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The composition of the vaginal microbiota varies throughout a woman's life and is sensitive to hormonal and environmental factors. Specifically, hormonal treatments necessary in the medically assisted procreation (MAP) processes can influence the vaginal microbiota. New sequencing techniques have been used to characterize the vaginal microbiota, demonstrating that the microbiota could be divided into 5 classes. The composition of the vaginal microbiota seems to have an implication in the evolution of a pregnancy after IVF. It is therefore essential to have more data on the evolution of the vaginal microbiota at the different stages of IVF treatment and to analyze whether this evolution can be predictive of the success of embryo implantation. Good endometrial progesterone impregnation is an essential prerequisite for ensuring embryo implantation. Indeed, supporting the luteal phase through vaginal progesterone is an essential step in IVF protocols to ensure synchronization between endometrial maturation and embryonic age. However, the serum progesterone level on the day of embryo transfer varies widely between patients. Several factors such as age, vaginal mucosa trophicity, estrogen impregnation and sexual activity are known to affect the vaginal absorption of progesterone. The treatments and vaginal examinations performed during the IVF procedure could also have an impact on the constitution of the vaginal microbiota. The hypothesis of this research is that there is an alteration in the vaginal microbiota during the IVF process which may alter the absorption of vaginal progesterone, with an impact on the failure or success of embryo implantation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Women undergoing IVF |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Vaginal swab | Other | Vaginal flora swab 3 months before stimulation, at oocyte puncture, embryo transfer and beta-human chorionic gonadotropin dosing |
|
| Measure | Description | Time Frame |
|---|---|---|
| Class of vaginal flora according to community state type | Classified into 5 classes of vaginal flora described according to Smith & Ravel 2017 | 3 Months before ovarian stimulation |
| Microbiota richness of vaginal flora | Measured by operational taxonomic unit | 3 Months before ovarian stimulation |
| Microbiota alpha diversity of vaginal flora | Shannon Index | 3 Months before ovarian stimulation |
| Microbiota beta diversity of vaginal flora | Bray Curtis index | 3 Months before ovarian stimulation |
| Plasma progesterone level on the day of embryo transfer | Measured by chemiluminescence (nmol/L) | Day of embryo transfer (Day 0) |
| Measure | Description | Time Frame |
|---|---|---|
| Class of vaginal flora according to community state type | Classified into 5 classes of vaginal flora described according to Smith & Ravel 2017 | Day of oocyte puncture (Month 3) |
| Class of vaginal flora according to community state type |
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Inclusion Criteria:
Exclusion Criteria:
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Patients aged 18 to 40 inclusive, Round1 or 2 of IVF or IVF-ICSI with fresh embryo transfer, without taking antibiotics in the 3 months preceding the first sample treated in the AMP center of the CHU de Nîmes.
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| Name | Affiliation | Role |
|---|---|---|
| Stéphanie Huberlant | CHU de Nimes | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU de Nimes | Nîmes | 30029 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27373840 | Background | Smith SB, Ravel J. The vaginal microbiota, host defence and reproductive physiology. J Physiol. 2017 Jan 15;595(2):451-463. doi: 10.1113/JP271694. Epub 2016 May 5. |
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| Blood test | Other | Blood sample to measure plasma dose of progesterone |
|
Classified into 5 classes of vaginal flora described according to Smith & Ravel 2017
| Day of embryo transfer (Day 93) |
| Class of vaginal flora according to community state type | Classified into 5 classes of vaginal flora described according to Smith & Ravel 2017 | Day of beta-human chorionic gonadotropin dosage (Day 108) |
| Microbiota richness of vaginal flora | Measured by operational taxonomic unit | Day of oocyte puncture (Month 3) |
| Microbiota richness of vaginal flora | Measured by operational taxonomic unit | Day of embryo transfer (Day 93) |
| Microbiota richness of vaginal flora | Measured by operational taxonomic unit | Day of beta-human chorionic gonadotropin dosage (Day 108) |
| Microbiota alpha diversity of vaginal flora | Shannon Index | Day of oocyte puncture (Month 3) |
| Microbiota alpha diversity of vaginal flora | Shannon Index | Day of embryo transfer (Day 93) |
| Microbiota alpha diversity of vaginal flora | Shannon Index | Day of beta-human chorionic gonadotropin dosage (Day 108) |
| Microbiota beta diversity of vaginal flora | Bray Curtis index | Day of oocyte puncture (Month 3) |
| Microbiota beta diversity of vaginal flora | Bray Curtis index | Day of embryo transfer (Day 93) |
| Microbiota beta diversity of vaginal flora | Bray Curtis index | Day of beta-human chorionic gonadotropin dosage (Day 108) |
| Pregnancy success | Yes/No | Month 3 |
| Pregnancy progression | Implantation failure/progression/miscarriage | Month 3 |
| Treatments received for IVF | Description of treatments, taken from patient file | Month 3 |
| Plasma progesterone level | Measured by chemiluminescence (nmol/L) | Month 3 |
| ID | Term |
|---|---|
| D006403 | Hematologic Tests |
| ID | Term |
|---|---|
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D008919 | Investigative Techniques |
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