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Endometrial microbiota and its impact on fertility

Endometrial microbiota and its impact on fertility

Our body is full of micro-organisms, which can bring us many benefits, although sometimes, due to hormonal imbalance or infection, they can become unstable and damage our organism. The endometrial microflora, for example, can play a very important role in influencing the implantation of the embryo and the success of the pregnancy.

The micro-organisms that live in our bodies can help us carry out many of the physiological functions we need to perform. Bacteria and other types of micro-organisms can, however, be a direct cause of infertility. We are talking about bacteria that cause diseases such as gonorrhoea, chlamydia or genital tuberculosis.

For some time now, this issue has been gaining momentum, especially since technological advances have made assisted reproduction a revolution in the world of fertility. For this reason, it is now possible to detect bacteria that were previously unknown and analyse them to see how they act, what their function is and whether they can affect a woman’s fertility.

Those women, who are undergoing assisted reproduction treatments because of fertility problems, 40% have alterations in their vaginal flora.

When a woman is healthy, her reproductive system is dominated by the so-called Lactobacillus, bacteria that protect the woman by creating an acidic pH that does not allow other bacteria to grow and develop. A woman’s endometrium has this Lactobacillus-dominated microbiome, but after a hormonal change, new bacteria can appear and damage fertility and reproductive health. There may be other factors that cause the microbiome to change, such as smoking, sexual activity, contraception or chemicals.

There are also diseases or disorders, such as endometriosis or PCOS, that are influenced by the balance of both the vaginal and gut microbiota. Ailments that can affect a woman’s fertility, as we have discussed in previous articles.

What can cause an infection or disruption of bacteria in the vagina?

• Problems conceiving.

• Increased risk of miscarriage.

• Increased risk of rupture of the membranes and premature delivery.

• Alteration in the receptivity of the endometrium and, therefore, greater difficulty for the embryo to attach properly. It has recently been discovered that the uterine cavity is not a sterile area, as previously thought. It has therefore been observed that the endometrium can influence the ability of an embryo to implant.

• The microbiome may influence sperm quality.

• Affecting follicular development, in some cases inhibiting the response to sex hormones.

Endometrial microbiotics during assisted reproductive processes

When a woman undergoes assisted reproduction treatment, such as IVF, she may suffer from an alteration of the vaginal microbiome, due to the changes caused by the hormonal stage, an important phase in the treatment.

In many cases, the presence of certain microorganisms in the cervix and uterine cavity determines the success of embryo implantation in the endometrium. We are talking about a higher success rate. Thus, the fewer germs and the more lactobacilli you have, the more successful the results will be. Therefore, if there are more than 10 % of bacteria other than Lactobacillums, the chances of implantation, pregnancy and birth will be lower.

Therefore, if pregnancy is not achieved in the first cycles, it is important to study whether the hormonal stimulation or the antibiotics used may be affecting the microbiome and, consequently, fertility.

However, there are endometrial tests that can detect certain alterations in the endometrial microbiota. Thanks to this detection, we can carry out a treatment with probiotics or antibiotics that help and have a positive effect on the pregnancy rate of our fertility treatments.

At Reproclinic we have a team of experts, with extensive experience in the world of fertility and assisted reproduction, who will analyse all the possible causes of your fertility problems. Furthermore, through our assisted reproduction treatments, we will make your dreams come true!