Can a probiotic improve fertility outcomes?

There is increasing evidence that supporting the vaginal microbiome might hold the key for some women finding it difficult to conceive. A recent pilot study investigated how probiotics (good bacteria), in particular strains of Lactobacillus (a beneficial bacteria that helps create and maintain a healthy reproductive environment), can improve the vaginal microbiome and overall reproductive health.

Understanding the Vaginal Microbiome

The vaginal microbiome is made up of more than 90% Lactobacillus species, all of which play a significant role in maintaining a healthy environment for reproductive health. Lactobacillus bacteria play a crucial role in keeping the environment acidic to deter pathogens (organisms that can give disease).

An imbalance in this microbiome, meaning a decrease in Lactobacillus and an increase in harmful bacteria, can lead to conditions such as bacterial vaginosis. This imbalance not only affects vaginal health but also has implications for fertility.

It has been shown that women with an unbalanced vaginal microbiome are 1.4 times less likely to achieve pregnancy after IVF treatment compared to women with a “normal” microbiome.

What did the study show?

The pilot study investigated the impact of three specific Lactobacillus strains—L. rhamnosus BPL205, L. plantarum BPL207, and L. crispatus BPL209—on restoring a healthy vaginal environment. Conducted over a period of ten weeks, the study recruited 21 women with low levels of vaginal Lactobacillus. The women were given a daily supplement combining these probiotics, plus vitamin D.

Key Findings

1. Restoration of Vaginal pH: All participants began the study with a vaginal pH greater than 4.5, signs of an unhealthy environment. After five weeks of supplementation, 66.7% of the women achieved a vaginal pH of less than 4.5. By the end of the ten-week period, all participants had normalised their vaginal pH, a sign of a healthy vaginal microbiome.

2. Improvement in Vaginal Flora (the bacteria that live inside the vagina): At the start of the study, most participants had vaginal microbiomes with signs of yeast infections or bacterial vaginosis.. After five weeks, 73.7% had transitioned to a healthy vaginal flora dominated by Lactobacillus species. This percentage increased to 89.5% after ten weeks.

3. Reduction in Menstrual Pain: Participants reported a significant reduction in menstrual pain. Using the NRS, a 10-point scale, with higher scores indicating stronger pain from an average intensity of 6.1, to 3.8 after five weeks, and further down to 1.5 by the tenth week. This suggests that the probiotic supplementation not only improved vaginal health but also had a positive impact on menstrual discomfort.

4. Decrease in Inflammatory Markers: In participants diagnosed with chronic endometritis (an infection or inflammation of the endometrium), levels of TNF (a protein that helps regulate the immune system and inflammation in the body) - decreased significantly, indicating a reduction in inflammation following the probiotic regimen.

Femceive: Probiotic Support for Fertility and Early Pregnancy

For women on their fertility journey and those in early pregnancy, Zita West recommends Femceive, a supplement that provides the strains mentioned in the study—L. rhamnosus BPL205, L. plantarum BPL207, and L. crispatus BPL209—at the therapeutic dose. This targeted support helps ensure a healthy vaginal environment, which is crucial for optimal fertility and overall reproductive health.

E González, Y Paisano, M I Ramos, P-552 Pilot study to determine efficacy of L. rhamnosus BPL205, L. plantarum BPL207 and L.crispatus BPL209 in normalizing the vaginal environment (study PROSALVAG), Human Reproduction, Volume 38, Issue Supplement_1, June 2023, dead093.892, https://doi.org/10.1093/humrep/dead093.892