Clinic for Reproductive Medicine and Gynecological Endocrinology, Cantonal Hospital Lucerne, 6000 Lucerne, Switzerland.
Fertility Medicine and Gynaecologic Endocrinology Unit, Department Woman-Mother-Child, Lausanne University Hospital, 1011 Lausanne, Switzerland.
Int J Mol Sci. 2019 Jul 11;20(14):3405. doi: 10.3390/ijms20143405.
Bacteria colonize most of the human body, and the female genital tract is not an exception. While the existence of a vaginal microbiota has been well established, the upper genital tract has been considered a sterile environment, with a general assumption that bacterial presence is associated with adverse clinical manifestation. However, recent metagenomic studies identified specific patterns of microbiota colonizing the uterus, fallopian tubes, ovaries, and placenta. These results need confirmation and further investigations since the data are only scarce. Bacterial colonization of these sites appears different from the vaginal one, despite evidence that vaginal bacteria could ascend to the upper genital tract through the cervix. Are these bacteria only commensal or do they play a role in the physiology of the female upper genital tract? Which are the genera that may have a negative and a positive impact on the female reproductive function? The aim of this review is to critically present all available data on upper genital tract microbiota and discuss its role in human reproduction, ranging from the technical aspects of these types of analyses to the description of specific bacterial genera. Although still very limited, research focusing on genital colonization of bacteria other than the vaginal milieu might bring novel insights into physiopathology of human reproduction.
细菌定植于人体的大部分部位，女性生殖系统也不例外。阴道微生物群的存在早已得到证实，而上生殖道一直被认为是无菌环境，一般认为细菌的存在与不良的临床症状有关。然而，最近的宏基因组学研究鉴定了定植于子宫、输卵管、卵巢和胎盘的特定微生物群模式。由于数据有限，这些结果需要进一步确认和研究。尽管有证据表明阴道细菌可以通过宫颈向上生殖道迁移，但这些部位的细菌定植与阴道的情况不同。这些细菌仅仅是共生菌，还是在女性上生殖道的生理功能中发挥作用？哪些菌属可能对女性生殖功能产生负面影响和积极影响？本文旨在批判性地介绍上生殖道微生物群的所有现有数据，并讨论其在人类生殖中的作用，从这些类型分析的技术方面到特定细菌属的描述。尽管研究仍然非常有限，但关注阴道以外的生殖器官细菌定植的研究可能会为人类生殖的病理生理学带来新的见解。
