Entries in fertility (2)

Thursday
Feb162017

New fertility treatment

There is no human life without beneficial bacteria. There is no conception, implantation and fetal growth without the right set of beneficial vaginal, cervical, placental bacteria.

Fertility and pregnancy success may be greatly enhanced by vaginal microbiome transplantation from healthy young pregnant women.

 

 

Hum Reprod. 2016 Apr;31(4):795-803. doi: 10.1093/humrep/dew026. Epub 2016 Feb 23.

Abnormal vaginal microbiota may be associated

with poor reproductive outcomes:

a prospective study in IVF patients.

Abstract

STUDY QUESTION:

What is the diagnostic performance of qPCR assays compared with Nugent scoring for abnormal vaginal microbiota and for predicting the success rate of IVF treatment?

SUMMARY ANSWER:

The vaginal microbiota of IVF patients can be characterized with qPCR tests which may be promising tools for diagnosing abnormal vaginal microbiota and for prediction of clinical pregnancy in IVF treatment.

WHAT IS KNOWN ALREADY:

Bacterial vaginosis (BV) is a common genital disorder with a prevalence of approximately 19% in the infertile population. BV is often sub-clinical with a change of the vaginal microbiota from being Lactobacillus spp. dominated to a more heterogeneous environment with anaerobic bacteria, such as Gardnerella vaginalis and Atopobium vaginae. Few studies have been conducted in infertile women, and some have suggested a negative impact on fecundity in the presence of BV.

STUDY DESIGN, SIZE, DURATION:

A cohort of 130 infertile patients, 90% Caucasians, attending two Danish fertility clinics for in vitro fertilization (IVF) treatment from April 2014-December 2014 were prospectively enrolled in the trial.

PARTICIPANTS/MATERIALS, SETTING AND METHODS:

Vaginal swabs from IVF patients were obtained from the posterior fornix. Gram stained slides were assessed according to Nugent's criteria. PCR primers were specific for four common Lactobacillus spp., G. vaginalis and A. vaginae. Threshold levels were established using ROC curve analysis.

MAIN RESULTS AND THE ROLE OF CHANCE:

The prevalence of BV defined by Nugent score was 21% (27/130), whereas the prevalence of an abnormal vaginal microbiota was 28% (36/130) defined by qPCR with high concentrations of Gardnerella vaginalis and/or Atopobium vaginae. The qPCR diagnostic approach had a sensitivity and specificity of respectively 93% and 93% for Nugent-defined BV. Furthermore, qPCR enabled the stratification of Nugent intermediate flora. Eighty-four patients completed IVF treatment. The overall clinical pregnancy rate was 35% (29/84). Interestingly, only 9% (2/22) with qPCR defined abnormal vaginal microbiota obtained a clinical pregnancy (P = 0.004).

LIMITATIONS, REASONS FOR CAUTION:

Although a total of 130 IVF patients were included in the study, a larger sample size is needed to draw firm conclusions regarding the possible adverse effect of an abnormal vaginal microbiota in relation to the clinical pregnancy rate and other reproductive outcomes.

WIDER IMPLICATIONS OF THE FINDINGS:

Abnormal vaginal microbiota may negatively affect the clinical pregnancy rate in IVF patients. If a negative correlation between abnormal vaginal microbiota and the clinical pregnancy rate is corroborated, patients could be screened and subsequently treated for abnormal vaginal microbiota prior to fertility treatment.

STUDY FUNDING/COMPETING INTERESTS:

This study was funded by The AP Møller Maersk Foundation for the advancement of Medical Science and Hospital of Central Jutland Research Fund, Denmark. No competing interests.

TRIAL REGISTRATION NUMBER:

The project was registered at clinicaltrials.gov (file number NCT02042352).

 

 

Wednesday
Mar092016

NOVEL TREATMENT FOR LOW FERTILITY AND PRETERM  BIRTH

Breaking news in fertility research, infant and reproductive health:
Semin Fetal Neonatal Med. 2016 Feb 26. pii: S1744-165X(16)00020-2. doi: 10.1016/j.siny.2016.02.004. [Epub ahead of print]



Maternal microbiome



Despite great medical advances in preventing maternal and infant mortality in the past century, one issue remains unresolved: why do so many women give birth prematurely? A major new field of human microbiome studies has begun to shed light on the impact of microbes (of both the commensal and pathogen varieties) on pregnancy outcomes. Recent advances in next-generation sequencing and metagenomic analysis have revealed that maternal microbiomes at a variety of niches including the oral, vaginal, gut, cervical, and even the placenta itself govern pregnancy outcomes. In this review, we describe how alterations in the microbial biomasses impact preterm birth and we discuss the major research questions concerning the cause and/or interdependent relationships between microbiome, infection, and preterm delivery.



 

We offer gut microbiome exchange (transplantation) as novel opportunity for lifespan extension, prevention and treatment of various and so far difficult to treat ailments (auto-immune diseases, multiple sclerosis, vision loss due to uveitis, metabolic disorders, neuro-psychiatric diseases, Parkinson and addictions, cardiovascular disease, endocrine disorders and low fertility, cancer).

 

PD Dr. med. Rainer Arendt
FMH Cardiology, Internal Medicine
Regenerative Medicine 

SWISS  PREVENTION  CLINIC
Klausstrasse 10
CH-8008 ZURICH
T +41 43 336 7260
M +41 78 825 0803
F +41 43 336 7261

rainer.arendt@swisspreventionclinic.ch

www.swisspreventionclinic.ch
www.patientcircle.org