News | Clinical evidence: Vaginal probiotics do not significantly improve the microbiome before IVF
As assisted reproductive treatment becomes more precise, the female reproductive-tract microbiome is receiving attention as another factor in IVF outcomes. A Lactobacillus-dominant vaginal microbiome has long been associated with higher pregnancy and live birth rates, while low Lactobacillus levels may reduce implantation.
Vaginal probiotics have therefore emerged as a possible treatment for dysbiosis. A new study, however, found that one vaginal probiotic capsule daily for 10 days did not improve an unfavorable microbiome. Led by Dr. Ida Engberg Jepsen of The Fertility Clinic at Zealand University Hospital, Denmark, the study was presented today at the 38th ESHRE annual meeting in Milan, Italy.
Clinical trial finds no significant difference from placebo
Conducted from April 2019 to February 2021 at a university reproductive medicine center, the study included 74 women undergoing IVF whose Lactobacillus profiles were rated low to medium.
Thirty-eight received vaginal probiotic capsules containing two Lactobacillus strains and 36 received placebo. Participants used one capsule daily for 10 days. Samples collected on cycle days 21–25 after treatment were tested for improvement.
Improvement meant moving from low to medium, medium to high, or low directly to high on the vaginal microbiome receptivity scale.
The microbiome improved in 40% of the placebo group and 29% of the probiotic group, a nonsignificant difference. Follow-up one cycle later also showed no significant difference.
Spontaneous improvement may be the key variable
Regardless of treatment, 34% of women improved naturally within one to three months. Researchers suggested that IVF might be delayed when the vaginal microbiome is unfavorable to allow possible spontaneous recovery.
“Our study shows that local vaginal Lactobacillus did not improve microbiome composition, while some patients recovered naturally after one to three months. This may inform treatment timing,” Dr. Jepsen said.
She cautioned that the probiotic contained only two Lactobacillus strains and does not represent all products. Current microbiome categories are also broad and may miss subtle but important changes.
Next steps: treatment timing and microbiome assessment need further study
Failure of this specific probiotic does not mean all probiotic treatment is ineffective. Researchers called for broader, multi-strain products and more sensitive testing methods.
Whether the vaginal microbiome should be assessed before IVF and used to guide timing is now an important clinical question.
News | Clinical evidence: Vaginal probiotics do not significantly improve the microbiome before IVF
News | Clinical evidence: Vaginal probiotics do not significantly improve the microbiome before IVF
As assisted reproductive treatment becomes more precise, the female reproductive-tract microbiome is receiving attention as another factor in IVF outcomes. A Lactobacillus-dominant vaginal microbiome has long been associated with higher pregnancy and live birth rates, while low Lactobacillus levels may reduce implantation.
Vaginal probiotics have therefore emerged as a possible treatment for dysbiosis. A new study, however, found that one vaginal probiotic capsule daily for 10 days did not improve an unfavorable microbiome. Led by Dr. Ida Engberg Jepsen of The Fertility Clinic at Zealand University Hospital, Denmark, the study was presented today at the 38th ESHRE annual meeting in Milan, Italy.
Clinical trial finds no significant difference from placebo
Conducted from April 2019 to February 2021 at a university reproductive medicine center, the study included 74 women undergoing IVF whose Lactobacillus profiles were rated low to medium.
Thirty-eight received vaginal probiotic capsules containing two Lactobacillus strains and 36 received placebo. Participants used one capsule daily for 10 days. Samples collected on cycle days 21–25 after treatment were tested for improvement.
Improvement meant moving from low to medium, medium to high, or low directly to high on the vaginal microbiome receptivity scale.
The microbiome improved in 40% of the placebo group and 29% of the probiotic group, a nonsignificant difference. Follow-up one cycle later also showed no significant difference.
Spontaneous improvement may be the key variable
Regardless of treatment, 34% of women improved naturally within one to three months. Researchers suggested that IVF might be delayed when the vaginal microbiome is unfavorable to allow possible spontaneous recovery.
“Our study shows that local vaginal Lactobacillus did not improve microbiome composition, while some patients recovered naturally after one to three months. This may inform treatment timing,” Dr. Jepsen said.
She cautioned that the probiotic contained only two Lactobacillus strains and does not represent all products. Current microbiome categories are also broad and may miss subtle but important changes.
Next steps: treatment timing and microbiome assessment need further study
Failure of this specific probiotic does not mean all probiotic treatment is ineffective. Researchers called for broader, multi-strain products and more sensitive testing methods.
Whether the vaginal microbiome should be assessed before IVF and used to guide timing is now an important clinical question.
Source:
Collected online