Vaginal microbiota correlations to gynecological symptoms, intimate hygiene practices, and background parameters of IVF patients: a cross-sectional study

Purpose To investigate baseline parameters and vaginal intimate hygiene habits comparing IVF patients with and without vaginal dysbiosis, a cross-sectional study. Methods Patients were grouped by the presence of vaginal dysbiosis status determined by a qPCR method (high quantities of Gardnerella spp. and/or Fannyhessea vaginae ) and a 16S rRNA gene sequencing-based method (VALENCIA). Patients were asked to fill out a questionnaire alongside an interview with healthcare personnel. Prevalence ratios (PR) were computed in case of statistically significant findings between groups. Results Among 1511 patients, the prevalence of vaginal dysbiosis by qPCR was 34%, and the prevalence of community state type IV was 32%. Prevalence of vaginal dysbiosis was higher with increasing BMI, BMI 25–30 (PR 1.23 (95% CI 1.05–1.44) and BMI > 30 (PR 1.50 (1.24–1.82). Fishy odor was reported relatively rarely, but vaginal dysbiosis was significantly more prevalent in the presence of fishy odor, PR 1.72 (95% CI 1.39–2.11). Finally, vaginal douching was highly prevalent and correlated significantly to vaginal dysbiosis, PR 1.31 (95% CI 1.11–1.53). In a sub-study, we interviewed N = 10 women about vaginal douching, and all of them reported the use of douching with the intention to feel clean, thus contradicting general recommendations. Conclusions The high prevalence of vaginal dysbiosis in IVF patients is predominantly a subclinical condition which is linked to lifestyle and intimate hygiene habits.