Bacterial Vaginosis and its Association with Infertility, Endometritis, and Pelvic Inflammatory Disease Original paper
Researched by:
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Divine Aleru
ID
Divine Aleru
I am a biochemist with a deep curiosity for the human microbiome and how it shapes human health, and I enjoy making microbiome science more accessible through research and writing. With 2 years experience in microbiome research, I have curated microbiome studies, analyzed microbial signatures, and now focus on interventions as a Microbiome Signatures and Interventions Research Coordinator.
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Bacterial Vaginosis
Bacterial Vaginosis
Bacterial vaginosis (BV) is caused by an imbalance in the vaginal microbiota, where the typically dominant Lactobacillus species are significantly reduced, leading to an overgrowth of anaerobic and facultative bacteria.
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Women’s Health
Women’s Health
Women’s health, a vital aspect of medical science, encompasses various conditions unique to women’s physiological makeup. Historically, women were often excluded from clinical research, leading to a gap in understanding the intricacies of women’s health needs. However, recent advancements have highlighted the significant role that the microbiome plays in these conditions, offering new insights and potential therapies. MicrobiomeSignatures.com is at the forefront of exploring the microbiome signature of each of these conditions to unravel the etiology of these diseases and develop targeted microbiome therapies.
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Divine Aleru
Researched by:
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Divine Aleru
ID
Divine Aleru
Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
Divine Aleru
What was Reviewed?
This expert review examined the associations between bacterial vaginosis (BV), endometritis, pelvic inflammatory disease (PID), and infertility, synthesizing evidence from clinical studies, microbiome research, and treatment outcomes. The authors explored how BV-related dysbiosis contributes to upper genital tract infections and reproductive complications, while evaluating diagnostic challenges and emerging therapeutic strategies.
Who was Reviewed?
The review analyzed data from diverse populations of reproductive-age women, including those with infertility, recurrent BV, or PID. It incorporated findings from studies on vaginal and endometrial microbiota, clinical trials on BV treatments (e.g., antibiotics, probiotics), and research on immune and inflammatory responses linked to infertility.
What were the most Important Findings?
BV, characterized by reduced Lactobacillus dominance and overgrowth of anaerobes like Gardnerella vaginalis and Atopobium vaginae, was strongly associated with tubal infertility (3.3-fold higher prevalence in infertile women) and PID. Major microbial associations (MMA) included elevated levels of proinflammatory cytokines (IL-1β, IL-6, IL-8) in BV-positive women, which disrupt endometrial receptivity. Subclinical PID, often linked to BV, reduced pregnancy likelihood by 40%. Notably, Lactobacillus crispatus probiotics reduced BV recurrence by 15% compared to placebo, while endometrial microbiota dominated by non-lactobacilli correlated with lower IVF success rates. Chronic endometritis (CE), prevalent in 34%–66% of unexplained infertility cases, improved fertility outcomes post-antibiotic treatment, with cured CE showing a 76.3% pregnancy rate versus 20% in persistent cases.
What are the Implications of this Review?
The findings underscore BV as a modifiable risk factor for infertility, emphasizing the need for early screening and treatment to prevent PID and CE. Clinicians should consider Lactobacillus-based probiotics and biofilm-disrupting agents for recurrent BV. For infertility workups, endometrial microbiota analysis and CE testing are critical, particularly in cases of repeated implantation failure. Future research should prioritize longitudinal studies to clarify causal links between BV dysbiosis and infertility, while optimizing personalized therapies targeting the vaginal microbiome.
Bacterial Vaginosis
Bacterial vaginosis (BV) is caused by an imbalance in the vaginal microbiota, where the typically dominant Lactobacillus species are significantly reduced, leading to an overgrowth of anaerobic and facultative bacteria.