Probiotics Ineffective at Improving Poor Vaginal Health: Study | Health

The chance of pregnancy in IVF can be affected by many factors, including the type of bacteria that naturally colonizes the reproductive tract. “Good” bacteria in the form of probiotics are of increasing interest in the treatment of women with imbalances in the vaginal microbiota.

However, a new study from the ReproHealth Research Consortium Zeeland University Hospital suggests that probiotics do not improve unhealthy vaginal flora when administered vaginally in one capsule daily to patients for 10 days before fertility treatment. No significant differences were seen between these women and those taking a placebo.

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However, more than a third (34%) of all women who participated in the trial showed an improvement between one month and three months later, regardless of whether they took a probiotic or not.

On this basis, the authors suggest that it may be worth postponing fertility treatment in patients with an “unfavourable” vaginal microbiome until a normal balance is achieved.

Principal investigator Ida Engberg Jepsen of The Fertility Clinic at Zeeland University Hospital, Denmark, will present the findings today at the 38th ESHRE Annual Meeting. She said the rate of ‘spontaneous’ improvement seen among patients may provide reason for a shift in focus towards IVF timing.

He added: ‘The study indicates that administration of vaginal lactobacillus probiotics may not improve a suboptimal vaginal microbiome.

‘However, a rate of spontaneous improvement over a period of one to three months may provide the basis for an alternative therapeutic approach. The strategy would involve postponing fertility treatment until spontaneous improvement occurs, but more research is needed. The specific vaginal probiotic tested in this study had no effect on the favorability of the vaginal microbiome before IVF. But probiotics, in general, should not be ruled out yet.’

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Research has shown that pregnancy and live birth rates are higher among women whose vaginal microbiota is dominated by lactobacillus, a genus of lactic acid-producing bacteria. Conversely, those with an imbalance, or dysbiosis, where the concentration of lactobacillus is too low may have a lower chance of an embryo implanting in the uterus.

The study was conducted at a university fertility clinic between April 2019 and February 2021. A total of 74 women referred for IVF treatment were recruited. All had an abnormal lactobacillus profile ranging from low to medium quality.

The women were randomly assigned to receive vaginal probiotic capsules (n=38) or a placebo (n=36). Samples were taken to determine the effect on the vaginal microbiome after the 10-day probiotic cycle and again in the subsequent menstrual cycle (cycle days 21-25). Improvement in the vaginal microbiome was defined as a change in responsiveness profile from low to medium; low to high; and medium to high.

The results showed that the vaginal microbiome improved by 40% in the placebo group and 29% in those taking the probiotic lactobacillus. This did not represent a significant difference. Similar results were seen in the menstrual cycle after the intervention.

The authors report that only two strains of lactobacilli were contained in the probiotic samples. Furthermore, they say that broad categorization of the vaginal microbiome profile may not capture “more subtle changes” that could affect fertility.

This story has been published from a news agency source with no changes to the text. Only the headline has been changed.

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