بررسی نقش تغییرات میکروبیوتای واژن بر ناباروری: مطالعه مروری

نوع مقاله : مروری

نویسندگان

1 دانشجوی دکتری بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران.

2 دانشیار گروه بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران.

10.22038/ijogi.2025.85742.6342

چکیده

مقدمه: ناباروری به‌‌عنوان یک معضل بهداشت عمومی، پیامدهای متعددی بر سلامت روحی، روانی و جسمی زوجین دارد. از آنجایی‌که ابتلاء به انواع عفونت­های باکتریایی دستگاه ادراری- تناسلی نقش مهمی در برهم زدن میکروبیوتای واژن دارند، به‌عنوان یکی از علل ناباروری اهمیت بالینی زیادی پیدا کرده است. مطالعه حاضر با هدف بررسی نقش تغییرات میکروبیوتای واژن بر ناباروری با استفاده از مرور متون انجام شد.
روش‌کار: این مطالعه مروری با جستجو در پایگاه‌های اطلاعاتی Irandoc، Magiran، SID، Iranmedex، Cochrane، Scopus، ISI Web of science، PubMed، Science direct و Google Scholar (به‌عنوان یک موتور جستجوگر) با استفاده از کلید واژه‌های vaginal microbiota،bacterial vaginitis ، bacterial agent، vaginal flora، reproductive health، women و معادل فارسی آنها انجام شد. مطالعاتی که در بازه زمانی 2000 تا 2022 به زبان انگلیسی و یا فارسی منتشر شده بودند، مورد بررسی قرار گرفتند. ارزیابی کیفیت مقالات با استفاده از چک‌لیست کانسورت انجام گرفت. از بین 153 مطالعه، در نهایت 24 مطالعه برای ارزیابی نهایی انتخاب شدند.
یافته ­ها: عوامل باکتریایی واژن با مختل نمودن تعادل از طریق کاهش شیوع کمتر لاکتوباسیل ­ها و افزایش شیوع بیشتر باکتری­ های بی‌هوازی میکروبیوتای واژن، منجر به بروز واژینوز­های باکتریایی، بیماری التهابی لگن و آندومتریت­ های مزمن می­ شوند. عوامل باکتریایی از طریق فعال‌سازی سیستم ایمنی سلولی و تولید سایتوکین­ های التهابی در بروز ناباروری می­ توانند نقش مهمی داشته باشند. به‌نظر می‌رسد در بین انواع علل ناباروری، ابتلاء به عفونت­ های باکتریال، بیشترین سهم را در ایجاد ناباروری با علل لوله‌ای دارد.
نتیجه ­گیری: غربالگری عفونت ­های باکتریال واژینال در زنان مبتلا به ناباروری ­های زنانه و استفاده از راهکارهای درمانی جهت بازیابی مجدد و تنظیم میکروبیوتای واژن می­ تواند در دستیابی به موفقیت بیشتر در درمان­ های کمک باروری کمک کننده باشد. همچنین در این زمینه توسعه تکنیک‌های بیولوژیکی مولکولی می‌تواند به ما در درک بهتر میکروبیوتای واژن کمک کند. 

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The role of vaginal microbiota changes on infertility: A review study

نویسندگان [English]

  • Shekoufeh Maleki 1
  • Mitra Savabi 2
1 PhD Student in Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
2 Associate Professor, Department of Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
چکیده [English]

Introduction: Infertility, as a public health problem, has numerous consequences on mental, psychological, and physical health of couples. Since various types of bacterial infections of the genitourinary tract play an important role in disrupting the vaginal microbiota, it has gained great clinical importance as one of the causes of infertility. The present study was conducted with aim to investigate the role of changes in the vaginal microbiota on infertility using a literature review.
Methods: This review study was conducted by searching in the databases of Irandoc, Magiran, SID, Iranmedex, Cochrane, Scopus, ISI Web of Science, PubMed, Science Direct, and Google Scholar (as a search engine) using the keywords of vaginal microbiota, bacterial vaginitis, bacterial agent, vaginal flora, reproductive health, women, and their Persian equivalents. Studies published in English or Persian between 2000 and 2022 were reviewed. The quality of the articles was assessed using the CONSORT checklist. Out of 153 studies, 24 were ultimately selected for final evaluation.
Results: Vaginal bacterial factors by disrupting the balance through decreasing the prevalence of lactobacilli and increasing the prevalence of anaerobic bacteria in the vaginal microbiota lead to bacterial vaginosis, pelvic inflammatory disease, and chronic endometritis. Bacterial factors can play an important role in infertility through activation of the cellular immune system and production of inflammatory cytokines. Among the various causes of infertility, bacterial infections seem to have the greatest contribution to the development of infertility due to tubal causes.
Conclusion: Screening for vaginal bacterial infections in women with female infertility and using therapeutic strategies to restore and regulate the vaginal microbiota can help achieve greater success in assisted reproductive treatments. Also, in this context, the development of molecular biological techniques can help us better understand the vaginal microbiota.

کلیدواژه‌ها [English]

  • Bacteria
  • Infertility
  • Microbiota
  • Vagina

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مجله زنان، مامایی و نازایی ایران
دوره 28، شماره 3
خرداد 1404
صفحه 76-91

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