The Endometrial Microbiota’s Role in Fertility: Updates and Future Directions

Advances in RNA sequencing have revealed diverse endometrial microbiota. As the field of reproductive endocrinology and infertility continues to optimize in vitro fertilization success, the role of endometrial microbiota in endometrial receptivity has gained attention. This review aims to provide a comprehensive summary of our current understanding of the endometrial microbiota and its relationship with fertility while also highlighting future directions.

Researchers have been able to build profiles of endometrial microbiomes that are associated with both fertility and infertility. Emerging patterns demonstrate endometrial microbiomes associated with infertility have similarities to those found in chronic endometritis. Studies are beginning to describe the intricate interplay between the microbiota and the immune system. An altered immune response to a dysbiotic endometrium may negatively impact fertility.

Understanding an individual’s microbiome could allow clinicians to personalize treatments to enhance reproductive success in infertile patients. Currently, investigations have shown promise in interventions that include antibiotics and steroids, but there are many other opportunities for emerging areas of research.