Department of Gynecology and Obstetrics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, P.R. China.
Department of Gynecology and Obstetrics, Huaian Maternal and Child Health Care Hospital, Huai'an, Jiangsu, P.R. China.
Am J Reprod Immunol. 2022 Aug;88(2):e13543. doi: 10.1111/aji.13543. Epub 2022 Apr 11.
To investigate how asymptomatic bacterial imbalance affects the clinical pregnancy rate after artificial insemination with the husband's semen (AIH).
This study included married heterosexual couples who underwent AIH. According to the follow-up results, participants were divided into the pregnancy and non-pregnancy groups. Based on the first 10 pair participants in each group with vaginal flora bacterial 16S rRNA sequencing results, six semen samples received bacterial-sperm mixed test. Moreover, 34 cytokines were detected in the peripheral blood sera of the first three pairs by high-throughput Luminex, which were verified in vaginal secretions, cervical mucus, and blood sera from the first 200 pairs by ELISA.
The results of the 16S sequencing of vaginal secretions showed that compared with the pregnant group, the non-pregnant group had a significantly increased bacterial species diversity, which was mainly manifested by a decrease in Lactobacillus crispatus and an increase in Prevotella bivia. When Prevotella bivia or Lactobacillus crispatus were mixed with sperms, the sperm motility was decreased (p < .05). The vaginal posterior fornix secretions, cervical mucus, and peripheral blood sera of the non-pregnant group showed decreased levels of MIP-1α and increased levels of IL-17A (p < .05).
The imbalance of vaginal flora leading to the increase of Prevotella bivia and the decrease of Lactobacillus crispatus may cause an imbalance of immune regulation. Low expression of MIP-1α and high expression of IL-17A were associated with reduced clinical pregnancy rate in AIH.
研究丈夫精液人工授精（AIH）后无症状细菌失衡如何影响临床妊娠率。
本研究纳入了行 AIH 的已婚异性恋夫妇。根据随访结果，将参与者分为妊娠组和非妊娠组。根据每组前 10 对参与者的阴道菌群 16S rRNA 测序结果，对 6 份精液样本进行细菌-精子混合试验。此外，通过高通量 Luminex 检测前 3 对参与者外周血清中的 34 种细胞因子，并通过 ELISA 验证前 200 对参与者的阴道分泌物、宫颈黏液和血清中的细胞因子。
阴道分泌物 16S 测序结果显示，与妊娠组相比，非妊娠组的细菌物种多样性显著增加，主要表现为乳杆菌脆杆菌减少和普雷沃氏菌增多。当普雷沃氏菌或乳杆菌脆杆菌与精子混合时，精子活力下降（p<0.05）。非妊娠组阴道后穹窿分泌物、宫颈黏液和外周血清中 MIP-1α 水平降低，IL-17A 水平升高（p<0.05）。
阴道菌群失衡导致普雷沃氏菌增加和乳杆菌脆杆菌减少可能引起免疫调节失衡。MIP-1α 低表达和 IL-17A 高表达与 AIH 临床妊娠率降低有关。
