Abstract
ObjectivesTo reveal the characteristics of vaginal microbiota in premature ovarian insufficiency (POI) patients and their relationship with ovarian function.Materials and MethodsIn this case-control study, the vaginal bacterial composition of 30 POI patients and 26 healthy women of comparable age was assessed by 16S rRNA gene sequencing targeting the V3-V4 hypervariable regions. The metabolic functions of vaginal microflora were preliminarily predicted through the PICRUSt2 analysis. Redundancy analysis and Spearman’s correlation analyzed the relationships between vaginal microbiota and ovarian function indicators.Results Actinobacteria, Atopobium, and Gardnerella were significantly increased in POI patients. Their increments were significantly negatively correlated with anti-müllerian hormone (AMH) and inhibin B, and positively correlated with follicle-stimulating hormone (FSH) and luteinizing hormone (LH). While Bifidobacterium was significantly decreased in POI patients. Its relative abundance was significantly positively correlated with AMH and negatively correlated with FSH and LH. Then, POI patients included in this study were divided into POI (25 < FSH ≤ 40) (n = 9) and premature ovarian failure (POF) (FSH > 40) (n = 21) subgroups according to serum FSH levels. Compared with the controls, Firmicutes and Lactobacillus were significantly decreased only in POF (FSH > 40) patients, while no difference was observed in POI (25 < FSH ≤ 40) patients. Lactobacillus was negatively correlated with FSH. Firmicutes was significantly reduced and Actinobacteria was significantly increased in POF (FSH > 40) patients compared with POI (25 < FSH ≤ 40) patients. The key bacterial taxa Gardnerella and Atopobium showed potency in predicting POI.ConclusionsHere we demonstrated significant changes in the vaginal microbiota of POI patients, and these changes were significantly correlated with reduced ovarian reserve, endocrine disruption, and symptoms of perimenopausal syndrome. Differences in vaginal microbiota between POI (25 < FSH ≤ 40) and POF (FSH > 40) patients were also identified. These findings may provide new evidence for the relationship between vaginal microbiota and ovarian function.
Highlights
Premature ovarian insufficiency (POI) is a medical condition in which ovarian follicles are depleted and cease to function normally in women under 40 years of age [1]
POI patients included in this study were divided into POI (25 < follicle-stimulating hormone (FSH) ≤ 40) (n = 9) and premature ovarian failure (POF) (FSH > 40) (n = 21) subgroups according to serum FSH levels
Firmicutes was significantly reduced and Actinobacteria was significantly increased in POF (FSH > 40) patients compared with POI (25 < FSH ≤ 40) patients
Summary
Premature ovarian insufficiency (POI) is a medical condition in which ovarian follicles are depleted and cease to function normally in women under 40 years of age [1]. The clinical manifestation differs between individuals, mainly including menstrual disturbance, subfertility or infertility, and symptoms of perimenopausal syndrome [2]. Long-term consequences of premature loss of ovarian function have a significant negative impact on psychological wellbeing and quality of life; it increases the risk of osteoporosis, and cardiovascular and neurological disorders [1, 3–6]. Multiple causes have been reported, including genetic [7–10], autoimmune [11, 12], iatrogenic [13–15], and environmental pollutants [16, 17], et al, the exact etiology of POI remains unclear. Over half of patients are diagnosed with idiopathic POI. Considering the serious adverse effects of POI on female reproductive and general health, it is of great importance to study POI
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