akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLC10.17749/2313-7347/ob.gyn.rep.2026.773akusherstvo-2881Research ArticleREVIEW ARTICLEНАУЧНЫЙ ОБЗОРA role of the vaginal and endometrial microbiome in the outcomes of assisted reproductive technologies and the prospects for probiotic correctionРоль вагинального и эндометриального микробиома в исходах вспомогательных репродуктивных технологий и перспективы пробиотической коррекцииhttps://orcid.org/0009-0004-0507-6335БурковаА. А.BurkovaA. A.

Буркова Анастасия Андреевна 

426056 Ижевск, ул. Коммунаров, д. 281

Anastasia A. Burkova

281 Kommunarov Str., Izhevsk 426056

burkovanauka@mail.ruhttps://orcid.org/0009-0006-2410-6434ГалявиеваР. И.GalyavievaR. I.

Галявиева Руфина Ирековна 

426056 Ижевск, ул. Коммунаров, д. 281

Rufina I. Galyavieva

281 Kommunarov Str., Izhevsk 426056

https://orcid.org/0009-0002-7090-7700ИдрисоваЛ. В.IdrisovaL. V.

Идрисова Лилия Васимовна 

450008 Уфа, ул. Ленина, д. 3

Liliya V. Idrisova

3 Lenin Str., Ufa 450008

https://orcid.org/0009-0009-9683-4053МерясоваГ. Ф.MeryasovaG. F.

Мерясова Гулия Фанузовна 

450008 Уфа, ул. Ленина, д. 3

Guliya F. Meryasova

3 Lenin Str., Ufa 450008

https://orcid.org/0000-0002-8917-3981ПетросянМ. А.PetrosyanM. A.

Петросян Мисак Андраникович 

450008 Уфа, ул. Ленина, д. 3

Misak A. Petrosyan

3 Lenin Str., Ufa 450008

https://orcid.org/0009-0004-6888-2035РахматуллинаД. И.RakhmatullinaD. I.

Рахматуллина Диляра Ильнуровна 

426056 Ижевск, ул. Коммунаров, д. 281

Dilyara I. Rakhmatullina

281 Kommunarov Str., Izhevsk 426056

https://orcid.org/0009-0008-1413-6810ФатхелисламоваЭ. И.FatkhelislamovaE. I.

Фатхелисламова Эльвира Илшатовна 

450008 Уфа, ул. Ленина, д. 3

Elvira I. Fatkhelislamova

3 Lenin Str., Ufa 450008

https://orcid.org/0009-0006-0795-8352ХазиевИ. Р.KhazievI. R.

Хазиев Ильмир Ришатович

426056 Ижевск, ул. Коммунаров, д. 281

Ilmir R. Khaziev

281 Kommunarov Str., Izhevsk 426056

https://orcid.org/0009-0006-8695-0411ЧернявскийМ. А.ChernyavskyM. A.

Чернявский Максим Александрович 

450008 Уфа, ул. Ленина, д. 3

Maksim A. Chernyavsky

3 Lenin Str., Ufa 450008

https://orcid.org/0009-0000-1846-8291ШайдуллинаД. И.ShaydullinaD. I.

Шайдуллина Динара Ильдаровна 

426056 Ижевск, ул. Коммунаров, д. 281

Dinara I. Shaydullina

281 Kommunarov Str., Izhevsk 426056

https://orcid.org/0009-0004-8128-8524ЯковлеваВ. В.YakovlevaV. V.

Яковлева Виктория Викторовна 

450008 Уфа, ул. Ленина, д. 3

Victoria V. Yakovleva

3 Lenin Str., Ufa 450008

ФГБОУ ВО «Ижевский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияIzhevsk State Medical University, Ministry of Health of the Russian FederationRussian FederationФГБОУ ВО «Башкирский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияBashkir State Medical University, Ministry of Health of the Russian FederationRussian Federation20261507202600Online First2881Copyright © Burkova A.A., Galyavieva R.I., Idrisova L.V., Meryasova G.F., Petrosyan M.A., Rakhmatullina D.I., Fatkhelislamova E.I., Khaziev I.R., Chernyavsky M.A., Shaydullina D.I., Yakovleva V.V., 20262026Буркова А.А., Галявиева Р.И., Идрисова Л.В., Мерясова Г.Ф., Петросян М.А., Рахматуллина Д.И., Фатхелисламова Э.И., Хазиев И.Р., Чернявский М.А., Шайдуллина Д.И., Яковлева В.В.Burkova A.A., Galyavieva R.I., Idrisova L.V., Meryasova G.F., Petrosyan M.A., Rakhmatullina D.I., Fatkhelislamova E.I., Khaziev I.R., Chernyavsky M.A., Shaydullina D.I., Yakovleva V.V.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/2881Introduction

Introduction. The microbiome of the female reproductive tract is considered a potentially important determinant of fertility, endometrial receptivity, implantation, and assisted reproductive technology (ART) outcomes.

Aim

Aim: to summarize current evidence on association between the vaginal microbiome and ART outcomes, and to evaluate a potential role of probiotic interventions in restoring the microbial profile, considering differences between Lactobacillus species, diagnostic approaches, and clinical patient subgroups.

Materials and Methods

Materials and Methods. An analytical review of 73 publications issued in 2011–2026 was conducted using PubMed/MEDLINE, Springer Link, ScienceDirect, eLibrary, CyberLeninka, and Google Scholar databases. Differences between Gram staining with Nugent scoring, culture-based methods and MALDI-TOF, 16S rRNA gene sequencing, and shotgun metagenomics were taken into account.

Results

Results. Lactobacillus-dominated profiles, particularly those enriched with L. crispatus, were more often associated with favorable reproductive outcomes. However, clinical interpretation depended on species- and strain-level composition, co-occurring taxa, community stability, hormonal status, endometrial condition, and the analytical method used. L. iners may be found in both stable eubiotic profiles and unstable or dysbiotic states. The origin of the endometrial microbiota and its dependence on the vaginal niche remain unresolved. Probiotics were generally well tolerated, but their effects on implantation, clinical pregnancy, and live birth were heterogeneous.

Conclusion

Conclusion. Microbiome profiling and probiotic administration cannot yet be recommended as universal components of ART programs. Standardized sampling and analytical protocols, contamination control, strain-specific approaches, and randomized trials with clinically meaningful reproductive endpoints are required.

Введение

Введение. Микробиом женского репродуктивного тракта рассматривается как потенциально значимый фактор фертильности, рецептивности эндометрия, имплантации и исходов программ вспомогательных репродуктивных технологий (ВРТ).

Цель

Цель: обобщить современные данные о роли вагинальной и эндометриальной микробиоты при бесплодии и неудачах ВРТ, а также оценить перспективы пробиотической коррекции.

Материалы и методы

Материалы и методы. Проведен аналитический обзор 73 публикаций за 2011–2026 гг., найденных в PubMed/MEDLINE, Springer Link, ScienceDirect, eLibrary, CyberLeninka и Google Scholar. Учитывали различия между окраской по Граму с расчетом индекса Ньюджента (Nugent), культуральными методами и MALDI-TOF, секвенированием гена 16S рРНК и полногеномной метагеномикой.

Результаты

Результаты. Профили с преобладанием Lactobacillus spp., особенно L. crispatus, чаще ассоциировались с благоприятными репродуктивными исходами. Вместе с тем клиническая интерпретация зависит от видового и штаммового состава, сопутствующих таксонов, стабильности сообщества, гормонального фона, состояния эндометрия и метода исследования. L. iners может выявляться как при устойчивом эубиотическом профиле, так и при нестабильных или дисбиотических состояниях. Происхождение эндометриальной микробиоты и степень ее зависимости от влагалищной ниши остаются дискуссионными. Пробиотики в большинстве исследований характеризовались удовлетворительной переносимостью, однако их влияние на имплантацию, клиническую беременность и живорождение было неоднородным.

Заключение

Заключение. Определение микробиомного профиля и назначение пробиотиков пока не могут быть рекомендованы как универсальный компонент программ ВРТ. Необходимы стандартизация забора и анализа образцов, контроль контаминации, штамм-специфический подход и рандомизированные исследования с оценкой клинически значимых репродуктивных исходов.

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