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Published in: Reproductive Health 1/2018

Open Access 01-12-2018 | Study protocol

The ReceptIVFity cohort study protocol to validate the urogenital microbiome as predictor for IVF or IVF/ICSI outcome

Authors: Rivka Koedooder, Martin Singer, Sam Schoenmakers, Paul Hendrik Maria Savelkoul, Servaas Antonie Morré, Jonathan Dennis de Jonge, Linda Poort, Willem-Jan Simon Stephanus Cuypers, Andries Edward Budding, Joop Stephanus Elisabeth Laven, ReceptIVFity study group

Published in: Reproductive Health | Issue 1/2018

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Abstract

Background

During the last decade, research has shown that besides the known predictive factors, such as duration of subfertility, a women’s age, the body mass index, also the microbiome might affect fertility. Micro-organisms together with their genetic information and the milieu in which they interact are called the microbiome. Studies have shown that the presence of certain microbiota during assisted reproductive technology (ART) has a positive impact on the outcome. However, the potential role of using the microbiome as a predictor for outcome of ART has not yet been investigated.

Methods

In a prospective study, 300 women of reproductive age and with an indication for in-vitro Fertilization (IVF) with or without Intra Cytoplasmic Sperm Injection (ICSI) treatment will be included. Prior to the IVF or IVF-ICSI treatment, these women provided a midstream urine sample and a vaginal swab. The composition of the urinary and vaginal microbiome will be analysed with both Next Generation Sequencing and the IS-pro technique. The endpoints of the study are pregnancy achieved after fresh embryo transfer (ET) and within the subsequent year after inclusion. External validation of the findings will take place in an additional cohort of 50 women with an IVF or IVF-ICSI indication.

Discussion

In the proposed study, the predictive accuracy of the composition of the urinary and vaginal microbiome for IVF or IVF-ICSI outcome will be only validated for fresh ET. Follow-up has to show whether the predictive accuracy will be similar during the consecutive frozen ET’s as part of the IVF or IVF-ICSI treatment or for subsequent stimulated or natural cycles. In addition, external validation will take place in another cohort and hospital. Predictive knowledge of the microbiome profile may enable couples to make a more substantiated decision on whether to continue treatment or not. Hence, the unnecessary physical and emotional burden of a failed IVF or IVF-ICSI treatment can be avoided.

Trial registration

ISRCTN ISRCTN83157250. Registered 17 August 2018. Retrospectively registered.
Literature
1.
go back to reference Edwards RG, Steptoe PC, Purdy JM. Establishing full-term human pregnancies using cleaving embryos grown in vitro. BJOG Int J Obstet Gynaecol. 1980;87(9):737–56.CrossRef Edwards RG, Steptoe PC, Purdy JM. Establishing full-term human pregnancies using cleaving embryos grown in vitro. BJOG Int J Obstet Gynaecol. 1980;87(9):737–56.CrossRef
2.
go back to reference Palermo G, Joris H, Devroey P, Van Steirteghem AC. Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte. Lancet. 1992;340(8810):17–8.CrossRefPubMed Palermo G, Joris H, Devroey P, Van Steirteghem AC. Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte. Lancet. 1992;340(8810):17–8.CrossRefPubMed
4.
go back to reference Brandes M, Hamilton C, van der Steen JOM, De Bruin JP, Bots R, Nelen W, Kremer JAM. Unexplained infertility: overall ongoing pregnancy rate and mode of conception. Hum Reprod. 2010;26(2):360–8.CrossRefPubMed Brandes M, Hamilton C, van der Steen JOM, De Bruin JP, Bots R, Nelen W, Kremer JAM. Unexplained infertility: overall ongoing pregnancy rate and mode of conception. Hum Reprod. 2010;26(2):360–8.CrossRefPubMed
5.
go back to reference ESHRE Capri Workshop Group. Failures (with some successes) of assisted reproduction and gamete donation programs. Hum Reprod Update. 2013;19(4):354–65. ESHRE Capri Workshop Group. Failures (with some successes) of assisted reproduction and gamete donation programs. Hum Reprod Update. 2013;19(4):354–65.
6.
go back to reference Nelson SM, Lawlor DA. Predicting live birth, preterm delivery, and low birth weight in infants born from in vitro fertilisation: a prospective study of 144,018 treatment cycles. PLoS Med. 2011;8(1):e1000386.CrossRefPubMedPubMedCentral Nelson SM, Lawlor DA. Predicting live birth, preterm delivery, and low birth weight in infants born from in vitro fertilisation: a prospective study of 144,018 treatment cycles. PLoS Med. 2011;8(1):e1000386.CrossRefPubMedPubMedCentral
7.
go back to reference Kok DJ, Laven JSE, Maghdid DM, Beckers NGM. Method and kit for prediction success of in vitro fertilization. Application No./Patent No. 11763787.6 – 1111 / 2742359. Kok DJ, Laven JSE, Maghdid DM, Beckers NGM. Method and kit for prediction success of in vitro fertilization. Application No./Patent No. 11763787.6 – 1111 / 2742359.
8.
go back to reference Templeton A, Morris JK, Parslow W. Factors that affect outcome of in-vitro fertilisation treatment. Lancet. 1996;348(9039):1402–6.CrossRefPubMed Templeton A, Morris JK, Parslow W. Factors that affect outcome of in-vitro fertilisation treatment. Lancet. 1996;348(9039):1402–6.CrossRefPubMed
9.
go back to reference Brosens JJ, Salker MS, Teklenburg G, Nautiyal J, Salter S, Lucas ES, Steel JH, Christian M, Chan Y-W, Boomsma CM. Uterine selection of human embryos at implantation. Sci Rep. 2014;4:3894.CrossRefPubMedPubMedCentral Brosens JJ, Salker MS, Teklenburg G, Nautiyal J, Salter S, Lucas ES, Steel JH, Christian M, Chan Y-W, Boomsma CM. Uterine selection of human embryos at implantation. Sci Rep. 2014;4:3894.CrossRefPubMedPubMedCentral
10.
go back to reference Graspeuntner S, Bohlmann MK, Gillmann K, Speer R, Kuenzel S, Mark H, Hoellen F, Lettau R, Griesinger G, Konig IR, et al. Microbiota-based analysis reveals specific bacterial traits and a novel strategy for the diagnosis of infectious infertility. PLoS One. 2018;13(1):e0191047.CrossRefPubMedPubMedCentral Graspeuntner S, Bohlmann MK, Gillmann K, Speer R, Kuenzel S, Mark H, Hoellen F, Lettau R, Griesinger G, Konig IR, et al. Microbiota-based analysis reveals specific bacterial traits and a novel strategy for the diagnosis of infectious infertility. PLoS One. 2018;13(1):e0191047.CrossRefPubMedPubMedCentral
11.
go back to reference Babu G, Singaravelu BG, Srikumar R, Reddy SV, Kokan A. Comparative study on the vaginal Flora and Incidence of asymptomatic vaginosis among healthy women and in women with infertility problems of reproductive age. J Clin Diagn Res. 2017;11(8):DC18–22.PubMedPubMedCentral Babu G, Singaravelu BG, Srikumar R, Reddy SV, Kokan A. Comparative study on the vaginal Flora and Incidence of asymptomatic vaginosis among healthy women and in women with infertility problems of reproductive age. J Clin Diagn Res. 2017;11(8):DC18–22.PubMedPubMedCentral
12.
go back to reference Campisciano G, Florian F, D'Eustacchio A, Stankovic D, Ricci G, De Seta F, Comar M. Subclinical alteration of the cervical-vaginal microbiome in women with idiopathic infertility. J Cell Physiol. 2017;232(7):1681–8.CrossRefPubMed Campisciano G, Florian F, D'Eustacchio A, Stankovic D, Ricci G, De Seta F, Comar M. Subclinical alteration of the cervical-vaginal microbiome in women with idiopathic infertility. J Cell Physiol. 2017;232(7):1681–8.CrossRefPubMed
13.
go back to reference Urszula K, Joanna E, Marek E, Beata M, Magdalena SB. Colonization of the lower urogenital tract with Ureaplasma parvum can cause asymptomatic infection of the upper reproductive system in women: a preliminary study. Arch Gynecol Obstet. 2014;289(5):1129–34.CrossRef Urszula K, Joanna E, Marek E, Beata M, Magdalena SB. Colonization of the lower urogenital tract with Ureaplasma parvum can cause asymptomatic infection of the upper reproductive system in women: a preliminary study. Arch Gynecol Obstet. 2014;289(5):1129–34.CrossRef
14.
go back to reference Wee BA, Thomas M, Sweeney EL, Frentiu FD, Samios M, Ravel J, Gajer P, Myers G, Timms P, Allan JA, et al. A retrospective pilot study to determine whether the reproductive tract microbiota differs between women with a history of infertility and fertile women. Aust N Z J Obstet Gynaecol. 2018;58(3):341–8.CrossRefPubMed Wee BA, Thomas M, Sweeney EL, Frentiu FD, Samios M, Ravel J, Gajer P, Myers G, Timms P, Allan JA, et al. A retrospective pilot study to determine whether the reproductive tract microbiota differs between women with a history of infertility and fertile women. Aust N Z J Obstet Gynaecol. 2018;58(3):341–8.CrossRefPubMed
15.
go back to reference Panda PS, Kashyap B, Prasad S. Microbiological profile of cervix of females attending in-vitro fertilization clinic of a tertiary care hospital, North India. Journal of Reproductive Health and Medicine. 2016;2:S7–S10.CrossRef Panda PS, Kashyap B, Prasad S. Microbiological profile of cervix of females attending in-vitro fertilization clinic of a tertiary care hospital, North India. Journal of Reproductive Health and Medicine. 2016;2:S7–S10.CrossRef
16.
go back to reference Costoya A, Morales F, Borda P, Vargas R, Fuhrer J, Salgado N, Cardenas H, Velasquez L. Mycoplasmateceae species are not found in fallopian tubes of women with tubo-peritoneal infertility. Braz J Infect Dis. 2012;16(3):273–8.CrossRefPubMed Costoya A, Morales F, Borda P, Vargas R, Fuhrer J, Salgado N, Cardenas H, Velasquez L. Mycoplasmateceae species are not found in fallopian tubes of women with tubo-peritoneal infertility. Braz J Infect Dis. 2012;16(3):273–8.CrossRefPubMed
17.
go back to reference Moreno I, Codoner FM, Vilella F, Valbuena D, Martinez-Blanch JF, Jimenez-Almazan J, Alonso R, Alama P, Remohi J, Pellicer A, et al. Evidence that the endometrial microbiota has an effect on implantation success or failure. Am J Obstet Gynecol. 2016;215(6):684–703.CrossRefPubMed Moreno I, Codoner FM, Vilella F, Valbuena D, Martinez-Blanch JF, Jimenez-Almazan J, Alonso R, Alama P, Remohi J, Pellicer A, et al. Evidence that the endometrial microbiota has an effect on implantation success or failure. Am J Obstet Gynecol. 2016;215(6):684–703.CrossRefPubMed
18.
go back to reference Kyono K, Hashimoto T, Nagai Y, Sakuraba Y. Analysis of endometrial microbiota by 16S ribosomal RNA gene sequencing among infertile patients: a single-center pilot study. Reprod Med Biol. 2018;17(3):297–306.CrossRefPubMedPubMedCentral Kyono K, Hashimoto T, Nagai Y, Sakuraba Y. Analysis of endometrial microbiota by 16S ribosomal RNA gene sequencing among infertile patients: a single-center pilot study. Reprod Med Biol. 2018;17(3):297–306.CrossRefPubMedPubMedCentral
19.
go back to reference Mangot-Bertrand J, Fenollar F, Bretelle F, Gamerre M, Raoult D, Courbiere B. Molecular diagnosis of bacterial vaginosis: impact on IVF outcome. Eur J Clin Microbiol Infect Dis. 2013;32(4):535–41.CrossRefPubMed Mangot-Bertrand J, Fenollar F, Bretelle F, Gamerre M, Raoult D, Courbiere B. Molecular diagnosis of bacterial vaginosis: impact on IVF outcome. Eur J Clin Microbiol Infect Dis. 2013;32(4):535–41.CrossRefPubMed
20.
go back to reference Haahr T, Jensen JS, Thomsen L, Duus L, Rygaard K, Humaidan P. Abnormal vaginal microbiota may be associated with poor reproductive outcomes: a prospective study in IVF patients. Hum Reprod. 2016;31(4):795–803.CrossRefPubMed Haahr T, Jensen JS, Thomsen L, Duus L, Rygaard K, Humaidan P. Abnormal vaginal microbiota may be associated with poor reproductive outcomes: a prospective study in IVF patients. Hum Reprod. 2016;31(4):795–803.CrossRefPubMed
21.
go back to reference Srinivasan S, Hoffman NG, Morgan MT, Matsen FA, Fiedler TL, Hall RW, Ross FJ, McCoy CO, Bumgarner R, Marrazzo JM. Bacterial communities in women with bacterial vaginosis: high resolution phylogenetic analyses reveal relationships of microbiota to clinical criteria. PLoS One. 2012;7(6):e37818.CrossRefPubMedPubMedCentral Srinivasan S, Hoffman NG, Morgan MT, Matsen FA, Fiedler TL, Hall RW, Ross FJ, McCoy CO, Bumgarner R, Marrazzo JM. Bacterial communities in women with bacterial vaginosis: high resolution phylogenetic analyses reveal relationships of microbiota to clinical criteria. PLoS One. 2012;7(6):e37818.CrossRefPubMedPubMedCentral
22.
go back to reference Budding AE, Grasman ME, Lin F, Bogaards JA, Soeltan-Kaersenhout DJ, Vandenbroucke-Grauls C, Van Bodegraven AA, Savelkoul PHM. IS-pro: high-throughput molecular fingerprinting of the intestinal microbiota. FASEB J. 2010;24(11):4556–64.CrossRefPubMed Budding AE, Grasman ME, Lin F, Bogaards JA, Soeltan-Kaersenhout DJ, Vandenbroucke-Grauls C, Van Bodegraven AA, Savelkoul PHM. IS-pro: high-throughput molecular fingerprinting of the intestinal microbiota. FASEB J. 2010;24(11):4556–64.CrossRefPubMed
23.
go back to reference Budding AE, Grasman ME, Eck A, Bogaards JA, Vandenbroucke-Grauls CMJE, van Bodegraven AA, Savelkoul PHM. Rectal swabs for analysis of the intestinal microbiota. PLoS One. 2014;9(7):e101344.CrossRefPubMedPubMedCentral Budding AE, Grasman ME, Eck A, Bogaards JA, Vandenbroucke-Grauls CMJE, van Bodegraven AA, Savelkoul PHM. Rectal swabs for analysis of the intestinal microbiota. PLoS One. 2014;9(7):e101344.CrossRefPubMedPubMedCentral
Metadata
Title
The ReceptIVFity cohort study protocol to validate the urogenital microbiome as predictor for IVF or IVF/ICSI outcome
Authors
Rivka Koedooder
Martin Singer
Sam Schoenmakers
Paul Hendrik Maria Savelkoul
Servaas Antonie Morré
Jonathan Dennis de Jonge
Linda Poort
Willem-Jan Simon Stephanus Cuypers
Andries Edward Budding
Joop Stephanus Elisabeth Laven
ReceptIVFity study group
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Reproductive Health / Issue 1/2018
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/s12978-018-0653-x

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