Mohammadi Anis, Moini Ashraf, Falsafi Sarvenaz, Feizabadi Mohammad Mehdi
Department of Microbiology, Faculty of Advanced Science and Technology, Tehran Medical Science, Islamic Azad University, Tehran, Iran.
Department of Gynecology and Obstetrics, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
J Family Reprod Health. 2025 Jun;19(2):122-127. doi: 10.18502/jfrh.v19i2.19300.
It is estimated that infertility affects approximately 9-30% of couples in their reproductive age and microorganisms may play an important role in such genital system dysfunction. The aim of this study was to investigate the presence of lactobacilli, , Enterobacteriaceae, and streptococci in the vagina, cervix and endometrium of women who referred for infertility and the healthy women who referred for oocyte donation.
The endometrial, cervical and vaginal swab specimens were collected three days after the end of menstruation and cultured to isolate lactobacilli. DNA form these specimens was extracted and subjected to quantitative real-time PCR to determine the frequency of the above bacteria. All uterine biopsy samples were tested for the presence of bacterial DNA by PCR method.
94% of uterine biopsy samples contained bacterial DNA. The frequency of lactobacilli identified by real-time quantitative PCR in these two groups was 40% (endometrial samples), 70% (cervical samples), and 80% (vaginal samples), which differed from lactobacilli isolated by the culture method. The number of lactobacilli from cervical endometrium of healthy donors was higher than in the diseased group. There was a significant difference in the mean of bacteria in the cervix and endometrium and in the cervix (p<0.05).
Considering the decrease of lactobacilli and the increase of other bacteria, it is suggested to consider the composition and number of bacteria in the genital tract of asymptomatic infertile women as one of the possible causes of infertility.
据估计，不孕症影响约9%-30%的育龄夫妇，微生物可能在这种生殖系统功能障碍中起重要作用。本研究的目的是调查因不孕前来就诊的女性以及因卵子捐赠前来就诊的健康女性的阴道、宫颈和子宫内膜中乳酸杆菌、肠杆菌科细菌和链球菌的存在情况。
在月经结束后三天采集子宫内膜、宫颈和阴道拭子标本，进行培养以分离乳酸杆菌。从这些标本中提取DNA，并进行定量实时PCR以确定上述细菌的频率。所有子宫活检样本均通过PCR方法检测细菌DNA的存在情况。
94%的子宫活检样本含有细菌DNA。通过实时定量PCR在这两组中鉴定出的乳酸杆菌频率分别为40%（子宫内膜样本）、70%（宫颈样本）和80%（阴道样本），这与通过培养方法分离出的乳酸杆菌不同。健康供体宫颈子宫内膜中的乳酸杆菌数量高于患病组。宫颈和子宫内膜中的细菌平均值与宫颈中的细菌平均值存在显著差异（p<0.05）。
考虑到乳酸杆菌减少和其他细菌增加，建议将无症状不孕女性生殖道中细菌的组成和数量作为不孕的可能原因之一。
