Mauries C, Ranisavljevic N, Gallet R, Fournier A, Gala A, Ferrières-Hoa A, Brouillet S, Hamamah S
Département de biologie de la reproduction, CHU de Montpellier, université de Montpellier, 34000 Montpellier, France.
Département de médecine de la reproduction, CHU de Montpellier, université de Montpellier, 34000 Montpellier, France.
Gynecol Obstet Fertil Senol. 2021 Mar;49(3):185-192. doi: 10.1016/j.gofs.2020.07.005. Epub 2020 Aug 3.
The genital microbiota actively participates in women's reproductive health. Indeed, a genital dysbiosis (microbial imbalance associated with adverse effects on host health) can lead to vaginal infections (such as mycoses or bacterial vaginosis). Recent data reported that genital dysbiosis (e.g. vaginal or endometrial) was associated with fewer chances of live births in assisted reproductive technologies (ART), via decreased pregnancy rates and an increased risk of miscarriages. The presence or diversity of certain bacterial strains (in particular Gardenellavaginalis, Proteobacteria, Lactobacillusjensenii, Lactobacilluscrispatus or Atopobiumvaginae) within the genital microbiota seem to be associated with the outcomes of ART cycles, suggesting new approaches to improve ART results. In this review, we aim at presenting the state of art on the association between the female genital microbiota and ART success. The diagnostic and therapeutic approaches (i.e. probiotics, antibiotic therapy and transplantation of vaginal microbiota) in the management of patients with altered microbiota will also be discussed. The confirmation of these data in the coming years could significantly improve the management of infertile patients in ART with a more personalized approach partially based on the female genital microbiotic profile.
女性生殖微生物群积极参与女性生殖健康。事实上,生殖生态失调(与对宿主健康产生不利影响相关的微生物失衡)会导致阴道感染(如真菌病或细菌性阴道病)。最近的数据表明,生殖生态失调(如阴道或子宫内膜的)与辅助生殖技术(ART)中活产几率降低有关,这是通过降低妊娠率和增加流产风险实现的。生殖微生物群中某些细菌菌株(特别是阴道加德纳菌、变形菌门、詹氏乳杆菌、卷曲乳杆菌或阴道阿托波氏菌)的存在或多样性似乎与ART周期的结果相关,这提示了改善ART结果的新方法。在这篇综述中,我们旨在阐述女性生殖微生物群与ART成功之间关联的最新情况。还将讨论微生物群改变患者管理中的诊断和治疗方法(即益生菌、抗生素治疗和阴道微生物群移植)。未来几年对这些数据的确认可能会显著改善ART中不孕患者的管理,采用一种更个性化的方法,部分基于女性生殖微生物特征。