Revealing the interaction between intrauterine adhesion and vaginal microbiota using high‑throughput sequencing

Area of Science:

• Reproductive Medicine
• Microbiome Research
• Gynecology

Background:

• Intrauterine adhesion (IUA) is a common reproductive disease with a high recurrence rate.
• Understanding the pathogenesis and recurrence factors of IUA is crucial for effective treatment.
• Vaginal microbiota alterations may play a role in IUA development and persistence.

Purpose of the Study:

• To investigate the differences in vaginal microbiota composition between women with IUA and healthy controls.
• To identify specific bacterial species or groups associated with IUA.
• To explore the potential impact of vaginal microbiota on IUA recurrence.

Main Methods:

• High-throughput sequencing was used to analyze vaginal microbiota from IUA patients (IAVS group) and healthy women (HVS group).
• Bacterial species diversity and relative abundance were compared between the two groups.
• Principal Coordinates Analysis (PCoA) was employed to visualize microbial community structure differences.

Main Results:

• IUA did not significantly alter the total number of vaginal bacterial species.
• Patients with IUA showed a lower percentage of Firmicutes and a higher percentage of Actinobacteria compared to controls (P<0.05).
• A significant reduction in Lactobacillus was observed in ~50% of IUA patients, alongside an overgrowth of Gardnerella and Prevotella (P<0.05).

Conclusions:

• Vaginal microbiota dysbiosis, characterized by reduced Lactobacillus and increased pathogens, is associated with IUA.
• The interaction between IUA and vaginal microbiota influences vaginal diversity in IUA patients.
• Increasing vaginal Lactobacillus populations could be a therapeutic strategy to improve IUA recovery and reduce recurrence rates.