Dr.med.scient. Verena Stiegelbauer, MSc. BSc.
The connection between infertility and the vaginal flora
Sterility is a global phenomenon with the number of effected couples rising every year. On average, every 6th couple in Austria is unable to have children, and the exact cause is still up for debate. Unsuccessful infertility treatment is a huge mental burden for the couple. Besides advanced age as one of the main causes, the composition of the vaginal flora may also be a cause of unexplained fertility. Scientific studies have been able to show how the composition and stability of the vaginal flora differ in pregnant and non-pregnant women. This hints towards the vaginal microbiome having an impact on fertility and birth.
Vaginal flora rich in lactobacilli has a positive effect on fertility
The vaginal microbiome is made up of about 250 different species of bacteria. It is important to note that the endometrium isn’t sterile, but rather inhabited by bacteria that can have a significant impact on the sterility of a woman. Dysfunctional bacterial colonisation can inhibit the implantation of a fertilised egg, according to scientific papers.
A team of Spanish researchers studied the microbiome of the uterus for the first time and the results showed that the microbiome in the majority of healthy women consisted of over 90% Lactobacilli. The occurrence of other germs or a lack of lactobacilli can significantly reduce fertility. Interestingly, a uterus microbiome dominated by lactobacilli had a 60,7% success rate during the implantation of the embryo during the first in vitro fertilisation, whereas a microbiome with a lack of lactobacilli only had a success rate of 23,1%. The ratio of successful pregnancies dropped with a lack of lactobacilli from 70,6% to 33,3% and the number of live births dropped from 58,8% to 6,7%.
Probiotics improve the chances of success during in vitro
Over the last few years, the use of probiotics at the gynecologist has gained more importance. Especially for treating and preventing negative changes towards the vaginal flora and recurring infections of the urinary and vaginal tract. Microbiome research over the last few years has made it possible to find efficient strains of bacteria for treating gynecological diseases. Scientists clearly proved that the best form of delivery is the oral intake of probiotic bacteria which imitates the natural colonisation of the vagina with the right microbes. This immigration of probiotic bacteria from the intestines creates a reservoir of bacteria for the permanent colonisation of the vagina, unlike the use of vaginal suppositories.