The Effect of Probiotic and Prebiotic Interventions on Bacterial Vaginosis: Evidence From Studies in Iranian Women

The microbial community of the lower genital tract plays a vital role in women's reproductive health and defense against pathogens. In reproductive-aged women, the vaginal microbiota is mainly dominated by Lactobacillus species, often exceeding ۷۰% of total bacteria. These bacteria maintain health by converting glycogen breakdown products into lactic acid, keeping the vaginal pH acidic (۳.۰-۴.۵) and inhibiting harmful microbes. They also produce antimicrobial compounds such as hydrogen peroxide and bacteriocins. A decline in Lactobacilli leads to dysbiosis, most notably Bacterial Vaginosis (BV), where anaerobic bacteria like Gardnerella vaginalis replace H₂O۲-producing Lactobacilli, increasing the vaginal pH above ۴.۵. Studies in Iranian women confirm reduced Lactobacillus abundance in BV and infertile patients. BV is linked to adverse outcomes, including higher risks of sexually transmitted infections, preterm birth, and infertility. Although antibiotics like metronidazole are standard treatments, recurrence rates often exceed ۵۰% within a year, prompting interest in prebiotic and probiotic therapies. Iranian studies show prebiotic vaginal gels enhance BV treatment and reduce recurrence, while probiotic use in Recurrent Implantation Failure increased Lactobacillus dominance but not pregnancy rates. Further focused research in Iran remains necessary.

کلیدواژه ها:

Bacterial Vaginosis ، Dysbiosis ، Infertility ، Iranian Women ، Lactobacillus ، Prebiotics ، Probiotics ، Reproductive Health