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Dr Odile Bagot (Gynecologist-obstetrician)
Medical validation:
July 16, 2022
A new study casts doubt on the ability of probiotics to restore the vaginal health of women undergoing medically assisted procreation (PMA), at least in the short term.
Itching, cystitis, repeated urinary tract infections… An unbalanced vaginal flora leads to many inconveniences and infections. The use of probiotics then often appears to be the solution. However, a study presented at the annual meeting of the European Society of Human Reproduction and Embryology (ESHRE) underlines that their effectiveness remains questionable, especially in women who experience fertility problems.
No significant improvement in the “vaginal microbiota”
To arrive at this observation, 74 women in the process of medically assisted procreation (PMA) participated in the study. All of them had an unbalanced, i.e. unhealthy, vaginal ecosystem.
Half of them received probiotic capsules based on lactobacilli (bacteria necessary for the body to balance the microbial flora of the vaginal mucosa), the other half a placebo.
At the end of the treatment and after a new menstrual cycle, the scientists found no significant difference between the two groups: the treated women did not show better results than those on the placebo.
One to three months after treatment, the study authors also noticed that 34.2% of women saw an improvement in their vaginal microbiota, whether they received a probiotic or a placebo.
“The study indicates that the ‘probiotic rush’ should be tempered with caution. We found that the use of a specific probiotic containing Lactobacillus rhamnosus and Lactobacillus gasseri did not improve an unfavorable (asymptomatic) vaginal microbiota in infertile womens,” confirmed study author Dr. Ida Enberg Jepson.
The track of a “spontaneous recovery” of the microbiota is to be studied
The team of scientists points out that further research is needed to better understand the impact of different strains of lactobacilli. Indeed, within the framework of this study, a single strain was tested, but other types of lactobacilli could prove to be effective.
Moreover, since an improvement in the microbiota was observed in 34.2% of women after one to three months, doctors suggest that postponing in vitro fertilization (IVF) in patients with an unfavorable vaginal microbiota might be a good idea.
In addition, the decision to start treatment with lactobacilli must be made on a case-by-case basis:
“The type of lactobacilli differs in each woman. This is why lactobacilli in the form of probiotics will not necessarily survive in the vaginal flora. Prebiotics, which constitute the original flora, are surely more usefuls”, underlines Dr. Bagot.