Impact of vaginal microecological differences on pregnancy outcomes and endometrial microbiota in frozen embryo transfer cycles

作者全名："Wei, Quan; Chen, Huijia; Zou, Heng; Zhang, Hong; Liu, Shuaibin; Zheng, Jie; Zhang, Shen; Hu, Lina"

作者地址："[Wei, Quan; Chen, Huijia; Zou, Heng; Zhang, Hong; Liu, Shuaibin; Zheng, Jie; Zhang, Shen; Hu, Lina] Chongqing Med Univ, Affiliated Hosp 2, Obstet & Gynecol Dept, Chongqing 400010, Peoples R China; [Zhang, Shen; Hu, Lina] Chongqing Med Univ, Joint Int Res Lab Reprod & Dev Minist Educ China, Chongqing 400010, Peoples R China; [Hu, Lina] Reprod & Stem Cell Therapy Res Ctr Chongqing, Chongqing 400010, Peoples R China; [Hu, Lina] Chongqing Med Univ, Infect & Immun Clin Study Overseas Expertise Intro, Chongqing 400010, Peoples R China"

通信作者："Zhang, S; Hu, LA (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Obstet & Gynecol Dept, Chongqing 400010, Peoples R China.; Zhang, S; Hu, LA (通讯作者)，Chongqing Med Univ, Joint Int Res Lab Reprod & Dev Minist Educ China, Chongqing 400010, Peoples R China.; Hu, LA (通讯作者)，Reprod & Stem Cell Therapy Res Ctr Chongqing, Chongqing 400010, Peoples R China.; Hu, LA (通讯作者)，Chongqing Med Univ, Infect & Immun Clin Study Overseas Expertise Intro, Chongqing 400010, Peoples R China."

来源：JOURNAL OF ASSISTED REPRODUCTION AND GENETICS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001171364200002

JCR分区：Q1

影响因子：3.2

年份：2024

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Frozen embryo transfer; Vaginal microecology; Clinical pregnancy; Endometrial microbiota; Assisted reproductive technologies

摘要："PurposeThis prospective study investigates the correlation between vaginal microecology and pregnancy outcomes and explores their impact on endometrial microbiota composition during frozen embryo transfer (FET) cycles. Additionally, the impact of transvaginal Lactobacillus supplementation on reproductive outcomes in patients with previous failed cycles was assessed.MethodsA total of 379 patients undergoing FET at a reproductive medicine center were categorized into clinical pregnancy (CP), miscarriage (MISC), and non-pregnant (NP) groups. Vaginal specimens were collected for microecological evaluation prior to embryo transfer. Endometrial microbiota samples were obtained during embryo transfer for 16S rRNA gene sequencing analysis to assess endometrial microbiota composition. Vaginal microecological indicators, including pH, Lactobacillus dominance, and leukocyte esterase activity, were measured. Transvaginal Lactobacillus supplementation was investigated in 60 patients with previous failed cycles.ResultsVaginal microecology significantly correlated with pregnancy outcomes, with normal microecology associated with a higher clinical pregnancy rate. Vaginal pH and leukocyte esterase activity were significantly associated with clinical pregnancy. Furthermore, vaginal microecological differences significantly impacted endometrial microbiota composition. However, no significant differences were observed in endometrial microbiota composition among the CP, MISC, and NP groups. Notably, transvaginal Lactobacillus supplementation increased the clinical pregnancy rate without affecting the miscarriage rate.ConclusionThis study highlights that normal vaginal microecology, characterized by lower pH and leukocyte esterase negativity, is associated with a higher likelihood of clinical pregnancy following FET. Importantly, vaginal microecological differences influence endometrial microbiota composition. Moreover, transvaginal Lactobacillus supplementation appears promising in improving clinical pregnancy rates in patients with previous failed cycles. These findings contribute to a better understanding of the interplay between vaginal and endometrial microbiota and offer potential interventions to enhance reproductive success in assisted reproductive technologies."

基金机构：National Natural Science Foundation of China

基金资助正文："The authors express gratitude to Zhi Yuan, Chengguang Sun, and Hongliang Yi for collection and handling of endometrial microbiota samples."