A pilot study using unique targeted testing of the urogenital microbiome has potential as a predictive test during IVF for implantation outcome

• Published in: Archives of gynecology and obstetrics Vol. 307; no. 6; pp. 1957 - 1967
• Main Authors: Evans, Gloria E., Mahajan, Vishakha, Wakeman, Sarah, Slatter, Tania, Ponnampalam, Anna P., Anderson, Trevor P., Sarwar, Makhdoom, Evans, John J.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.06.2023; Springer Nature B.V
• Subjects: Embryo Implantation; Endocrinology; Female; Fertilization in Vitro - methods; Gynecologic Endocrinology and Reproductive Medicine; Gynecology; Human Genetics; Humans; Male; Medicine; Medicine & Public Health; Microbiota; Obstetrics/Perinatology/Midwifery; Pilot Projects; Pregnancy; Pregnancy Rate; Vagina; Vagina - microbiology; IVF; Implantation rates; Urogenital microbiome; Predictive test
• ISSN: 1432-0711; 0932-0067; 1432-0711
• DOI: 10.1007/s00404-023-06987-w

Purpose This pilot study aimed to develop a methodology characterising the urogenital microbiome as a predictive test in the IVF workup. Methods Using unique custom qPCRs, we tested for the presence of specific microbial species from vaginal samples and First Catch Urines from the male. The test panel included a range of potential urogenital pathogens, STIs, ‘favourable bacteria’ ( Lactobacillus spp.) and ‘unfavourable bacteria’ (anaerobes) reported to influence implantation rates. We tested couples attending Fertility Associates, Christchurch, New Zealand for their first round of IVF. Results We found that some microbial species affected implantation. The qPCR result was interpreted qualitatively using the Z proportionality test. Samples from women at the time of Embryo Transfer who did not achieve implantation had significantly higher percent of samples that were positive for Prevotella bivia and Staphylococcus aureus compared to women who did achieve implantation. Discussion The results provide evidence that most other microbial species chosen for testing had little functional effect on implantation rates. The addition of further microbial targets (yet to be determined) could be combined in this predictive test for vaginal preparedness on the day of embryo transfer. This methodology has a substantial advantage of being affordable and easily performed in any routine molecular laboratory. This methodology is most suitable as a foundation on which to develop a timely test of microbiome profiling. Using the indicators detected to have a significant influence, these results can be extrapolated. Conclusion Using a rapid antigen test, a woman can self-sample prior to embryo transfer and obtain an indication of microbial species present which could influence implantation outcome.