In recent years, the vaginal microbiome has emerged as an important factor in understanding reproductive health, providing valuable insights into fertility success and outcomes. A balanced vaginal microbiome, characterised by a predominance of beneficial bacteria like Lactobacilli, is essential for maintaining reproductive well-being and reducing the risk of complications such as miscarriage. Lactobacilli produce lactic acid and maintain a protective acidic pH in the vagina, acting as a defence mechanism against pathogens.
The Importance of a Healthy Vaginal Microbiome
Research has underscored the significance of a healthy vaginal microbiome in fertility outcomes. Studies have demonstrated that individuals with a healthy vaginal microbiome, rich in Lactobacilli, tend to experience higher rates of fertility success and lower incidences of pregnancy complications. Women exhibiting a dominant Lactobacillus vaginal microbiota (≥ 90%) tend to experience higher success rates in both term pregnancy and live birth. Conversely, a non-predominant presence (<90%) of the Lactobacillus genus correlates directly with an increased likelihood of miscarriage and decreased implantation success following embryo transfers.
To maintain a healthy vaginal microbiome, prioritise a balanced lifestyle – a nutritious diet, plenty of water, regular exercise, abstaining from smoking and alcohol, managing stress and practising good hygiene.
Understanding Dysbiosis
Dysbiosis refers to an imbalance or disruption in the normal composition of microorganisms within a particular environment. In the context of the vagina, dysbiosis typically involves a decrease in beneficial bacteria like Lactobacilli and an increase in harmful bacteria. This imbalance can lead to various adverse outcomes, including increased susceptibility to infections and complications during pregnancy. Women at risk of an unbalanced vaginal microbiome include those with recurrent infections like thrush and bacterial vaginosis and recent antibiotic use. Age and reducing oestrogen levels also impact the vaginal microbiome.In reproductive health, dysbiosis in the vaginal microbiome has been associated with reduced fertility success and higher risks of pregnancy complications.
Maintaining a Healthy Vaginal Microbiome
We now know that maintaining a healthy vaginal microbiome is important for supporting reproductive health and fertility outcomes. So how do we do this?
Lifestyle factors, including wearing breathable underwear and practising good hygiene habits, avoiding scented soaps and excess douching can help support a balanced vaginal microbiome. Additionally, dietary choices rich in fibre, polyphenols, and prebiotics can promote the growth of beneficial bacteria like Lactobacilli as well as regular exercise, abstaining from smoking and alcohol, managing stress and practising good hygiene.
Regular monitoring of the vaginal microbiome through testing allows individuals to identify dysbiosis early and take proactive steps to restore microbial balance, thereby optimising reproductive health and fertility success.There are many companies that offer at home testing kits and there are many pharmaceutical companies that can support vaginal microbiome with the right choice of probiotic supplements.
In summary, the vaginal microbiome plays a pivotal role in reproductive health, with dysbiosis potentially impacting fertility outcomes and pregnancy complications. Understanding and maintaining a healthy vaginal microbiome is essential for supporting overall reproductive well-being
References
Koedooder R, et al (2019).The vaginal microbiome as a predictor for outcome of in vitro fertilisation with or without intracytoplasmic sperm injection: a prospective study. Hum Reprod. 2019 Jun 4;34(6):1042-1054 PMID: 31119299.
Souza SV,et al (2023). Vaginal microbioma and the presence of Lactobacillus spp. as interferences in female fertility: A review system. JBRA Assist Reprod. 2023 Sep 12;27(3):496-506 PMID: 37417853
Thanaboonyawat I et al (2023) Pregnancy outcomes after vaginal probiotic supplementation before frozen embryo transfer: a randomised controlled study. PMID: 37482568