Vaginal microbiome changes in composition throughout a woman’s lifetime. There is a delicate balance between various microbes and human cells in the vagina at all times. The delicate balance of these can be disturbed by antibiotics & medications, aging, sexual activities, and more. These can have an impact of recurring urinary tract infections, miscarriages, odor, yeast infections, and vaginal dryness, as examples.
A specific class of microbiome, called Mollicutes are implicated in causing fertility issues. Increased presence of specific bacterial taxa along with higher abundance of Candida (yeast) and reduced Lactobacillus in the vaginal microbiome, is often present in women with fertility problems. Research also confirms the vaginal microbiome as being a component that influences outcomes with IVF and assisted reproductive technology (ART).
In a healthy pregnancy, the mucous plug at the cervix blocks bacteria from ascending into the uterus. However, a subset of vaginal microbiome organisms are able to ascend to the upper genital tract and gain access to the uterus and amniotic sac during pregnancy. The subset of bacteria that do this are able to degrade hyaluronan and other amino sugars that form the matrix of cervical mucous plug. By degrading the mucous plug of the cervix, and thereby gaining access to uterus, the microbiome can act on the amniotic sac and cause preterm birth and other prenatal and postpartum complications. Microbiome testing can be useful in cases with history of preterm birth, spontaneous abortions, preterm labor, chorioamnionitis, amnionitis, and PPROM (Preterm premature rupture of membrane during pregnancy) [3].