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- Title
A mikrobiom és az infertilitás kérdései.
- Authors
Dóra, Vesztergom; Miklós, Sipos; 2 3 Árvai Kristóf, Illés Anett; Pál, Kósa János; Nándor, Ács
- Abstract
More and more research is aimed at investigating the microbial composition of the female reproductive tract and their role in reproduction and pregnancy. The aim of this review is to clarify the basic concepts, to present the current literature on the issue of microbiome and infertility, and to discuss possible treatment regimes in clinical practice. Full mapping of microbes has only become possible with modern molecular genetic methods, in which regeneration sequencing has been combined with traditional PCR techniques. The microbial community affects the entire female and male reproductive systems and all aspects of reproduction from gametogenesis to fertilization and embryo migration, and it also influences the success of implantation. Numerous studies suggest a strong association between some gynecological diseases and an altered (dysbiotic) endometrial microbiota. In infertility recurrent implantation failure, recurrent pregnancy loss, preterm birth, adenomyosis, chronic endometritis, dysbiotic microbiome are more common, furthermore dysfunctional endometrial bleeding, endometrial polyps, endometrial carcinoma and hyperplasia also differ in endometriosis. The development of chronic endometritis (CE) may be caused by the aberrant inflammatory immunological response induced by the dysbiotic flora and certain pathogens. In the past, the role of a dysbiotic microbiome in infertility has been underestimated however today it is considered a potential cause of infertility with unknown origin. Furthermore, it may also be the cause of recurrent implantation failure (RIF) and recurrent pregnancy loss (RPL), whose incidence can exceed 50%. In the clinical practice, broad-spectrum antibiotic therapy is the primary standard treatment of CE, but due to NGS techniques, treatment can be tailored to clinically relevant pathogens and their general antibiotic sensitivity. Furthermore, several studies have shown that antibiotic therapy has a positive effect in RIF in the presence of CE. Related to this, the use of pre- and probiotics, microbiome transplantation, or intra-uterine antibiotic infusion may also be promising approaches. It is possible that in the future the treatment of CE and uterine dysbiosis will be an integral part of infertility treatments. In the meantime, there is a need for further randomized clinical trials which examine both the advantages of antibiotic treatment and other therapies to improve reproductive outcomes in infertile women with CE.
- Publication
Magyar Nőorvosok Lapja, 2021, Vol 84, Issue 3, p128
- ISSN
0025-021X
- Publication type
Article