Kyono Koichi, Hashimoto Tomoko, Kikuchi Suguru, Nagai Yoko, Sakuraba Yoshiyuki
Kyono ART Clinic Takanawa Tokyo Japan.
Varinos Inc. Tokyo Japan.
Reprod Med Biol. 2018 Oct 25;18(1):72-82. doi: 10.1002/rmb2.12250. eCollection 2019 Jan.
The present study aimed to analyze the pregnancy outcomes of IVF patients presenting -dominated microbiota (LDM) or non--dominated microbiota (NLDM) of their endometrium and to report cases who were treated for NLDM concurrently with antibiotics and prebiotic/probiotic supplements in a Japanese infertile population.
Ninety-two IVF patients were recruited from August 2017 to March 2018. Endometrial fluid samples for sequencing were collected using an IUI catheter. The bacterial status of the endometrium and the pregnancy outcomes were analyzed. For cases with NLDM, antibiotics and prebiotics/probiotics were administered according to their individual microbial conditions.
Forty-seven cases (51.1%) presented LDM and 45 cases (48.9%) presented NLDM at initial analysis. Nine Patients with NLDM were treated by antibiotics and prebiotics/probiotics, and successfully became -dominant. Pregnancy rates by single vitrified-warmed blastocyst transfers were higher in the LDM group (58.9% per patient and 36.3% per FBT) than in the NLDM group (47.2% per patient and 34.7% per FBT) but not significantly different.
The results of this study could not necessarily prove the clear benefit of establishing -dominated endometrium in terms of pregnancy outcome, but there is significance in searching for endometrial microbial status of infertile patients and recovering -dominated endometrium might benefit implantation.
本研究旨在分析子宫内膜呈现以某种微生物为主导(LDM)或非以某种微生物为主导(NLDM)的体外受精(IVF)患者的妊娠结局,并报告在日本不孕人群中同时接受抗生素及益生元/益生菌补充剂治疗的NLDM患者病例。
2017年8月至2018年3月招募了92例IVF患者。使用宫内人工授精(IUI)导管收集用于测序的子宫内膜液样本。分析子宫内膜的细菌状况及妊娠结局。对于NLDM病例,根据其个体微生物状况给予抗生素及益生元/益生菌。
初始分析时,47例(51.1%)呈现LDM,45例(48.9%)呈现NLDM。9例NLDM患者接受了抗生素及益生元/益生菌治疗,并成功转变为以某种微生物为主导。LDM组单囊胚冻融移植的妊娠率(每位患者58.9%,每次冻融移植36.3%)高于NLDM组(每位患者47.2%,每次冻融移植34.7%),但差异无统计学意义。
本研究结果不一定能证明在妊娠结局方面建立以某种微生物为主导的子宫内膜有明显益处,但对不孕患者子宫内膜微生物状况进行检测具有重要意义,恢复以某种微生物为主导的子宫内膜可能有利于着床。