Infertility and the microbiota

Microbiota exist virtually on every surface of the human body and plays a vital role in maintaining human health. As a significant public health issue, infertility poses a great risk to the physical and mental health of the couple and their future quality of life. Over the past decade, intensive research on the microbiota of the reproductive tract has led to the identification of microbiota in the vagina, uterus, cervix, and male testes that play a vital role in maintaining a normal pregnancy. Additionally, dysbiosis of the gut microbiota has been linked to infertility. This review summarizes the mechanisms by which dysbiosis of the reproductive tract and gut microbiota triggers infertility, focusing on dysbiosis of bacterial ecological ratios, microbiota-mediated imbalance of the immune system, inflammatory responses, and effects on signaling pathways. In addition, we discuss the significant capacity of gender-specific microbiota for diagnosis, prognosis, and treatment of infertility-associated reproductive disorders, respectively. Finally, we extensively analyze therapeutic strategies targeting the microbiota to prevent or treat infertility, laying the foundation for future customized precision medicine.