阴道微生物组及其与辅助生殖的关系:系统性审查和元分析
Marise Samama1,2, Joji Ueno2,3, Eduardo Carvalho de Arruda Veiga2,3
1Department of Gynecoloy, Escola Paulista de Medicina, Federal University of São Paulo-UNIFESP, São Paulo 04024-002, Brazil.
Life (Basel, Switzerland)
|September 27, 2025
概括
良好的阴道微生物群,特别是丰富的乳酸菌,显著改善了接受辅助生殖技术的妇女的怀孕和活产率. 这凸显了微生物组在繁殖成功中的关键作用.
科学领域:
- 生殖科学 生殖科学
- 微生物组研究 微生物组研究
- 临床产科和妇科 临床产科和妇科
背景情况:
- 阴道微生物组组成是接受辅助生殖技术 (ART) 的女性生殖结果的关键决定因素.
- 了解阴道微生物群与ART成功之间的联系对于改善生育治疗至关重要.
研究的目的:
- 系统地审查和分析证据,证实有利的阴道微生物组与不利的微生物组相比,与优越的生殖结果有关.
- 确定与成功怀孕相关的特定微生物特征,例如乳酸菌的丰富性.
主要方法:
- 在PubMed和MEDLINE中使用"阴道微生物组"和"繁殖"等关键词,对过去10年内发表的研究进行系统审查和元分析.
- 包括1735个记录,将参与者分为有利和不利的阴道微生物组组.
- 用多变量关联与线性模型 (MaAsLin2) 来进行物种级分类学分辨率的56名女性队列的生物信息分析.
主要成果:
- 与阴道微生物组不利的女性相比,具有良好的阴道微生物组的女性的怀孕率 (RR: 1.59) 和活产率 (RR: 1.41) 显著更高.
- 在具有有利微生物组的妇女中观察到明显较低的流产率 (RR:0.65).
- 生物信息分析显示,高相对丰富的Lactobacillus crispatus与怀孕的可能性增加六倍有关.
结论:
- 一个有利的阴道微生物组,以高丰富的Lactobacillus crispatus为特征,与改善的生殖结果密切相关,包括更高的临床怀孕和活产率.
- 这些发现强调了阴道微生物组在ART成功中的重要性,并建议治疗干预的潜在目标.
- 尽管有积极的关联,但分析指出,所包含的研究中存在低质量的偏差,这需要谨慎的解释.
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