Features of the effect of endometrium microbiome on ART outcomes

Introduction. Infertility is a significant global health problem affecting millions of people of reproductive age. According to the World Health Organization (WHO), approximately 17.5% of the adult population suffers from infertility, which corresponds to about one in six people worldwide. The impact of endometrial bacterial communities on human reproductive function remains a subject of active discussion in the scientific community. Current evidence suggests that the composition of the endometrial microbiota may have both positive and negative effects on fertility, but the mechanisms of these interactions require further investigation.

Aim. To evaluate the features of endometrioid microbiome composition in women with infertility and repeated failed IVF programs and its impact on the outcomes of assisted reproductive technology cycles.

Materials and metods. A pilot prospective single-center non-randomized study including 53 female patients aged from 18 to 42 years with infertility and unsuccessful IVF attempts in anamnesis was conducted. Additionally, endometrial biopsy was performed from the 15th to the 25th day of the menstrual cycle in order to assess the endometrial microbiome by metagenomic analysis (MEMA).

Results. According to the results of endometrial metagenomic sequencing, 19 patients had a predominance of Lactobacillus spp., 23 had other strains, and 11 had dysbiotic disorders. Clinical pregnancy was recorded in 7 (30.4%) of the 23 patients with opportunistic microorganisms and in 8 (72.7%) of the 11 women with dysbiotic disorders after the treatment.

Conclusions. It is summarized that women who do not need treatment are 4.75 times more likely to become pregnant than women who receive therapy (p = 0.021). At the same time, the chances of pregnancy in patients who received antibiotic therapy followed by probiotic therapy were 7.7 times lower compared to patients who did not receive this treatment.

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