The Effect of Probiotic Supplementation in Intrauterine Sperm Insemination Pregnancy Rate

Background: By using probiotic products, such as Lactovag, which contain high amounts of a safe and beneficial bacterial strain, the vaginal microbiome can be near healthy in infertile women, and as a consequence, the reproductive outcomes are improved. Objectives: The present study was done to assess the effect of Lactovag on pregnancy outcomes in IUI cycles. Methods: This single-blind clinical trial was conducted on 194 infertile women who underwent IUI in the infertility clinic of Yas Hospital between December 2021 and March 2022. In the intervention group, two weeks before IUI, Lactovage suppository was prescribed once per night, while in the control group, no extra interventions were done. All the patients underwent IUI in the same way. The primary outcomes of the study were biochemical and clinical pregnancy rates. Results: The average age of women was 30.51 ± 4.6 years, ranging from 22 to 43 years. The average age of the women’s partner was 34.89 ± 4.41 years, ranging from 24 to 49 years. There were no significant differences regards the basic information of the two study groups. The most common infertility cause was polycystic ovary syndrome (40.7%). The biochemical and clinical pregnancy rate was 12.4% in the Lactovage group and 10.3% in the control group. Although the pregnancy rate improved with a Lactovage prescription, this difference was insignificant (P-value = 0.651). Conclusions: While the pregnancy rate in women with probiotic therapy was higher, it was insignificant. Future randomized studies are needed to definitively examine probiotic therapy and establish its benefit in women candidates for IUI.

[1]  M. Valadan,et al.  The Effect of the Time Interval From Sperm Processing to Intrauterine Insemination on the Pregnancy Outcomes of Infertile Women , 2022, Journal of family & reproductive health.

[2]  H. Yim,et al.  The microbiome and male infertility: looking into the past to move forward. , 2022, Human fertility.

[3]  A. Budding,et al.  Microbiome as a predictor of implantation , 2022, Current opinion in obstetrics & gynecology.

[4]  Yan Liu,et al.  Microorganisms in the reproductive system and probiotic's regulatory effects on reproductive health , 2022, Computational and structural biotechnology journal.

[5]  D. Brandon,et al.  Fetal exposure to the maternal microbiota in humans and mice. , 2019, JCI insight.

[6]  M. Kavousi,et al.  The effect of a natural vaginal product based on honey on the success of intrauterine insemination (IUI) in infertility treatment , 2019, Avicenna journal of phytomedicine.

[7]  Z. Rosenwaks,et al.  Optimizing the first-line fertility treatment , 2018, Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology.

[8]  J. Jimenez-Almazan,et al.  Evidence that the endometrial microbiota has an effect on implantation success or failure. , 2016, American journal of obstetrics and gynecology.

[9]  Christine L. Sun,et al.  Temporal and spatial variation of the human microbiota during pregnancy , 2015, Proceedings of the National Academy of Sciences.

[10]  F. Azizi,et al.  The Prevalence and Causes of Primary Infertility in Iran: A Population-Based Study , 2015, Global journal of health science.

[11]  A. Leader,et al.  Social egg freezing: risk, benefits and other considerations , 2015, Canadian Medical Association Journal.

[12]  M. Ehlers,et al.  Normal flora and bacterial vaginosis in pregnancy: an overview , 2015, Critical reviews in microbiology.

[13]  P. De Sutter,et al.  Risks associated with bacterial vaginosis in infertility patients: a systematic review and meta-analysis. , 2013, Human reproduction.

[14]  Zaid Abdo,et al.  Temporal Dynamics of the Human Vaginal Microbiota , 2012, Science Translational Medicine.

[15]  Ronald W. Davis,et al.  The dynamics of the vaginal microbiome during infertility therapy with in vitro fertilization-embryo transfer , 2012, Journal of Assisted Reproduction and Genetics.

[16]  S. Robertson,et al.  Peri‐Conceptual Cytokines – Setting the Trajectory for Embryo Implantation, Pregnancy and Beyond , 2011, American journal of reproductive immunology.

[17]  R. Brotman,et al.  Bacterial vaginosis assessed by gram stain and diminished colonization resistance to incident gonococcal, chlamydial, and trichomonal genital infection. , 2010, The Journal of infectious diseases.

[18]  G. Reid,et al.  Vaginal Microbiota and the Use of Probiotics , 2009, Interdisciplinary perspectives on infectious diseases.

[19]  T. Jakobsson,et al.  Changes in the predominant human Lactobacillus flora during in vitro fertilisation Tell Jakobsson and Urban Forsum* , 2008 .

[20]  P. Brocklehurst,et al.  Antibiotics for treating bacterial vaginosis in pregnancy. , 2005, The Cochrane database of systematic reviews.