Volume 49, Issue 4 (3-2026)
Research in Medicine 2026, 49(4): 47-59 |
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Ardforoosh A, Eftekhari Afshar Z, Darghahi R. Vaginal Microbiome: From Advanced Diagnostics to Clinical Interventions in Infections and Reproductive Disorders. Research in Medicine 2026; 49 (4) :47-59
URL: http://pejouhesh.sbmu.ac.ir/article-1-3503-en.html
URL: http://pejouhesh.sbmu.ac.ir/article-1-3503-en.html
Department of Microbiology and Microbial Biotechnology, Faculty of Biological Sciences and Microbial Biotechnology, Shahid Beheshti University, Tehran, Iran. , arezoo.ardforoosh@gmail.com
Abstract: (1379 Views)
Background and Aim: A major challenge in women's health is the accurate characterization of the vaginal microbiome and understanding its role in preventing common infections, including bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), and sexually transmitted infections (STIs), as well as improving reproductive health by reducing the risks of preterm birth, infertility, polycystic ovary syndrome (PCOS), and endometriosis. Vaginal microbiome dysbiosis may exacerbate these conditions. This systematic review investigated diagnostic methods ranging from traditional culture to next- generation sequencing (NGS) and metagenomics, as well as the preventive role of the vaginal microbiome in infections and its impact on reproductive health, focusing on studies published between 2020 and 2025 and exploring probiotic and personalized interventions.
Methods: This systematic review followed the PRISMA 2020 guidelines (protocol registered in PROSPERO: CRD42025412345). Literature searches were conducted in the PubMed, Scopus, Web of Science, and Google Scholar databases using the keywords "vaginal microbiome," "metagenomic diagnosis," "infection prevention," "reproductive health," and "probiotics." English- language articles published between January 2020 and October 2025, including reviews, original studies, and clinical trials, were included (final number: 85). Irrelevant animal studies, case reports, and articles not directly related to humans were excluded.
Results: In diagnostics, NGS and metagenomics increased diagnostic accuracy to 95%, whereas traditional culture detects only approximately 1% of microorganisms. In infection prevention, a Lactobacillus- dominated vaginal microbiome inhibited pathogen growth by 50% through lactic acid and H₂O₂ production, while dysbiosis increased the risk of BV by 20-30% and STIs by 30%. In reproductive health, dysbiosis was associated with a 10-20% increased risk of preterm birth and infertility. Probiotics reduced BV and VVC recurrence by 50% and improved in vitro fertilization (IVF) success rates by 40%. Artificial intelligence (AI) models predicted IVF outcomes with an accuracy of 85%.
Conclusion: Modulation of the vaginal microbiome using probiotics, vaginal microbiota transplantation (VMT), and rapid diagnostic technologies, including CRISPR based methods and biosensors, represents a promising frontier in infection prevention and fertility enhancement. Future research should focus on standardization, longitudinal studies, and the influence of environmental factors.
Methods: This systematic review followed the PRISMA 2020 guidelines (protocol registered in PROSPERO: CRD42025412345). Literature searches were conducted in the PubMed, Scopus, Web of Science, and Google Scholar databases using the keywords "vaginal microbiome," "metagenomic diagnosis," "infection prevention," "reproductive health," and "probiotics." English- language articles published between January 2020 and October 2025, including reviews, original studies, and clinical trials, were included (final number: 85). Irrelevant animal studies, case reports, and articles not directly related to humans were excluded.
Results: In diagnostics, NGS and metagenomics increased diagnostic accuracy to 95%, whereas traditional culture detects only approximately 1% of microorganisms. In infection prevention, a Lactobacillus- dominated vaginal microbiome inhibited pathogen growth by 50% through lactic acid and H₂O₂ production, while dysbiosis increased the risk of BV by 20-30% and STIs by 30%. In reproductive health, dysbiosis was associated with a 10-20% increased risk of preterm birth and infertility. Probiotics reduced BV and VVC recurrence by 50% and improved in vitro fertilization (IVF) success rates by 40%. Artificial intelligence (AI) models predicted IVF outcomes with an accuracy of 85%.
Conclusion: Modulation of the vaginal microbiome using probiotics, vaginal microbiota transplantation (VMT), and rapid diagnostic technologies, including CRISPR based methods and biosensors, represents a promising frontier in infection prevention and fertility enhancement. Future research should focus on standardization, longitudinal studies, and the influence of environmental factors.
Keywords: vaginal microbiome, metagenomic diagnosis, infection prevention, reproductive health, probiotics, dysbiosis, next- generation sequencing, bacterial vaginosis, candidiasis, sexually transmitted infections, Lactobacillus, shotgun metagenomics
Type of Study: Review |
Subject:
Microbiology
Received: 2025/10/29 | Accepted: 2026/04/26 | Published: 2026/06/2
Received: 2025/10/29 | Accepted: 2026/04/26 | Published: 2026/06/2
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