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The effect of normalizing vaginal microbiome using Lactovag in improving pregnancy outcomes in frozen embryo transfer cycles: a randomized clinical trial

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Introduction

Successful frozen-thawed embryo transfer (FTET) depends on multiple factors among which the woman’s vaginal microbiota has recently been considered important. Using probiotic products, such as Lactovag in infertile women, the vaginal microbiome can become close to the healthy status.

Objectives

The aim of this study was to evaluate the effect of Lactovag on normalizing vaginal microbiome, as well as its role in improving pregnancy outcomes in FTET cycles.

Patients and methods

This randomized blinded clinical trial was conducted on 103 patients undergoing Assisted Reproductive Technology (ART) treatment at a tertiary university-based hospital between January and August of 2019. In the experiment group, the vaginal suppository Lactavag was prescribed, whereas in the control group, patients did not receive any microbiome supplements. Then, the pregnancy rate was compared in the two groups.

Results

There were no significant differences in baseline characteristics between the two study groups (p > 0.05). Positive B hCG was present in 28% (n = 26) of women, clinical pregnancy was achieved in 23.4% (n = 22) of them and fetal heart rate was detected in 21.3% (n = 20). These proportions were higher in the Lactovag group, although these differences were not significant (p > 0.05). Results showed that although transferring fetuses with grade A increased the odds of pregnancy with 1.53 (p = 0.001) folds, this ratio would be improved using Lactovag;1.68 (P value = 0.008).

Conclusions

It seems that the vaginal microbiota critically interplays with women's health and reproduction. A probiotic agent such as Lactovag can be useful in normalizing this environment and improving pregnancy outcomes in infertile women.

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Data availability

The data is available per request from corresponding author.

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Funding

No funding was received for conducting this research.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Fatemeh Davari Tanha, Zohre Rahmani, Zahra Rezaei, Firouzeh Akbari Asbagh, Mahbod Ebrahimi & Elham Feizabad

  2. Department of OBS & GYN & Reproductive Endocrinology, Vali-asr Health Research Center, Vali-asr Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Fatemeh Davari Tanha

  3. Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Samaneh Hosseini Quchani

  4. Department of Community Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Elham Feizabad

  5. Zabol Medicinal Plants Research Center, Zabol University of Medical Sciences, Zabol, Iran

    Zahra Shahraki

Authors
  1. Fatemeh Davari Tanha
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Contributions

All authors passed four criteria for authorship contribution based on recommendations of the International Committee of Medical Journal Editors. FD and ZRa participated in the Conception and design of the study, library searches and assembling relevant literature, critical review of the paper, supervising the writing of the paper, and Database management. ZRe, FA, ME, SH and EF participated in Data collection, library searches and assembling relevant literature, writing the article, and critical review of the report. All Authors read and approved the final version of the manuscript.

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Correspondence to Zahra Shahraki.

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Tanha, F.D., Rahmani, Z., Rezaei, Z. et al. The effect of normalizing vaginal microbiome using Lactovag in improving pregnancy outcomes in frozen embryo transfer cycles: a randomized clinical trial. Arch Gynecol Obstet 308, 1587–1592 (2023). https://doi.org/10.1007/s00404-023-07147-w

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