• Dr. H. Singh, ND

Optimizing the Endometrial Microbiome to Improve Pregnancy Rates and Reduce Miscarriage Rates



Increasing amounts of research are looking towards shifts in the microbiome to treat various health conditions. It is an exciting avenue to search for novel therapeutic approaches to improving human health and quality of life.


The largest microbiome in the body is the gut microbiome, and this is where a lot of research has recently focused. The gut microbiome seems to significantly impact blood sugar control, activity of the immune system, nutrient absorption, insulin sensitivity, and inflammation. Since all of the these activities can significantly impact health, looking at how to improve the gut microbiome to protect health is important.


Recently the research has also focused on the reproductive biome. Previously the uterine cavity was believed to be a sterile environment and the presence of any harmful bacteria considered an infection. However, it has been seen that there are difference strains of bacteria found within the uterine cavity. And the impact the different strains of bacteria have on implantation, pregnancy, and miscarriage rates varies significantly.


As you can probably guess, the first step to optimizing the microbiome is to support the health of the gut microbiome. If inflammation is elevated, insulin sensitivity decreased, blood sugar control worsened, or hormone reabsorption affected then all of these factors will most likely impact the reproductive microbiome as well. In fact, improving the gut microbiome appears to be essential to treatment of polycystic ovarian syndrome (PCOS). Secondly, a closer look at the reproductive microbiome for patients struggling with infertility is vital.


Ideally, the uterine environment should be dominant in the lactobacillus spp. as they have an anti-inflammatory function in the uterine cavity and seem to support fertility outcomes. If other pathogens start to grow and lactobacillus spp. is no longer dominant, the fertility rates appear to decline. Specifically, having a lactobacillus spp. dominant uterine microbiome vs. a non-dominant lactobacillus spp. microbiome appears to improve implantation rates with fertility treatments (60% vs 23%), in pregnancy rates (70% vs 33%), and in live birth rate (60% vs 7%).


It is important to note that dysbiosis of the uterine microbiome (deviation from the healthy balance in the bacterial populations) is asymptomatic in approximately 20-50% of patients. Sometimes there are notable changes, such as, clear discharge that is odourless or coloured discharge with odour, but in many cases there are no changes that can be noted. Therefore it is important to evaluate if reproductive microbiome dysbiosis is present, especially in patients that have had recurrent implantation failure, miscarriages, and/or unexplained infertility.


his article is in no way a replacement for medical advice or medical care, it is advised that anyone concerned about their Health should speak with their Naturopathic Doctor. Please discuss with your healtcare provider and only make changes to your medications regimen if recommended by your doctor and under their guidance.

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