Franasiak J M, Werner M D, Juneau C R, Tao X, Landis J, Zhan Y, Treff N R, Scott R T
Division of Reproductive Endocrinology, Department of Obstetrics Gynecology and Reproductive Sciences, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA.
Reproductive Medicine Associates of New Jersey, 140 Allen Road, Basking Ridge, NJ, 07920, USA.
J Assist Reprod Genet. 2016 Jan;33(1):129-36. doi: 10.1007/s10815-015-0614-z. Epub 2015 Nov 7.
Characterization of the human microbiome has become more precise with the application of powerful molecular tools utilizing the unique 16S ribosomal subunit's hypervariable regions to greatly increase sensitivity. The microbiome of the lower genital tract can prognosticate obstetrical outcome while the upper reproductive tract remains poorly characterized. Here, the endometrial microbiome at the time of single embryo transfer (SET) is characterized by reproductive outcome.
Consecutive patients undergoing euploid, SET was included in the analysis. After embryo transfer, performed as per routine, the most distal 5-mm portion of the transfer catheter was sterilely placed in a DNA free PCR tube. Next-generation sequencing of the bacteria specific 16S ribosome gene was performed, allowing genus and species calls for microorganisms.
Taxonomy assignments were made on 35 samples from 33 patients and 2 Escherichia coli controls. Of the 33 patients, 18 had ongoing pregnancies and 15 did not. There were a total of 278 different genus calls present across patient samples. The microbiome at time of transfer for those patients with ongoing pregnancy vs. those without ongoing pregnancy was characterized by top genera by sum fraction. Lactobacillus was the top species call for both outcomes.
The data presented here show the microbiome at the time of embryo transfer can successfully be characterized without altering standard clinical practice. This novel approach, both in specimen collection and analysis, is the first step toward the goal of determining physiologic from pathophysiologic microbiota. Further studies will help delineate if differences in the microbiome at the time of embryo transfer have a reliable impact on pregnancy outcome.
随着利用独特的16S核糖体亚基高变区的强大分子工具的应用，人类微生物组的特征描述变得更加精确，从而大大提高了灵敏度。下生殖道微生物组可以预测产科结局，而上生殖道微生物组的特征仍知之甚少。在此，通过生殖结局对单胚胎移植（SET）时的子宫内膜微生物组进行特征描述。
分析纳入接受整倍体SET的连续患者。按照常规进行胚胎移植后，将移植导管最远端5毫米的部分无菌放入无DNA的PCR管中。对细菌特异性16S核糖体基因进行下一代测序，以确定微生物的属和种。
对来自33名患者的35个样本和2个大肠杆菌对照进行了分类学鉴定。33名患者中，18名有持续妊娠，15名没有。患者样本中共有278种不同的属。通过总和分数按优势属对有持续妊娠的患者与无持续妊娠的患者移植时的微生物组进行了特征描述。两种结局中最常见的菌种都是乳酸杆菌。
此处呈现的数据表明，在不改变标准临床实践的情况下，可以成功地对胚胎移植时的微生物组进行特征描述。这种在标本采集和分析方面的新方法是朝着从病理生理微生物群中确定生理微生物群这一目标迈出的第一步。进一步的研究将有助于确定胚胎移植时微生物组的差异是否对妊娠结局有可靠影响。
