乱れた膣内マイクロバイオータは、より高い受精失敗率の潜在的な指標となる可能性がある

The Disordered Vaginal Microbiota Is a Potential Indicator for a Higher Failure of Fertilization.

• Yao Kong
• Zhaoxia Liu
• Qingyao Shang
• Yuan Gao
• Xia Li
• Cihua Zheng
• Xiaorong Deng
• Tingtao Chen

抄録

不妊症は生殖器系の疾患の中で最も一般的なものの一つであり、その治療に有効な方法はない。不妊症の臨床的な妊娠成績を向上させるために受精（体外受精）が広く行われているが，原因不明の不満足な妊娠率が得られている．本研究では，体外受精失敗の原因として考えられるものを特定するために，555人の患者を登録し，関連する臨床的特徴と膣内細菌叢を調べた。その結果、体外受精を受けた妊娠患者（P群）と非妊娠患者（NP群）では、年齢と子宮内膜の厚さが妊娠成功率に有意な影響を与え、P群では黄体形成ホルモン、エストロゲン、プロゲステロンが高値を示した。さらに、PLS-DA（Partial Least Squares Discriminant Analysis）により、P群とNP群では微生物組成が異なり、非妊娠患者では妊娠患者に比べて高い微生物量が確認された。属レベルでは，妊娠中の患者では，非妊娠中の患者に比べて，妊娠中の患者の方が高い菌体量と低い菌体量が得られた．したがって、非妊娠患者ではプロバイオティクスの減少と病原体の過剰増殖によって特徴づけられる無秩序なマイクロバイオータは、体外受精の失敗率を高める潜在的な指標として使用される可能性がある。

Infertility is one of the most common reproductive system diseases, and no effective method is available for its treatment. Although fertilization (IVF) has been widely used to enhance the clinical pregnancy outcome of infertility, the unsatisfied pregnancy rate with unknown reasons is obtained. To identify the possible cause of IVF failure, 555 patients were enrolled in the present study to determine their relevant clinical characteristics and vaginal microbiota. Our results indicated that the age and endometrium thickness significantly affected the pregnancy success rate of pregnant patients (P group) and non-pregnant patients (NP group) receiving IVF, and high values of luteinizing hormone, estrogen and progesterone were observed from P group. Furthermore, the Partial Least Squares Discriminant Analysis (PLS-DA) indicated a different microbial composition in P group and NP group, and a higher microbial abundance had been identified in non-pregnant patients compared with pregnant patients. At phylum level, a higher abundance of and , and a lower abundance of , and were obtained in pregnant patients compared with non-pregnant patients. At genus level, a lower abundance of the probiotic , and higher abundance of pathogens and were identified from non-pregnant patients. Therefore, the disordered microbiota, characterizing by the reduction of probiotics and overgrowth of pathogens in non-pregnant patients, may be used as a potential indicator for a higher IVF failure rate.

Copyright © 2020 Kong, Liu, Shang, Gao, Li, Zheng, Deng and Chen.