akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLC10.17749/2313-7347/ob.gyn.rep.2025.592akusherstvo-2360Research ArticleREVIEW ARTICLESНАУЧНЫЕ ОБЗОРЫThe role of uterine and vaginal microbiome affecting the outcomes of assisted reproductive technologiesРоль микробиома матки и влагалища в исходах вспомогательных репродуктивных технологийhttps://orcid.org/0000-0001-7114-4050БахтияровК. Р.BakhtiyarovK. R.

Бахтияров Камиль Рафаэльевич, д.м.н., проф.

Scopus Author ID: 57208396965

119048 Москва, ул. Трубецкая, д. 8, стр. 2

Kamil R. Bakhtiyarov, MD, Dr Sci Med, Prof.

Scopus Author ID: 57208396965

8 bldg. 2, Trubetskaya Str., Moscow 119048

https://orcid.org/0000-0002-9945-3848ИгнаткоИ. В.IgnatkoI. V.

Ирина Владимировна Игнатко, д.м.н., проф., член-корр. РАН.

Scopus Author ID: 15118951800

WoS ResearcherID: H-2442-2018

119048 Москва, ул. Трубецкая, д. 8, стр. 2

Irina V. Ignatko, MD, Dr Sci Med, Prof., Corresponding Member of RAS

Scopus Author ID: 15118951800

WoS ResearcherID: H-2442-2018

8 bldg. 2, Trubetskaya Str., Moscow 119048

https://orcid.org/0009-0001-9755-2201ЗуеваА. С.ZuevaA. S.

Зуева Алина Сергеевна

Scopus Author ID: 59132162700

WoS ResearcherID: JWO-2945-2024

119048 Москва, ул. Трубецкая, д. 8, стр. 2

Alina S. Zueva, MD

Scopus Author ID: 59132162700

WoS ResearcherID: JWO-2945-2024

8 bldg. 2, Trubetskaya Str., Moscow 119048

alina-zueva02@mail.ruhttps://orcid.org/0009-0009-7469-2971СиняковаЕ. В.SiniakovaE. V.

Синякова Елизавета Владиславовна

Scopus Author ID: 59411067300

WoS ResearcherID: ABH-4680-2022

119048 Москва, ул. Трубецкая, д. 8, стр. 2

Elizaveta V. Siniakova

Scopus Author ID: 59411067300

WoS ResearcherID: ABH-4680-2022

8 bldg. 2, Trubetskaya Str., Moscow 119048

https://orcid.org/0009-0004-7414-2471КапыринаТ. Д.KapyrinaT. D.

Капырина Татьяна Дмитриевна

Scopus Author ID: 58631437000

119048 Москва, ул. Трубецкая, д. 8, стр. 2

Tatyana D. Kapyrina, MD

Scopus Author ID: 58631437000

8 bldg. 2, Trubetskaya Str., Moscow 119048

ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет)РоссияSechenov UniversityRussian Federation202510052025192273281Copyright © Bakhtiyarov K.R., Ignatko I.V., Zueva A.S., Siniakova E.V., Kapyrina T.D., 20252025Бахтияров К.Р., Игнатко И.В., Зуева А.С., Синякова Е.В., Капырина Т.Д.Bakhtiyarov K.R., Ignatko I.V., Zueva A.S., Siniakova E.V., Kapyrina T.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gynecology.su/jour/article/view/2360

Infertility is a high-priority medical and social issue, which prevalence reaches 15 % according to the World Health Organization. One of the methods for infertility treatment, which is often resorted to by sub-fertile couples, is the use of assisted reproductive technologies (ART). It is known that the microbiome of the uterine cavity and vagina can affect ART-related fertility potential. The normal vaginal microbiome is characterized by the dominance of Lactobacillus spp. representatives, which ensure the maintenance of optimal pH values and prevent pathogenic microbial penetration and multiplication. It is assumed that the normal endometrial microbiome is characterized by predominance of Lactobacillus spp., but relevant studies are prominently heterogeneous. According to the current hypothesis, the dominance of Lactobacillus spp. and, particularly, Lactobacillus crispatus, in the vagina and uterine cavity is associated with favorable reproductive outcomes in ART programs. Recurrent implantation failures are related to spreading of opportunistic microflora in such niches. Nevertheless, some authors have reported no direct correlation between Lactobacillus spp. level, presence of opportunistic microorganisms and favorable outcomes of ART programs, which underlies a need to conduct further large-scale studies.

Бесплодие является актуальной медико-социальной проблемой, распространенность которой, согласно данным Всемирной организации здравоохранения, достигает 15 %. Одним из методов лечения бесплодия, к которому часто прибегают субфертильные пары, является применение вспомогательных репродуктивных технологий (ВРТ). Известно, что микробиом полости матки и влагалища может влиять на потенциал фертильности при использовании ВРТ. Нормальный микробиом влагалища характеризуется доминированием представителей Lactobacillus spp., которые обеспечивают поддержание оптимальных значений pH, препятствуют проникновению и размножению патогенных микроорганизмов. Предполагается, что нормальный микробиом эндометрия характеризуется достоверно значимым преобладанием Lactobacillus spp., однако исследования представлены выраженной гетерогенностью результатов. Согласно существующей гипотезе, доминирование представителей семейства Lactobacillus spp. и, в частности, Lactobacillus crispatus во влагалище и полости матки ассоциировано с благоприятными репродуктивными исходами в программах ВРТ. Повторные неудачи имплантации связаны с распространением условно-патогенной микрофлоры в данных микробиомах. Тем не менее некоторые авторы сообщают об отсутствии прямой корреляции между концентрацией Lactobacillus spp., присутствием условно-патогенных микроорганизмов и благоприятными исходами программ ВРТ, что создает необходимость в проведении дополнительных крупномасштабных исследований.

микробиом влагалищамикробиом маткивспомогательные репродуктивные технологииВРТэкстракорпоральное оплодотворениеЭКОбесплодиеповторные неудачи имплантацииvaginal microbiomeuterine microbiomeassisted reproductive technologiesARTin vitro fertilizationIVFinfertilityrepeated implantation failuresReferencesШермухамедова М.П., Хомидова Г.Ж., Насриддинова К.П. Современные подходы к диагностике и лечению женского бесплодия. Экономика и социум. 2022;(1–2):408–12.Shermukhamedova M.P., Khomidova G.Zh., Nasriddinova K.P. Modern approaches to the diagnosis and treatment of female infertility. [Sovremennye podhody k diagnostike i lecheniyu zhenskogo besplodiya]. Ekonomika i socium. 2022;(1–2):408–12. (In Russ.).Li P., Wei K., He X. et al. Vaginal probiotic Lactobacillus crispatus seems to inhibit spem activity and subsequently reduces pregnancies in rat. Front Cell Dev Bioly. 2021;9:705690. https://doi.org/10.3389/fcell.2021.705690.Li P., Wei K., He X. et al. Vaginal probiotic Lactobacillus crispatus seems to inhibit spem activity and subsequently reduces pregnancies in rat. Front Cell Dev Bioly. 2021;9:705690. https://doi.org/10.3389/fcell.2021.705690.V?in?m? S., Saqib S., Kalliala I. et al. Longitudinal analysis of vaginal microbiota during IVF fresh embryo transfer and in early pregnancy. Microbiol Spectr. 2023;11(6):e0165023. https://doi.org/10.1128/spectrum.01650-23.V?in?m? S., Saqib S., Kalliala I. et al. Longitudinal analysis of vaginal microbiota during IVF fresh embryo transfer and in early pregnancy. Microbiol Spectr. 2023;11(6):e0165023. https://doi.org/10.1128/spectrum.01650-23.Tian Q., Jin S., Zhang G. et al. Assessing vaginal microbiome through Vaginal Microecology Evaluation System as a predictor for in vitro fertilization outcomes: a retrospective study. Front Endocrinol. 2024:9(15):1380187. https://doi.org/10.3389/fendo.2024.1380187.Tian Q., Jin S., Zhang G. et al. Assessing vaginal microbiome through Vaginal Microecology Evaluation System as a predictor for in vitro fertilization outcomes: a retrospective study. Front Endocrinol. 2024:9(15):1380187. https://doi.org/10.3389/fendo.2024.1380187.Рудакова Е.Б., Стрижова Т.В., Федорова Е.А. и др. Материнские факторы риска неудач и дефектов имплантации после ЭКО. Медицинский совет. 2020;(13):166–78. https://doi.org/10.21518/2079-701X-2020-13-166-178.Rudakova E.B., Strizhova T.V., Fedorova E.A. et al. The maternal factors of failures and defects of implantation after IVF. [Materinskie faktory riska neudach i defektov implantacii posle EKO]. Medicinskij sovet. 2020;(13):166–78. (In Russ.). https://doi.org/10.21518/2079-701X-2020-13-166-178.Подзолкова Н.М., Шамугия, Н.Л. Варлакова П.М. Роль фактора эндометрия в повторных неудачах имплантации (обзор литературы). Медицинский алфавит. 2023;(3):30–6. https://doi.org/10.33667/2078-5631-2023-3-30-36.Podzolkova N.M., Shamugia N.L., Varlakova P.M. The role of endometrial factor in recurrent implantation failure (literature review). [Rol' faktora endometriya v povtornyh neudachah implantacii (obzor literatury)]. Medicinskij alfavit. 2023;(3):30–6. (In Russ.). https://doi.org/10.33667/2078-5631-2023-3-30-36.Barrientos-Dur?n A., Fuentes-L?pez A., de Salazar A. et al. Reviewing the composition of vaginal microbiota: inclusion of nutrition and probiotic factors in the maintenance of eubiosis. Nutrients. 2020;12(2):419. https://doi.org/10.3390/nu12020419.Barrientos-Dur?n A., Fuentes-L?pez A., de Salazar A. et al. Reviewing the composition of vaginal microbiota: inclusion of nutrition and probiotic factors in the maintenance of eubiosis. Nutrients. 2020;12(2):419. https://doi.org/10.3390/nu12020419.Foteinidou P., Exindari M., Chatzidimitriou D., Gioula G. Endometrial microbiome and its correlation to female infertility: a systematic review and meta-analysis. Acta Microbiologica Hellenica. 2024;69(1):14–28. https://doi.org/10.3390/amh69010004.Foteinidou P., Exindari M., Chatzidimitriou D., Gioula G. Endometrial microbiome and its correlation to female infertility: a systematic review and meta-analysis. Acta Microbiologica Hellenica. 2024;69(1):14–28. https://doi.org/10.3390/amh69010004.Elkafas H., Walls M., Al-Hendy A., Ismail N. Gut and genital tract microbiomes: dysbiosis and link to gynecological disorders. Front Cell Infect Microbiol. 2022;12:1059825. https://doi.org/10.3389/fcimb.2022.1059825.Elkafas H., Walls M., Al-Hendy A., Ismail N. Gut and genital tract microbiomes: dysbiosis and link to gynecological disorders. Front Cell Infect Microbiol. 2022;12:1059825. https://doi.org/10.3389/fcimb.2022.1059825.Wensel C.R., Pluznick J.L., Salzberg S.L., Sears C.L. Next-generation sequencing: insights to advance clinical investigations of the microbiome. J Clin Invest. 2022;132(7):e154944. https://doi.org/10.1172/JCI154944.Wensel C.R., Pluznick J.L., Salzberg S.L., Sears C.L. Next-generation sequencing: insights to advance clinical investigations of the microbiome. J Clin Invest. 2022;132(7):e154944. https://doi.org/10.1172/JCI154944.Sola-Leyva A., Andr?s-Le?n E., Molina N.M. et al. Mapping the entire functionally active endometrial microbiota. Hum Reprod. 2021;36(4):1021–31. https://doi.org/10.1093/humrep/deaa372.Sola-Leyva A., Andr?s-Le?n E., Molina N.M. et al. Mapping the entire functionally active endometrial microbiota. Hum Reprod. 2021;36(4):1021–31. https://doi.org/10.1093/humrep/deaa372.Vanstokstraeten R., Callewaert E., Blotwijk S. et al. Comparing vaginal and endometrial microbiota using culturomics: proof of concept. Int J Mol Sci. 2023;24(6):5947. https://doi.org/10.3390/ijms24065947.Vanstokstraeten R., Callewaert E., Blotwijk S. et al. Comparing vaginal and endometrial microbiota using culturomics: proof of concept. Int J Mol Sci. 2023;24(6):5947. https://doi.org/10.3390/ijms24065947.Gao X., Louwers Y.V., Laven J.S.E., Schoenmakers S. Clinical relevance of vaginal and endometrial microbiome investigation in women with repeated implantation failure and recurrent pregnancy loss. Int J Mol Sci. 2024;25(1):622. https://doi.org/10.3390/ijms25010622.Gao X., Louwers Y.V., Laven J.S.E., Schoenmakers S. Clinical relevance of vaginal and endometrial microbiome investigation in women with repeated implantation failure and recurrent pregnancy loss. Int J Mol Sci. 2024;25(1):622. https://doi.org/10.3390/ijms25010622.Carosso A., Revelli A., Gennarelli G. et al. Controlled ovarian stimulation and progesterone supplementation affect vaginal and endometrial microbiota in IVF cycles: a pilot study. J Assist Reprod Genet. 2020;37(9):2315–26. https://doi.org/10.1007/s10815-020-01878-4.Carosso A., Revelli A., Gennarelli G. et al. Controlled ovarian stimulation and progesterone supplementation affect vaginal and endometrial microbiota in IVF cycles: a pilot study. J Assist Reprod Genet. 2020;37(9):2315–26. https://doi.org/10.1007/s10815-020-01878-4.Kyono K., Hashimoto T., Nagai Y., Sakuraba Y. Analysis of endometrial microbiota by 16S ribosomal RNA gene sequencing among infertile patients: a single-center pilot study. Reprod Med Biol. 2018;17(3):297–306. https://doi.org/10.1002/rmb2.12105.Kyono K., Hashimoto T., Nagai Y., Sakuraba Y. Analysis of endometrial microbiota by 16S ribosomal RNA gene sequencing among infertile patients: a single-center pilot study. Reprod Med Biol. 2018;17(3):297–306. https://doi.org/10.1002/rmb2.12105.Ji L., Peng C., Bao X. Effect of vaginal flora on clinical outcome of frozen embryo transfer. Front Cell Infect Microbiol. 2022;12:987292. https://doi.org/10.3389/fcimb.2022.987292.Ji L., Peng C., Bao X. Effect of vaginal flora on clinical outcome of frozen embryo transfer. Front Cell Infect Microbiol. 2022;12:987292. https://doi.org/10.3389/fcimb.2022.987292.Lledo B., Fuentes A., Lozano F. M. et al. Identification of vaginal microbiome associated with IVF pregnancy. Sci Rep. 2022;12(1):6807. https://doi.org/10.1038/s41598-022-10933-2.Lledo B., Fuentes A., Lozano F. M. et al. Identification of vaginal microbiome associated with IVF pregnancy. Sci Rep. 2022;12(1):6807. https://doi.org/10.1038/s41598-022-10933-2.Ravel J., Gajer P., Abdo Z. et al. Vaginal microbiome of reproductive-age women. Proc Natl Acad Sci U S A. 2011;108 Suppl 1(Suppl 1):4680–7. https://doi.org/10.1073/pnas.1002611107.Ravel J., Gajer P., Abdo Z. et al. Vaginal microbiome of reproductive-age women. Proc Natl Acad Sci U S A. 2011;108 Suppl 1(Suppl 1):4680–7. https://doi.org/10.1073/pnas.1002611107.France M.T., Ma B., Gajer P. et al. VALENCIA: a nearest centroid classification method for vaginal microbial communities based on composition. Microbiome. 2020;8:166. https://doi.org/10.1186/s40168-020-00934-6.France M.T., Ma B., Gajer P. et al. VALENCIA: a nearest centroid classification method for vaginal microbial communities based on composition. Microbiome. 2020;8:166. https://doi.org/10.1186/s40168-020-00934-6.Hugerth L.W., Krog M.C., Vomstein K. et al. Defining Vaginal Community Dynamics: daily microbiome transitions, the role of menstruation, bacteriophages, and bacterial genes. Microbiome. 2024;12(1):153. https://doi.org/10.1186/s40168-024-01870-5.Hugerth L.W., Krog M.C., Vomstein K. et al. Defining Vaginal Community Dynamics: daily microbiome transitions, the role of menstruation, bacteriophages, and bacterial genes. Microbiome. 2024;12(1):153. https://doi.org/10.1186/s40168-024-01870-5.Haahr T., Jensen J.S., Thomsen L. et al. Abnormal vaginal microbiota may be associated with poor reproductive outcomes: a prospective study in IVF patients. Hum Reprod. 2016;31(4):795–803. https://doi.org/10.1093/humrep/dew026.Haahr T., Jensen J.S., Thomsen L. et al. Abnormal vaginal microbiota may be associated with poor reproductive outcomes: a prospective study in IVF patients. Hum Reprod. 2016;31(4):795–803. https://doi.org/10.1093/humrep/dew026.Lebedeva O.P., Popov V.N., Syromyatnikov M.Y. et al. Female reproductive tract microbiome and early miscarriages. APMIS. 2023;131(2):61–76. https://doi.org/10.1111/apm.13288.Lebedeva O.P., Popov V.N., Syromyatnikov M.Y. et al. Female reproductive tract microbiome and early miscarriages. APMIS. 2023;131(2):61–76. https://doi.org/10.1111/apm.13288.Fu M., Zhang X., Liang Y. et al. Alterations in vaginal microbiota and associated metabolome in women with recurrent implantation failure. mBio. 2020;11(3):e03242-19. https://doi.org/10.1128/mBio.03242-19.Fu M., Zhang X., Liang Y. et al. Alterations in vaginal microbiota and associated metabolome in women with recurrent implantation failure. mBio. 2020;11(3):e03242-19. https://doi.org/10.1128/mBio.03242-19.Lledo B., Fuentes A., Lozano F.M. et al. Identification of vaginal microbiome associated with IVF pregnancy. Sci Rep. 2022;12(1):6807. https://doi.org/10.1038/s41598-022-10933-2.Lledo B., Fuentes A., Lozano F.M. et al. Identification of vaginal microbiome associated with IVF pregnancy. Sci Rep. 2022;12(1):6807. https://doi.org/10.1038/s41598-022-10933-2.Wang R., Zhou G., Wu L. et al. The microbial composition of lower genital tract may affect the outcome of in vitro fertilization-embryo transfer. Front Microbiol. 2021;12:729744. https://doi.org/10.3389/fmicb.2021.729744.Wang R., Zhou G., Wu L. et al. The microbial composition of lower genital tract may affect the outcome of in vitro fertilization-embryo transfer. Front Microbiol. 2021;12:729744. https://doi.org/10.3389/fmicb.2021.729744.Su W., Gong C., Zhong H. et al. Vaginal and endometrial microbiome dysbiosis associated with adverse embryo transfer outcomes. Reprod Biol Endocrinol. 2024;22(1):111. https://doi.org/10.1186/s12958-024-01274-y.Su W., Gong C., Zhong H. et al. Vaginal and endometrial microbiome dysbiosis associated with adverse embryo transfer outcomes. Reprod Biol Endocrinol. 2024;22(1):111. https://doi.org/10.1186/s12958-024-01274-y.Koedooder R., Singer M., Schoenmakers S. et al. The vaginal microbiome as a predictor for outcome of in vitro fertilization with or without intracytoplasmic sperm injection: a prospective study. Hum Reprod. 2019;34(6):1042–54. https://doi.org/10.1093/humrep/dez065.Koedooder R., Singer M., Schoenmakers S. et al. The vaginal microbiome as a predictor for outcome of in vitro fertilization with or without intracytoplasmic sperm injection: a prospective study. Hum Reprod. 2019;34(6):1042–54. https://doi.org/10.1093/humrep/dez065.Wang J., Li Z., Ma X. et al. Translocation of vaginal microbiota is involved in impairment and protection of uterine health. Nat Commun. 2021:12(1):4191. https://doi.org/10.1038/s41467-021-24516-8.Wang J., Li Z., Ma X. et al. Translocation of vaginal microbiota is involved in impairment and protection of uterine health. Nat Commun. 2021:12(1):4191. https://doi.org/10.1038/s41467-021-24516-8.Tomaiuolo R., Veneruso I., Cariati F., D'Argenio V. Microbiota and human reproduction: the case of female infertility. High Throughput. 2020;9(2):12. https://doi.org/10.3390/ht9020012.Tomaiuolo R., Veneruso I., Cariati F., D'Argenio V. Microbiota and human reproduction: the case of female infertility. High Throughput. 2020;9(2):12. https://doi.org/10.3390/ht9020012.Moreno I., Garcia-Grau I., Perez-Villaroya D. et al. Endometrial microbiota сomposition is associated with reproductive outcome in infertile patients. Microbiome. 2022;10(1):1. https://doi.org/10.1186/s40168-021-01184-w.Moreno I., Garcia-Grau I., Perez-Villaroya D. et al. Endometrial microbiota сomposition is associated with reproductive outcome in infertile patients. Microbiome. 2022;10(1):1. https://doi.org/10.1186/s40168-021-01184-w.Chen Q., Zhang X., Hu Q. et al. The alteration of intrauterine microbiota in chronic endometritis patients based on 16S rRNA sequencing analysis. Ann Clin Microbiol Antimicrob. 2023;22(1):4. https://doi.org/10.1186/s12941-023-00556-4.Chen Q., Zhang X., Hu Q. et al. The alteration of intrauterine microbiota in chronic endometritis patients based on 16S rRNA sequencing analysis. Ann Clin Microbiol Antimicrob. 2023;22(1):4. https://doi.org/10.1186/s12941-023-00556-4.Leoni C., Ceci O., Manzari C. et al. Human endometrial microbiota at term of normal pregnancies. Genes. 2019;10(12):971. https://doi.org/10.3390/genes10120971.Leoni C., Ceci O., Manzari C. et al. Human endometrial microbiota at term of normal pregnancies. Genes. 2019;10(12):971. https://doi.org/10.3390/genes10120971.Moreno I., Codo?er F.M., Vilella F. et al. Evidence that the endometrial microbiota has an effect on implantation success or failure. Am J Obstet Gynecol. 2016;6(215):684–703. https://doi.org/10.1016/j.ajog.2016.09.075.Moreno I., Codo?er F.M., Vilella F. et al. Evidence that the endometrial microbiota has an effect on implantation success or failure. Am J Obstet Gynecol. 2016;6(215):684–703. https://doi.org/10.1016/j.ajog.2016.09.075.Kaluanga Bwanga P., Tremblay-Lemoine P.L., Timmermans M. et al. The endometrial microbiota: challenges and prospects. Medicina. 2023;59(9):1540. https://doi.org/10.3390/medicina59091540.Kaluanga Bwanga P., Tremblay-Lemoine P.L., Timmermans M. et al. The endometrial microbiota: challenges and prospects. Medicina. 2023;59(9):1540. https://doi.org/10.3390/medicina59091540.Li F., Chen C., Wei W. et al. The metagenome of the female upper reproductive tract. Gigascience. 2018;7(10):giy107. https://doi.org/10.1093/gigascience/giy107.Li F., Chen C., Wei W. et al. The metagenome of the female upper reproductive tract. Gigascience. 2018;7(10):giy107. https://doi.org/10.1093/gigascience/giy107.Wang W., Feng D., Ling B. Biologia Futura: endometrial microbiome affects endometrial receptivity from the perspective of the endometrial immune microenvironment. Biol Futur. 2022;73(3):291–300. https://doi.org/10.1007/s42977-022-00134-3.Wang W., Feng D., Ling B. Biologia Futura: endometrial microbiome affects endometrial receptivity from the perspective of the endometrial immune microenvironment. Biol Futur. 2022;73(3):291–300. https://doi.org/10.1007/s42977-022-00134-3.Zheng N., Guo R., Wang J. et al. Contribution of Lactobacillus iners to vaginal health and diseases: a systematic review. Front Cell Infect Microbiol. 2021;11:792787. https://doi.org/10.3389/fcimb.2021.792787.Zheng N., Guo R., Wang J. et al. Contribution of Lactobacillus iners to vaginal health and diseases: a systematic review. Front Cell Infect Microbiol. 2021;11:792787. https://doi.org/10.3389/fcimb.2021.792787.Zhang H., Zou H., Zhang C., Zhang S. Chronic endometritis and the endometrial microbiota: implications for reproductive success in patients with recurrent implantation failure. Ann Clin Microbiol Antimicrob. 2024;23(1):49. https://doi.org/10.1186/s12941-024-00710-6.Zhang H., Zou H., Zhang C., Zhang S. Chronic endometritis and the endometrial microbiota: implications for reproductive success in patients with recurrent implantation failure. Ann Clin Microbiol Antimicrob. 2024;23(1):49. https://doi.org/10.1186/s12941-024-00710-6.Cariati F., Carotenuto C., Bagnulo F. et al. Endometrial microbiota profile in in-vitro fertilization (IVF) patients by culturomics-based analysis. Front Endocrinol. 2023;14:1204729. https://doi.org/10.3389/fendo.2023.1204729.Cariati F., Carotenuto C., Bagnulo F. et al. Endometrial microbiota profile in in-vitro fertilization (IVF) patients by culturomics-based analysis. Front Endocrinol. 2023;14:1204729. https://doi.org/10.3389/fendo.2023.1204729.Баринова В.В., Кузнецова Н.Б., Буштырева И.О. и др. Микробиом эндометрия у женщин с многократными неудачами экстракорпорального оплодотворения. Вопросы гинекологии, акушерства и перинатологии. 2021;20(3):5–11. https://doi.org/10.20953/1726-1678-2021-3-5-11.Barinova V.V., Kuznetsova N.B., Bushtyreva I.O. et al. Endometrial microbiome in women with multiple failed in vitro fertilization cycles. [Mikrobiom endometriya u zhenshchin s mnogokratnymi neudachami ekstrakorporal'nogo oplodotvoreniya]. Voprosy ginekologii, akusherstva i perinatologii. 2021;20(3):5–11. (In Russ.). https://doi.org/10.20953/1726-1678-2021-3-5-11.Баринова В.В., Кузнецова Н.Б., Буштырева И.О. и др. Микробиом эндометрия при многократных неудачах вспомогательных репродуктивных технологий и у здоровых женщин: где норма и где патология? Акушерство и гинекология. 2021;(6):105–14. https://doi.org/10.18565/aig.2021.6.105-114.Barinova V.V., Kuznetsova N.B., Bushtyreva I.O. et al. Endometrial microbiome in women with and without a history of repeated failures of assisted reproductive technology: what are norm and pathology? [Mikrobiom endometriya pri mnogokratnyh neudachah vspomogatel'nyh reproduktivnyh tekhnologij i u zdorovyh zhenshchin: gde norma i gde patologiya?] Akusherstvo i ginekologiya. 2021;(6):105–14. (In Russ.). https://doi.org/10.18565/aig.2021.6.105-114.Турсунова Н.Б., Лебедева О.П., Алтухова О.Б., Нагорный А.В. Современный взгляд на роль микробиома женского репродуктивного тракта в исходах ЭКО. Акушерство, Гинекология и Репродукция. 2023;17(4):512–25. https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.433.Tursunova N.B., Lebedeva O.P., Altukhova O.B., Nagorny A.V. An updated view on the role of the female reproductive tract microbiome in IVF outcomes. [Sovremennyj vzglyad na rol' mikrobioma zhenskogo reproduktivnogo trakta v iskhodah EKO]. Obstetrics, Gynecology and Reproduction. 2023;17(4):512–25. (In Russ.). https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.433.Куценко И.И., Боровиков И.О., Кравцова Е.И. и др. Вагинальный и эндометриальный микробиом: оценка, влияние на имплантацию эмбриона. Медицинский вестник Юга России. 2023;14(3):5–15. https://doi.org/10.21886/2219-8075-2023-14-3-5-15.Kutsenko I.I., Borovikov I.O., Kravtsova E.I. et al. Vaginal and endometrial microbiome: evaluation, effect on embryo implantation. [Vaginal'nyj i endometrial'nyj mikrobiom: ocenka, vliyanie na implantaciyu embriona]. Medicinskij vestnik Yuga Rossii. 2023;14(3):5–15. (In Russ.). https://doi.org/10.21886/2219-8075-2023-14-3-5-15.Keburiya L.K., Smolnikova V.Y., Priputnevich T.V. et al. Does the uterine microbiota affect the reproductive outcomes in women with recurrent implantation failures? BMC Womens Health. 2022;22(1):168. https://doi.org/10.1186/s12905-022-01750-w.Keburiya L.K., Smolnikova V.Y., Priputnevich T.V. et al. Does the uterine microbiota affect the reproductive outcomes in women with recurrent implantation failures? BMC Womens Health. 2022;22(1):168. https://doi.org/10.1186/s12905-022-01750-w.

The authors declare that there are no conflicts of interest present.