Ughade Prachi A, Shrivastava Deepti, Chaudhari Kamlesh
Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Aug 16;16(8):e67040. doi: 10.7759/cureus.67040. eCollection 2024 Aug.
Dysbiosis, an imbalance in microbial communities, significantly impacts the health and functionality of the human genital tract, with profound implications for fertility and reproductive health. This review explores the intricate relationship between genital tract microbiota and reproductive outcomes, highlighting the composition and dynamics of these microbial communities in both females and males. In females, the vaginal microbiota, primarily dominated by Lactobacillus species, is essential for maintaining a healthy vaginal environment, preventing infections, and supporting reproductive functions. In males, the genital microbiota influences sperm quality and reproductive health. Dysbiosis in the genital tract, manifesting as bacterial vaginosis, yeast infections, urethritis, or prostatitis, disrupts these microbial communities, leading to adverse reproductive outcomes such as infertility, pregnancy, and increased susceptibility to sexually transmitted infections. This review delves into the mechanisms through which dysbiosis affects fertility, including alterations in vaginal pH, mucosal immunity, inflammation, sperm viability, and motility. It also evaluates diagnostic methods, clinical implications, and management strategies, including probiotics, prebiotics, antibiotics, antifungal treatments, lifestyle interventions, and emerging therapeutic approaches. By understanding the microbial landscape of the genital tract and its impact on fertility, this review aims to inform targeted interventions that restore microbial balance and enhance reproductive health, ultimately improving fertility outcomes and the potential for healthy pregnancies.
微生物群落失调,即微生物群落失衡,会对人类生殖道的健康和功能产生重大影响,对生育能力和生殖健康具有深远意义。本综述探讨了生殖道微生物群与生殖结局之间的复杂关系,重点介绍了这些微生物群落在女性和男性中的组成和动态变化。在女性中,主要由乳酸杆菌属主导的阴道微生物群对于维持健康的阴道环境、预防感染和支持生殖功能至关重要。在男性中,生殖微生物群会影响精子质量和生殖健康。生殖道失调表现为细菌性阴道病、酵母菌感染、尿道炎或前列腺炎,会破坏这些微生物群落,导致诸如不孕、妊娠问题以及性传播感染易感性增加等不良生殖结局。本综述深入探讨了失调影响生育能力的机制,包括阴道pH值变化、黏膜免疫、炎症、精子活力和运动能力。它还评估了诊断方法、临床意义和管理策略,包括益生菌、益生元、抗生素、抗真菌治疗、生活方式干预以及新兴治疗方法。通过了解生殖道的微生物状况及其对生育能力的影响,本综述旨在为恢复微生物平衡和增强生殖健康的针对性干预提供依据,最终改善生育结局和实现健康妊娠的可能性。