Behind-the-Scenes Actors in Fertility: A Comprehensive Review of the Female Reproductive Tract Microbiome and Its Clinical Relevance

The study of the microbiome has rapidly progressed over the past few decades, capturing the interest of both scientists and the general public. Nevertheless, there is still no widely agreed-upon definition for the term “microbiome” despite tremendous advances in our knowledge. The international scie...

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Main Authors: Anthi Papakonstantinou, Efthalia Moustakli, Anastasios Potiris, Athanasios Zikopoulos, Ermioni Tsarna, Chrysi Christodoulaki, Ioannis Tsakiridis, Themistoklis Dagklis, Periklis Panagopoulos, Peter Drakakis, Sofoklis Stavros
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Language:English
Published: MDPI AG 2025-06-01
Series:Life
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Online Access:https://www.mdpi.com/2075-1729/15/6/916
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author Anthi Papakonstantinou
Efthalia Moustakli
Anastasios Potiris
Athanasios Zikopoulos
Ermioni Tsarna
Chrysi Christodoulaki
Ioannis Tsakiridis
Themistoklis Dagklis
Periklis Panagopoulos
Peter Drakakis
Sofoklis Stavros
author_facet Anthi Papakonstantinou
Efthalia Moustakli
Anastasios Potiris
Athanasios Zikopoulos
Ermioni Tsarna
Chrysi Christodoulaki
Ioannis Tsakiridis
Themistoklis Dagklis
Periklis Panagopoulos
Peter Drakakis
Sofoklis Stavros
author_sort Anthi Papakonstantinou
collection DOAJ
description The study of the microbiome has rapidly progressed over the past few decades, capturing the interest of both scientists and the general public. Nevertheless, there is still no widely agreed-upon definition for the term “microbiome” despite tremendous advances in our knowledge. The international scientific literature consistently underscores the difference between the human microbiome and human microbiota. Recent research has emphasized the importance of the female reproductive tract microbiome in fertility, impacting natural conception and assisted reproductive technologies (ARTs). This review explores the relationship between infertility and the microbiota of the female reproductive tract through a thorough evaluation of research papers and large-scale studies published up to 2024. The objective of this review is to critically assess current evidence on the role of the reproductive tract microbiome in female infertility and ART outcomes. Relevant papers were identified and analyzed through the electronic medical databases PubMed/MEDLINE and Scopus. A comprehensive synthesis of data from 36 original studies was performed, including observational, case–control, cohort, and randomized trials. By focusing on the vagina, cervix, and endometrium, this study offers a comprehensive overview of the microbiome throughout the female reproductive tract. RIF and poor reproductive outcomes are strongly linked to dysbiosis, which is characterized by a reduction in <i>Lactobacillus</i> species. <i>Lactobacillus crispatus</i>, in particular, plays a significant role in protecting against bacterial vaginosis and infertility. A thorough understanding of how the microbiome impacts fertility and the development of clinical strategies to improve reproductive outcomes requires standardized microbiome investigation techniques and larger, randomized trials that account for diverse patient characteristics.
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spelling doaj-art-53fda75f660e4671a124d37de50aba122025-08-20T03:27:40ZengMDPI AGLife2075-17292025-06-0115691610.3390/life15060916Behind-the-Scenes Actors in Fertility: A Comprehensive Review of the Female Reproductive Tract Microbiome and Its Clinical RelevanceAnthi Papakonstantinou0Efthalia Moustakli1Anastasios Potiris2Athanasios Zikopoulos3Ermioni Tsarna4Chrysi Christodoulaki5Ioannis Tsakiridis6Themistoklis Dagklis7Periklis Panagopoulos8Peter Drakakis9Sofoklis Stavros10Third Department of Obstetrics and Gynecology, University General Hospital “ATTIKON”, Medical School, National and Kapodistrian University of Athens, 12462 Athens, GreeceLaboratory of Medical Genetics, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, GreeceThird Department of Obstetrics and Gynecology, University General Hospital “ATTIKON”, Medical School, National and Kapodistrian University of Athens, 12462 Athens, GreeceThird Department of Obstetrics and Gynecology, University General Hospital “ATTIKON”, Medical School, National and Kapodistrian University of Athens, 12462 Athens, GreeceSecond Department of Obstetrics and Gynecology, Aretaieion University Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, GreeceThird Department of Obstetrics and Gynecology, University General Hospital “ATTIKON”, Medical School, National and Kapodistrian University of Athens, 12462 Athens, GreeceThird Department of Obstetrics and Gynecology, General Hospital Ippokratio, Medical School, Aristotle University of Thessaloniki, 54642 Thessaloniki, GreeceThird Department of Obstetrics and Gynecology, General Hospital Ippokratio, Medical School, Aristotle University of Thessaloniki, 54642 Thessaloniki, GreeceThird Department of Obstetrics and Gynecology, University General Hospital “ATTIKON”, Medical School, National and Kapodistrian University of Athens, 12462 Athens, GreeceThird Department of Obstetrics and Gynecology, University General Hospital “ATTIKON”, Medical School, National and Kapodistrian University of Athens, 12462 Athens, GreeceThird Department of Obstetrics and Gynecology, University General Hospital “ATTIKON”, Medical School, National and Kapodistrian University of Athens, 12462 Athens, GreeceThe study of the microbiome has rapidly progressed over the past few decades, capturing the interest of both scientists and the general public. Nevertheless, there is still no widely agreed-upon definition for the term “microbiome” despite tremendous advances in our knowledge. The international scientific literature consistently underscores the difference between the human microbiome and human microbiota. Recent research has emphasized the importance of the female reproductive tract microbiome in fertility, impacting natural conception and assisted reproductive technologies (ARTs). This review explores the relationship between infertility and the microbiota of the female reproductive tract through a thorough evaluation of research papers and large-scale studies published up to 2024. The objective of this review is to critically assess current evidence on the role of the reproductive tract microbiome in female infertility and ART outcomes. Relevant papers were identified and analyzed through the electronic medical databases PubMed/MEDLINE and Scopus. A comprehensive synthesis of data from 36 original studies was performed, including observational, case–control, cohort, and randomized trials. By focusing on the vagina, cervix, and endometrium, this study offers a comprehensive overview of the microbiome throughout the female reproductive tract. RIF and poor reproductive outcomes are strongly linked to dysbiosis, which is characterized by a reduction in <i>Lactobacillus</i> species. <i>Lactobacillus crispatus</i>, in particular, plays a significant role in protecting against bacterial vaginosis and infertility. A thorough understanding of how the microbiome impacts fertility and the development of clinical strategies to improve reproductive outcomes requires standardized microbiome investigation techniques and larger, randomized trials that account for diverse patient characteristics.https://www.mdpi.com/2075-1729/15/6/916microbiomemicrobiotafemale reproductive systemfemale infertility<i>Lactobacillus</i>
spellingShingle Anthi Papakonstantinou
Efthalia Moustakli
Anastasios Potiris
Athanasios Zikopoulos
Ermioni Tsarna
Chrysi Christodoulaki
Ioannis Tsakiridis
Themistoklis Dagklis
Periklis Panagopoulos
Peter Drakakis
Sofoklis Stavros
Behind-the-Scenes Actors in Fertility: A Comprehensive Review of the Female Reproductive Tract Microbiome and Its Clinical Relevance
Life
microbiome
microbiota
female reproductive system
female infertility
<i>Lactobacillus</i>
title Behind-the-Scenes Actors in Fertility: A Comprehensive Review of the Female Reproductive Tract Microbiome and Its Clinical Relevance
title_full Behind-the-Scenes Actors in Fertility: A Comprehensive Review of the Female Reproductive Tract Microbiome and Its Clinical Relevance
title_fullStr Behind-the-Scenes Actors in Fertility: A Comprehensive Review of the Female Reproductive Tract Microbiome and Its Clinical Relevance
title_full_unstemmed Behind-the-Scenes Actors in Fertility: A Comprehensive Review of the Female Reproductive Tract Microbiome and Its Clinical Relevance
title_short Behind-the-Scenes Actors in Fertility: A Comprehensive Review of the Female Reproductive Tract Microbiome and Its Clinical Relevance
title_sort behind the scenes actors in fertility a comprehensive review of the female reproductive tract microbiome and its clinical relevance
topic microbiome
microbiota
female reproductive system
female infertility
<i>Lactobacillus</i>
url https://www.mdpi.com/2075-1729/15/6/916
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