Study Protocol: The Periodontal-Reproductive Axis: A Scoping Review of Systemic Inflammation, Microbial Translocation and Female Infertility Disorders

This scoping review aimed to map and synthesize current evidence linking periodontitis to female reproductive disorders, specifically infertility, endometriosis, and recurrent implantation failure (RIF). Methods: Following PRISMA-ScR guidelines, we conducted a comprehensive search of the PubMed and EMBASE databases for studies published between January 2020 and October 2025, identifying 11 relevant publications, including systematic reviews, observational studies, and Mendelian randomization studies. Results: Findings indicate a biologically plausible association between periodontal disease and reduced fecundability. Mechanistic data highlight the systemic translocation of periodontal pathogens, such as Porphyromonas gingivalis and Fusobacterium nucleatum, as well as their extracellular vesicles, which could disrupt the hypothalamic–pituitary–ovarian axis and compromise endometrial receptivity. Furthermore, evidence supports a causal link between periodontitis and endometriosis mediated by microbial-driven phenotypic transitions of endometrial fibroblasts. Conclusions: Periodontitis and female infertility disorders appear to share a common pathophysiological framework defined by systemic inflammation, immune dysregulation, and microbial components translocation. The findings of this scoping review suggest that integrating periodontal assessment into fertility care pathways could enhance reproductive outcomes, although longitudinal interventional trials are necessary to establish definitive causality in clinical practice.