The human microbiome is a vast collection of bacteria, viruses, fungi and other micro-organisms that reside in various parts of our body. While predominantly our gut microbiome has gained popularity, interconnected microbiomes exist within the body including on our skin, hair, eyes, and within/surrounding different internal structures such as the peritoneal cavity, uterus, vagina, testes and more. Largely, the health of these microbiomes is directed via our gut microbiome.
Recent research suggests vaginal and seminal microbiomes play an important role in fertility. The balance of these microbes can have a profound effect on reproductive outcomes, from conception to maintaining a healthy pregnancy.
The Vaginal Microbiome and Fertility
The vaginal microbiome is a complex ecosystem predominantly composed of Lactobacillus species, which help maintain an acidic environment with a low pH (around 3.8 to 4.5). This acidity is crucial for protecting the vagina from pathogenic bacteria and promoting positive fertility outcomes.
How the Vaginal Microbiome Affects Fertility
Protection Against Infections: A healthy vaginal microbiome can help prevent infections like bacterial vaginosis (BV), sexually transmitted infections (STIs), and yeast infections, all of which can negatively affect fertility.
Sperm Survival: The balance of vaginal bacteria influences sperm viability. A healthy vaginal environment, dominated by Lactobacillus, is more conducive to sperm survival and motility. On the other hand, an imbalanced microbiome, characterised by overgrowth of harmful bacteria, can lower the chances of sperm reaching the egg.
Pregnancy and Preterm Birth: Women with an dysbiotic vaginal microbiome may experience challenges in achieving and maintaining pregnancy. Dysbiosis has been linked to conditions such as preterm birth and miscarriages. Maintaining a balanced microbiome may reduce these risks.
Common Disruptors of the Vaginal Microbiome:
Overuse of antibiotics, which can kill beneficial bacteria along with harmful ones
Douching or the use of harsh vaginal cleansers
Hormonal fluctuations, including those caused by previous birth control medicines
Various products used internally such as some lubricants
An imbalance in gut bacteria is strongly associated with a dysbiotic vaginal microbiome. We can test for this via a stool sample analysis using the latest technology such as shotgun-metagenomics
The Seminal Microbiome and Male Fertility
Semen is not just a carrier for sperm, but a complex fluid containing a variety of bacteria, predominantly Lactobacillus species, contributing to the overall health of sperm and reproductive outcomes
How the Seminal Microbiome Impacts Fertility
Sperm Health: Research has shown that men with fertility issues, such as low sperm count or poor sperm motility, often have an imbalanced seminal microbiome.
Harmful bacteria present in semen can damage sperm cells or impair motility, making it harder to reach the egg. While healthy populations of Lactobacillus species reduce DNA fragmentation
Transmission to the Vaginal Microbiome: During intercourse, the seminal microbiome interacts with the vaginal microbiome. This exchange of bacteria can either benefit or harm the vaginal environment and visa versa. A healthy seminal microbiome may help reinforce the vaginal balance, whereas a disrupted seminal microbiome can contribute to dysbiosis in the vaginal environment, affecting both partners’ reproductive health
How to Support a Healthy Reproductive Microbiome for both men and women
Maintaining balanced vaginal and seminal microbiota is critical for reproductive success. Here are some steps to help both partners promote microbial health:
Healthy Diet: Eating a diet rich in probiotics and prebiotics can support the growth of beneficial bacteria. Fermented foods, like yogurt, kefir, kombucha, kimchi, and sauerkraut, are rich in probiotics, while prebiotic rich foods including vegetables, fruit and whole grains feed the good bacteria. If you react to these foods, its a queue to investigate your gut microbiome further.
Limit Antibiotic Use (Where possible): Antibiotics can disrupt the balance of beneficial bacteria in both the vaginal and seminal microbiomes. Only use antibiotics when necessary according to your healthcare provider and consult with a clinical nutritionist with a clinical focus on gut health like myself to provide restorative strategies for your gut and reproductive microbiome.
Avoid Harsh Cleansers: Avoid practices like douching or using harsh cleansers in the genital area, as they can disrupt the microbiome. Washing with mild pH balances soap and water is sufficient for both men and women. This includes brands like Yes Cleanse Intimate Wash. https://yesyesyesaustralia.com.au/products/yes®-cleanse-intimate-wash
Probiotic Supplements/Pessaries: Use specific strains of probiotic supplements can help restore the natural balance of the microbiome. The strains that support vaginal health, such as Lactobacillus crispatus and Lactobacillus jensenii, and others that can be discussed during a consultation.
Vaginal Microbiome Testing: If you’re trying to conceive, it’s a great idea to undertake testing for microbiome imbalances or infections. I offer this testing through one of the labs where a swab is sent for PCR analysis. We can then target imbalances and treatments according to the results. An example of the report is pictured below.
Gut Microbiome Testing: As previously mentioned, the health of your gut microbiome impacts the composition of your vaginal and seminal microbiome. Restoring gut health is paramount. I can arrange state-of-the-art shotgun metagenomic testing to identify and put together strategies to correct gut dysbiosis.
As research into the fertility microbiome continues to grow, understanding and maintaining the health of these ecosystems will become an increasingly important aspect of reproductive care. Both partners should prioritise their microbiome health as they embark on their fertility journey by prioritising all aspects of preconception care including gut health. If you need help knowing what foods to eat and supplements to help optimise your microbiome, I'm here to help.
Bec xx
References
1. Ravel, J., et al. (2011). Vaginal microbiome of reproductive-age women. Proceedings of the National Academy of Sciences.
2. Baud, D., et al. (2019). The seminal microbiome and its impact on male fertility. Frontiers in Reproductive Health.
3. Vinturache, A.E., et al. (2020). The role of the vaginal microbiome in reproductive health. Journal of Reproductive Immunology.
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