阴道微生物菌群分布特征与IVF-ET妊娠结局的相关性  

Correlation between distribution characteristics of vaginal microflora and IVF-ET pregnancy outcomes

作　　者：周欣业 黄晓帆[1] 王丽蔓[1] 郭少丽[1] 吴淑卿[1] ZHOU Xinye;HUANG Xiaofan;WANG Liman;GUO Shaoli;WU Shuqing(Reproductive Medicine Center,Shantou Central Hospital,Shantou,Guangdong,China,515041)

机构地区：[1]汕头市中心医院生殖医学中心,广东汕头515041

出　　处：《分子诊断与治疗杂志》2023年第2期277-280,共4页Journal of Molecular Diagnostics and Therapy

基　　金：汕头市科技局汕府科(2018)11号。

摘　　要：目的 探讨阴道微生物菌群分布特征及其与体外受精-胚胎移植(IVF-ET)患者妊娠结局的关系。方法 选择2019年10月至2021年10月汕头市中心医院生殖医学中心82例IVF-ET患者为研究对象,将IVF-ET后妊娠成功的50例患者设为妊娠组,IVF-ET后妊娠失败的32例患者设为非妊娠组。采集两组后窟窿部位阴道分泌物,利用PCR扩增细菌16S rRNAV46保守区,分析两组阴道微菌群的分布特征、α-多样性和β-多样性,并利用logistics回归分析其与IVF-ET妊娠结局的相关性。结果 非妊娠组Shannon指数和Simpson指数均高于妊娠组,差异均有统计学意义(t=2.891、2.665,P<0.05);经PLS-DA分析显示,妊娠组与非妊娠组之间的阴道微生物群落存在显著差异。妊娠组乳酸杆菌属高于非妊娠组,而加德纳菌属、奇异菌属、纤毛菌属、普雷沃菌属、双歧杆菌属、脲原体属、棒状杆菌、链球菌等均低于非妊娠组,差异均有统计学意义(P<0.05)。阴道加德纳菌属、奇异菌属、纤毛菌属、普雷沃菌属、脲原体属过度生长是影响IVF-ET妊娠结局的独立危险因素,乳酸杆菌属平衡则是其保护性因素,差异均用统计学意义(P<0.05)。结论 阴道微生物群与IVF-ET患者的妊娠结局存在密切联系,IVF-ET妊娠失败患者阴道微生物群以乳酸杆菌减少和厌氧微生物过度生长为主要特征,且可能是IVF-ET妊娠失败的潜在预测指标。Objective To investigate the distribution characteristics of vaginal microbial flora and its relationship with pregnancy outcomes in patients with in vitro fertilization-embryo transfer(IVF-ET).Methods From October 2019 to October 2021,82 patients with IVF-ET in the Reproductive Medicine Center of Shantou Central Hospital were selected as the research objects,and 50 patients who had successful pregnancy after IVF-ET were set as the pregnancy group. The vaginal secretions from the posterior hole were collected from the two groups,and the conserved region of bacterial 16S rRNA V46 was amplified by PCR to analyze the distribution characteristics,α-diversity and β-diversity of the vaginal microflora in the two groups. Logistic regression was used to analyze its correlation with IVF-ET pregnancy outcomes. Results The Shannon index and Simpson index in the non-pregnant group were higher than those in the pregnant group,and the differences were statistically significant(t=2.891、2.665,P<0.05). The PLS-DA analysis revealed significant differences in vaginal microbial communities between pregnant and non-pregnant groups. The genus of Lactobacillus in the pregnant group was higher than that in the non-pregnant group,while Gardnerella,Miriamella,Ciliary,Prevotella,Bifidobacterium,Ureaplasma,Corynebacterium and Streptococcus were lower than those in the nonpregnant group,the difference was statistically significant(P<0.05). Overgrowth of Gardnerella vaginalis,Mitobacterium,Ciliary,Prevotella,and Ureaplasma were independent risk factors for pregnancy outcome in IVF-ET,and the balance of Lactobacillus was a protective factor. All differences were statistically significant(P<0.05). Conclusion There is a close relationship between vaginal microbiota and the pregnancy outcome of IVF-ET patients. The vaginal microbiota in patients with IVF-ET pregnancy failure is mainly characterized by the reduction of lactobacillus and the excessive growth of anaerobic microorganisms,and may be a potential predictor of IVF-ET pregnancy failur

关 键 词：阴道微生物菌群 体外受精-胚胎移植 妊娠结局 

分 类 号：R714.8[医药卫生—妇产科学]