The human body contains tens of times more bacteria than cells in general. Currently, in all advanced research and international conferences, much attention is directed not only to pathogens, but to the normal human microbiome. Traditionally, it was believed that bacteria, viruses and other microorganisms that live in our body are always harmful, but this is not the case.
Microbiome (or microflora) is a collection of microorganisms that live in our body.
Thanks to genetic sequencing methods, it was possible to analyze all the microorganisms that share space with us, and this made it possible to demonstrate that they are important for the correct balance of our health.
As you and I know, several factors are necessary for successful embryo implantation, the main of which are: euploid embryo (chromosomally healthy), harmonious functioning of the endocrine system of the woman, as well as the quality of the endometrium (the inner lining of the uterine cavity), there must be no inflammatory process, polyps , nodes that deform the uterine cavity, in addition, the microflora itself, that is, the microbiome, is extremely important.
In 2016, studies were conducted that showed that women with a proven violation of the vaginal microflora had a 40% lower rate of pregnancy.
For a long time, it was believed that the uterus is a sterile environment, the closure of which is provided by cervical mucus, and its microflora changes only in case of acute infectious inflammatory diseases.
Since the discovery of Dederlein’s rods, it has been thought that they are unique to the vaginal environment and that the rest of the reproductive system is sterile. In the 1980s, positive cultures began to be reported specifically from the endometrium (the inner part of the uterine cavity). The existence of a microbiome in the uterus, fallopian tubes, and even the peritoneum has been confirmed by sequencing methods. During the menstrual cycle, the gynecological microflora tends to change.
Lactobacilli, or Dederlein’s bacilli, predominate in a woman’s vaginal microflora, but sometimes there is a change in their number, which causes a violation of this balance. In this case, opportunistic pathogens are activated and join those that can cause chronic long-term pathological processes without obvious symptoms, but with their own negative consequences (for example, chronic endometritis, which we talked about earlier).
It has now been proven that the microflora of a woman’s reproductive tract has a tremendous impact on the success of IVF programs. Modern research confirms that the uterus, like all other parts of our body, contains its own normal microflora. A woman’s reproductive system contains 9% of the body’s microflora. In 2016, the microbiome from the uterine catheter during embryo transfer was investigated for the first time.
The mechanism of transfer of microflora to the uterine cavity has not been clearly established, however, the most likely hypothesis that explains it is colonization from the vagina as a result of peristaltic movements of the muscular layer of the uterus. In addition, pathogens seep through the intestinal wall through the intestinal wall, entering the abdominal cavity, leukocytes transport them to other parts of the body, including the uterus and fallopian tubes. Considering the different origin of the gynecological microbiome, it should be taken into account that the endometrium can be inhabited not only by vaginal, but also by intestinal microflora.
Characteristic changes in the microflora of the uterine cavity have been confirmed in women with endometriosis and adenomyosis. Also, with confirmed chronic endometritis, there are changes in the microbiome that cause it. The level of chronic endometritis in women undergoing IVF is from 8 to 72%. Its connection with implantation failures or repeated pregnancy interruptions is reliable, and the treatment of chronic endometritis and the normalization of one’s own microflora significantly improve the chances of pregnancy.
Studies have confirmed that the rate of pregnancy in women whose microflora is dominated by Lactobacilli (normal vaginal microflora) is much higher than in women with microbiome disorders. The microbiome of the reproductive system, in addition to success in pregnancy, is important for providing the newborn with the correct microflora during its passage through the birth canal.
In turn, it is important to know that the correct microflora in a woman’s body depends on proper nutrition (excessive sweet environment – increasing the level of sugar consumption, pastries, pastries, gluten create favorable conditions for the rapid growth of Escherichia coli and fungal flora, but inhibit the development of beneficial lactobacilli) . It is also important to take a high-quality probiotic based on live cultures of lactobacilli. The ability to inhabit and maintain the ideal pH environment in the female body depends on the hormonal balance. Because beneficial lactobacilli can exist and restrain opportunistic flora only with the proper level of estrogen (it is he who supports the formation of glycogen, which the beneficial lactobacilli feed on and convert into lactic acid).
Improvement of the vaginal microflora helps to reduce the frequency of implantation failures, pregnancy interruptions, and also improve the effectiveness of programs with assisted reproductive technologies.