Unique targeted testing of the urogenital microbiome has potential as a predictive test during IVF for implantation outcome.

Abstract The aim of this pilot study was to develop a method characterising the urogenital microbiome as a predictive test in the IVF workup. Using unique custom qPCRs we tested for the presence of specific microbial species from vaginal samples and First Catch Urines from the male. The test panel included a range of potential urogenital pathogens, STIs, ‘favourable’ (Lactobacilli spp.) and ‘unfavourable’ bacteria (anaerobes) reported to influence implantation rates. We tested couples attending Fertility Associates, Christchurch, New Zealand for their first round of IVF and found that some microorganisms affected implantation. The qPCR result was interpreted qualitatively using the Z proportionality test. Samples from women at the time of Embryo Transfer who did not achieve implantation had significantly higher percent of samples that were positive for Prevotella bivia and Staphylococcus aureus compared to women who did achieve implantation. The results provide evidence that most microorganisms chosen for testing had little functional effect on implantation rates. The addition of further microbial targets (yet to be determined) could be combined in this predictive test for vaginal preparedness on the day of Embryo Transfer. This methodology has a substantial advantage of being affordable and easily performed in any routine molecular laboratory. This methodology is most suitable as a foundation on which to develop a timely test of microbiome profiling. Using the indicators detected to have a significant influence, these results can be extrapolated to a rapid antigen test for a woman to self-sample prior to Embryo Transfer as an indicator of likely implantation.