ASSESSMENT OF THE INTESTINAL AND VAGINA MICROBIOMA DURING EXTRACORPORAL FERTILIZATION PROGRAMS
Khikmatova I. Nigina, Pakhomova Y. Janna, Ruzieva Kh. Nazira
It is now known that the possibility of conceiving and carrying a pregnancy is largely due to the interaction of a woman's macroorganism with microorganisms involved in the formation of the microbiome of the intestine, vagina and other organs. Attempts to treat infertility using in vitro fertilization (IVF) are not always successful. Probably, the disruption of the vaginal and intestinal microbiome can significantly reduce the effectiveness of IVF programs. The aim of our work was to study the vaginal and intestinal microbiome in women with infertility in preparation for IVF programs. Materials and research methods. 40 women suffering from infertility were examined. Primary infertility was in 12 women and secondary in 28 patients. Of these, the 1st group consisted of 20 women suffering from infertility who had 2-4 unsuccessful IVF attempts in history; Group 2 consisted of 20 women who, after infertility treatment, had a pregnancy that ended in premature birth. The control group consisted of 20 healthy women. Bacteriological studies of the vaginal and intestinal microbiome were carried out using the method of light microscopy. The level of pro-inflammatory and anti-inflammatory cytokines in the blood serum was determined by the enzyme immunoassay. Results. When conducting bacteriological examination in the 1st and 2nd groups of patients, it was found that the vaginal microbiome is characterized by a sharp decrease in normal flora (lacto-, bifidobacteria) and a significant increase in opportunistic flora (eubacteria, prevotella, peptostreptococcus). In the intestinal microbiome, a decrease in species diversity, an increase in the number of enterococci, Klebsiella, proteobacteria, characteristic of intestinal dysbiosis associated with inflammation, were found. Thus, in both groups of women, a violation of the vaginal microbiome was found in 71.7%, a violation of the intestinal microbiome - in 86.7% of patients. While in the control group, there was no violation of the vaginal microbiome, and the violation of the intestinal microbiome occurred in 10% of women. Conclusions. According to the results of the study, it can be considered that the risk factors for failed IVF attempts and premature birth are a violation of the microbiome of the vagina and intestines, as well as an imbalance of pro-inflammatory and anti-inflammatory cytokines in women with infertility. To develop individual fertility treatment programs, it is necessary to include an assessment of the vaginal and intestinal microbiome in the examination. In addition, drugs that normalize the microbiome of these organs should be included in IVF programs and for the prevention of preterm birth in women with a history of infertility, which will increase the effectiveness of IVF programs and reduce reproductive losses.