What constitutes a healthy vaginal microbiome? Implications for intervention strategies

We read with interest the Article by Tine Wrønding and colleagues,1 published in The Lancet Microbe, which reports a double-blind, randomised controlled trial of vaginal microbiota transplantation (VMT) to promote conversion to a Lactobacillus-dominant vaginal microbiome. Although the authors did not observe an increased rate of conversion compared with the placebo, they did report evidence suggesting donor engraftment and improved efficacy following antiseptic pretreatment.1 This study represents an important step in evaluating microbiota-based interventions within a rigorous clinical trial framework.