The Microbiome-Infertility Connection: A Systematic Review of Emerging Opportunities for Intervention

Authors

• Lynn Dudley, Shenandoah UniversityFollow
• Jennifer Miller, Shenandoah UniversityFollow

Specialty

Reproductive Health

Advisor

Jennifer Miller

Abstract

Abstract 

Importance: Infertility impacts over 16% of couples worldwide, yet current diagnostic and therapeutic strategies often overlook the microbiome as a modifiable determinant of reproductive outcomes.

Objective: To synthesize peer-reviewed research that evaluates interventions that directly target the gut or vaginal microbiota for the purpose of improving fertility endpoints such as pregnancy, live birth, or miscarriage.

Evidence Review: Four intervention categories were identified: oral probiotics, oral fiber, vaginal probiotics, and targeted treatment for vaginal dysbiosis. Five of the seven studies yielded statistically significant positive outcomes; two did not.

Findings: Table 1 summarizes the findings. One study targeting the gut microbiome showed that oral supplementation with partially hydrolyzed guar gum not only improved gut dysbiosis but also led to a 58.3% pregnancy success rate in the treatment group undergoing assisted reproductive technology (ART), which is much higher than typical ART success rates. Six studies targeted the vaginal microbiome using oral or intravaginal probiotics, with four showing statistically significant improvements in reproductive outcomes, including higher birth rates and lower miscarriage rates. In one compelling study, oral administration of Ligilactobacillus salivarus CECT5713 had a considerable effect, resulting in statistically significant increases in pregnancy and live birth rates compared with control groups. In contrast, two studies failed to show statistically significant increases in pregnancy rates.

Conclusion & Relevance: Though early results are mixed, gut and vaginal microbiota show promise as modifiable determinants of reproductive health. Larger, prospective, and controlled trials are needed.

Relevance: Microbiome-targeted interventions are a non-invasive, affordable, self-administered therapeutic strategy to address the global burden of infertility.

Recommended Citation

Dudley L, Miller J. The Microbiome-Infertility Connection: A Systematic Review of Emerging Opportunities for Intervention. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2026; 8(1).