The Vaginal Microbiome: Patient- versus Physician-Collected Microbial Swab: A Pilot Study

The composition of the vaginal microbiota prior to an IVF/IVF-ICSI treatment can predict the chance of achieving a pregnancy. To improve clinical applicability and be more patient-friendly, the self-collection of vaginal samples would be preferable. However, the reliability of patient-collected samples compared to physician-collected samples remains unclear. This study compares microbiome outcomes from patient-collected versus physician-collected vaginal samples. This is a prospective pilot study consisting of two cohorts: Cohort I involved patient self-sampling of the vagina, followed by a physician-collected vaginal swab, while Cohort II involved the reversed order of collection. The interspace profiling (IS-Pro) technique was used to analyze the microbiota composition in all samples. From May 2021 to March 2022, a total of 444 samples were collected from n = 222 patients (aged 21-44 years), with Cohort I (n = 109) and Cohort II (n = 113). The vaginal microbiome composition of both cohorts was highly similar, regardless of the sampling order, with a mean cosine similarity of 0.93 (95% CI 0.91, 0.95) in Cohort I and 0.94 (95% CI 0.92, 0.96) in Cohort II. Furthermore, ANOVA analysis revealed no significant differences in bacterial species abundance between physician- and patient-collected samples, nor between first and second sample collections. The self-collection of vaginal samples can be considered comparable to physician-collected samples and indicates a more patient-friendly and convenient collection of the vaginal microbiome in an outpatient clinical setting.