Keywords
assisted reproduction treatments
EMMA®
ALICE ®
probiotics
antibiotics
How to Cite
Abstract
Study question: Isthere a relation ship between endometrial microbiota dysbiosis and unfavorable outcomes in assisted reproductive treatments (ART)? SummaryAnswer: 64% ofpatients with endometrial dysbiosis and failed ART achieved positive outcomes in new attempts after receiving specific antibiotic treatment and a probiotic regimen, suggesting that personalized correction of the endometrial microbiota could be aneffective strategy to improve success rates. What is known?: Thereis a relation ship between reproductive tract dysbiosis, characterized by reduced lactobacilliand pathogenic bacterial growth, and several pathologies. During pregnancy, a healthy vaginal microbiota isassociated with low bacterial diversity and a predominance of Lactobacillusspp. However, there is limited information regarding the impact of endometrial dysbiosis on ART outcomes. Study design: Cross-sectional,observational study Materials and Methods: Nineteen patients from the HAVVA Center forGynecological Medicine and Fertility in Paraná, Entre Ríos, with more than two failed ART attempts, were selected between August 2022 and April 2024. The EMMA® and ALICE®tests (Igenomix) were analyzed to assess endometrial health and the presence of chronic endometritis, respectively. Patients with abnormal results received antibiotic and probiotic treatment. These outcomes were then correlated with the evolutionary pregnancy rate in a new ART attempt. Results: 74% of the patients showed pathological results in at leastone test. Following the intervention with specific antibiotics and probiotics to restore the microbiota, 43% of the treated patients achieved subsequent successful embryo transfers, resulting in ongoing pregnancies or live births to date. Study limitations: The small sample size,the lack of consideration of other factors or aspects of reproductive health, and the exclusive use ofthe EMMA® and ALICE ®tests as sole indicators of endometrial health. Embryo selection was based solely on morphokinetic assessment. Preimplantation genetic testing for aneuploidy (PGT-A) was not performed.
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