The composition of the vaginal microbiota varies throughout a woman's life and is sensitive to hormonal and environmental factors. Specifically, hormonal treatments necessary in the medically assisted procreation (MAP) processes can influence the vaginal microbiota. New sequencing techniques have been used to characterize the vaginal microbiota, demonstrating that the microbiota could be divided into 5 classes. The composition of the vaginal microbiota seems to have an implication in the evolution of a pregnancy after IVF. It is therefore essential to have more data on the evolution of the vaginal microbiota at the different stages of IVF treatment and to analyze whether this evolution can be predictive of the success of embryo implantation. Good endometrial progesterone impregnation is an essential prerequisite for ensuring embryo implantation. Indeed, supporting the luteal phase through vaginal progesterone is an essential step in IVF protocols to ensure synchronization between endometrial maturation and embryonic age. However, the serum progesterone level on the day of embryo transfer varies widely between patients. Several factors such as age, vaginal mucosa trophicity, estrogen impregnation and sexual activity are known to affect the vaginal absorption of progesterone. The treatments and vaginal examinations performed during the IVF procedure could also have an impact on the constitution of the vaginal microbiota. The hypothesis of this research is that there is an alteration in the vaginal microbiota during the IVF process which may alter the absorption of vaginal progesterone, with an impact on the failure or success of embryo implantation.
Study Type
OBSERVATIONAL
Enrollment
60
Vaginal flora swab 3 months before stimulation, at oocyte puncture, embryo transfer and beta-human chorionic gonadotropin dosing
Blood sample to measure plasma dose of progesterone
CHU de Nimes
Nîmes, France
Class of vaginal flora according to community state type
Classified into 5 classes of vaginal flora described according to Smith \& Ravel 2017
Time frame: 3 Months before ovarian stimulation
Microbiota richness of vaginal flora
Measured by operational taxonomic unit
Time frame: 3 Months before ovarian stimulation
Microbiota alpha diversity of vaginal flora
Shannon Index
Time frame: 3 Months before ovarian stimulation
Microbiota beta diversity of vaginal flora
Bray Curtis index
Time frame: 3 Months before ovarian stimulation
Plasma progesterone level on the day of embryo transfer
Measured by chemiluminescence (nmol/L)
Time frame: Day of embryo transfer (Day 0)
Class of vaginal flora according to community state type
Classified into 5 classes of vaginal flora described according to Smith \& Ravel 2017
Time frame: Day of oocyte puncture (Month 3)
Class of vaginal flora according to community state type
Classified into 5 classes of vaginal flora described according to Smith \& Ravel 2017
Time frame: Day of embryo transfer (Day 93)
Class of vaginal flora according to community state type
Classified into 5 classes of vaginal flora described according to Smith \& Ravel 2017
Time frame: Day of beta-human chorionic gonadotropin dosage (Day 108)
Microbiota richness of vaginal flora
Measured by operational taxonomic unit
Time frame: Day of oocyte puncture (Month 3)
Microbiota richness of vaginal flora
Measured by operational taxonomic unit
Time frame: Day of embryo transfer (Day 93)
Microbiota richness of vaginal flora
Measured by operational taxonomic unit
Time frame: Day of beta-human chorionic gonadotropin dosage (Day 108)
Microbiota alpha diversity of vaginal flora
Shannon Index
Time frame: Day of oocyte puncture (Month 3)
Microbiota alpha diversity of vaginal flora
Shannon Index
Time frame: Day of embryo transfer (Day 93)
Microbiota alpha diversity of vaginal flora
Shannon Index
Time frame: Day of beta-human chorionic gonadotropin dosage (Day 108)
Microbiota beta diversity of vaginal flora
Bray Curtis index
Time frame: Day of oocyte puncture (Month 3)
Microbiota beta diversity of vaginal flora
Bray Curtis index
Time frame: Day of embryo transfer (Day 93)
Microbiota beta diversity of vaginal flora
Bray Curtis index
Time frame: Day of beta-human chorionic gonadotropin dosage (Day 108)
Pregnancy success
Yes/No
Time frame: Month 3
Pregnancy progression
Implantation failure/progression/miscarriage
Time frame: Month 3
Treatments received for IVF
Description of treatments, taken from patient file
Time frame: Month 3
Plasma progesterone level
Measured by chemiluminescence (nmol/L)
Time frame: Month 3
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