The Role of Vaginal Microbiota Changes on Infertility: A Review Study Publisher



S Maleki SHEKOFEH ; M Savabi MITRA
Source: Iranian Journal of Obstetrics, Gynecology and Infertility Published:2025

Abstract

Introduction: Infertility, as a public health problem, has numerous consequences on mental, psychological, and physical health of couples. Since various types of bacterial infections of the genitourinary tract play an important role in disrupting the vaginal microbiota, it has gained great clinical importance as one of the causes of infertility. The present study was conducted with aim to investigate the role of changes in the vaginal microbiota on infertility using a literature review. Methods: This review study was conducted by searching in the databases of Irandoc, Magiran, SID, Iranmedex, Cochrane, Scopus, ISI Web of Science, PubMed, Science Direct, and Google Scholar (as a search engine) using the keywords of vaginal microbiota, bacterial vaginitis, bacterial agent, vaginal flora, reproductive health, women, and their Persian equivalents. Studies published in English or Persian between 2000 and 2022 were reviewed. The quality of the articles was assessed using the CONSORT checklist. Out of 153 studies, 24 were ultimately selected for final evaluation. Results: Vaginal bacterial factors by disrupting the balance through decreasing the prevalence of lactobacilli and increasing the prevalence of anaerobic bacteria in the vaginal microbiota lead to bacterial vaginosis, pelvic inflammatory disease, and chronic endometritis. Bacterial factors can play an important role in infertility through activation of the cellular immune system and production of inflammatory cytokines. Among the various causes of infertility, bacterial infections seem to have the greatest contribution to the development of infertility due to tubal causes. Conclusion: Screening for vaginal bacterial infections in women with female infertility and using therapeutic strategies to restore and regulate the vaginal microbiota can help achieve greater success in assisted reproductive treatments. Also, in this context, the development of molecular biological techniques can help us better understand the vaginal microbiota. © 2025 Elsevier B.V., All rights reserved.