Like the human gut, the female genital tract houses its own complex microbial ecosystem. Known as the vaginal microbiome, this colony of beneficial bacteria, fungi and other single cellular organisms is highly dynamic and unique to every female.
The vaginal microbiome plays an important role in maintaining vaginal health and protecting the host from disease. But if the balance of good and bad bacteria gets skewed, it can cause vaginal dysbiosis that can increase in risk of acquiring and transmitting STDs and poor birth outcomes.
To find ways to remedy serious cases of this condition, researchers at the Hvidovre University Hospital in Denmark have tested what is known as vaginal microbiota transplantation (VMT), a procedure in which vaginal secretions are collected from a donor and transplanted to the recipient.
“Vaginal dysbiosis affects approximately 16-20% of women and is associated with health issues such as infertility, pregnancy loss, preterm labour, and bacterial vaginosis,” says Dr Ana Nunes, Vice President of the Portuguese Society for Innovation in Microbiome and Probiotics.
Potential of Vaginal Microbiota Transplantation
The researchers at Hvidovre University Hospital published a case study in the eClinicalMedicine Journal of a 30-year-old woman suffering from vaginal dysbiosis and pregnancy-related complications who received a VMT. They studied the genetic makeup of microbes before and after the procedure to see how it would transform her vaginal flora.
The researchers reported a remarkable outcome, in which the VMT led to a significant shift in the woman’s vaginal microbiota, reducing harmful bacteria and increasing beneficial Lactobacillus species. This resulted in the resolution of her vaginal symptoms, and notably, she successfully became pregnant, delivering a healthy baby at full term.
“The goal of VMT is to restore the diversity, stability, normal composition, and function of the vaginal microbiota,” adds Dr Nunes.
An evolving landscape
While VMT is still an experimental medical intervention with limited evidence, its potential could be substantial. Dr Seema Goyal, an obstetrician and gynaecologist, from Ludhiana, Punjab believes that Vaginal Microbiota Transplantation could address infertility caused by vaginal dysbiosis.
She highlights that while VMT is still in the experimental stage, certain aspects of its principles are already being applied in clinical practice to enhance fertility rates. This includes the use of probiotics, particularly Lactobacillus probiotics, during in vitro fertilization cycles and the incorporation of VMT concepts into Intrauterine Insemination (IUI).
IUI is a procedure in which sperm is carefully prepared in a laboratory and introduced directly into the woman’s uterus, bypassing vaginal flora. This process aims to create a more conducive environment for successful fertilization.
“The potential of VMT in assisted reproductive technologies such as in vitro fertilization, where enhancing the vaginal microbiome before embryo transfer could enhance implantation rates and pregnancy success,” adds Dr Nunes.
Nonetheless, further research is needed to assess the safety and efficacy of VMT over extended periods. But experts believe it could be a potentially groundbreaking avenue for improving women’s reproductive health, warranting further exploration.
“Larger studies are needed to validate and further explore these connections, despite the promising potential of VMT,” says Dr Goyal.