, estradiol; FSH, follicle‐stimulating hormone; LH, luteinizing hormone; P, progesterone; PRL, prolactin; T, testosterone.

Highlights

• Pregnancy rates vary among women with different vaginal microbiome communities.

• Too high abundances of both Lactobacillus crispatus and Lactobacillus  iners have negative effects on in vitro fertilization (IVF) outcomes.

• A moderate abundance (around 80%) of Lactobacillus is more beneficial for pregnancy.