ASSISTED REPRODUCTION TECHNOLOGIES

Journal of Assisted Reproduction and Genetics

, Volume 29, Issue 2, pp 105-115

The dynamics of the vaginal microbiome during infertility therapy with in vitro fertilization-embryo transfer

  • Richard W. HymanAffiliated withDepartment of Biochemistry, Stanford UniversityDepartment of Stanford Genome Technology Center, Stanford University
  • , Christopher N. HerndonAffiliated withDepartment of Obstetrics, Gynecology and Reproductive Sciences, University of California
  • , Hui JiangAffiliated withDepartment of Stanford Genome Technology Center, Stanford UniversityDepartment of Statistics, Stanford UniversityDepartment of Biostatistics, University of Michigan
  • , Curtis PalmAffiliated withDepartment of Biochemistry, Stanford UniversityDepartment of Stanford Genome Technology Center, Stanford University
  • , Marilyn FukushimaAffiliated withDepartment of Stanford Genome Technology Center, Stanford University
  • , Denise BernsteinAffiliated withDepartment of Obstetrics, Gynecology and Reproductive Sciences, University of California
  • , Kim Chi VoAffiliated withDepartment of Obstetrics, Gynecology and Reproductive Sciences, University of California
  • , Zara ZelenkoAffiliated withDepartment of Obstetrics, Gynecology and Reproductive Sciences, University of California
  • , Ronald W. DavisAffiliated withDepartment of Biochemistry, Stanford UniversityDepartment of Stanford Genome Technology Center, Stanford UniversityDepartment of Genetics, Stanford University
    • , Linda C. GiudiceAffiliated withDepartment of Obstetrics, Gynecology and Reproductive Sciences, University of California Email author 

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Abstract

Purpose

To determine the vaginal microbiome in women undergoing IVF-ET and investigate correlations with clinical outcomes.

Methods

Thirty patients had blood drawn for estradiol (E2) and progesterone (P4) at four time points during the IVF-ET cycle and at 4–6 weeks of gestation, if pregnant. Vaginal swabs were obtained in different hormonal milieu, and the vaginal microbiome determined by deep sequencing of the 16S ribosomal RNA gene.

Results

The vaginal microbiome underwent a transition during therapy in some but not all patients. Novel bacteria were found in 33% of women tested during the treatment cycle, but not at 6–8 weeks of gestation. Diversity of species varied across different hormonal milieu, and on the day of embryo transfer correlated with outcome (live birth/no live birth). The species diversity index distinguished women who had a live birth from those who did not.

Conclusions

This metagenomics approach has enabled discovery of novel, previously unidentified bacterial species in the human vagina in different hormonal milieu and supports a shift in the vaginal microbiome during IVF-ET therapy using standard protocols. Furthermore, the data suggest that the vaginal microbiome on the day of embryo transfer affects pregnancy outcome.

Keywords

Metagenomics Vagina Microbiome Infertility IVF Pregnancy