Interaction between endometriosis and bacteria in infertile women in Iran

authors:

avatar Anis Mohammadi 1 , avatar Ashraf Moini 2 , 3 , 4 , avatar Sarvenaz Falsafi 1 , avatar Mohamma Feizabadi ORCID 5 , 6 , 7 , *

Department of Microbiology, Faculty of Advanced Science and Technology, Tehran Medical Science, Islamic Azad university, Tehran, Iran
Department of Gynecology and Obstetrics, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
Breast Disease Research Center (BDRC), Tehran University of Medical Sciences, Tehran, Iran
Department of Endocrinology and Female Infertility at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Thorax Research Center, Tehran University of Medical Sciences, Tehran, Iran
Thoracic Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences
Jundishapur Journal of Microbiology: Vol.17, issue 6; e147025
published online: July 24, 2024
article type: Research Article
revised: July 12, 2024
DOI: https://doi.org/10.5812/jjm-147025

how to cite: Mohammadi A, Moini A, Falsafi S, Feizabadi M. Interaction between endometriosis and bacteria in infertile women in Iran. Jundishapur J Microbiol. 2024;17(6):e147025. https://doi.org/10.5812/jjm-147025.

Abstract

Background: Endometriosis is a common disorder that affects 20-50% of infertile women. Disease correlates with the loading of lactobacilli and changes in the number of gram-negative and gram-positive bacteria.
 Objectives: This article aims to investigate the interaction between endometriosis and some bacteria. Methods: One hundred women between 18 and 40 years of age referred to the IVF department of Arash Women's Hospital in Tehran were studied. Fifty of them were diagnosed with endometriosis and the rest were referred for investigation or freezing of their gametes or embryos. Specimens were collected from endometrial tissue and cervix using swab. They were used for cultures and real time PCR to quantify Lactobacillus. 
Results: Seventeen different gram positive and gram negative bacteria and 3 yeasts were isolated from women with and without endometriosis. The highest prevalence was related to Enterococcus faecalis, followed by Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Enterococcus faecium, Proteus mirabilis, Edwardsiella tarda and Citrobacter spp. In cases with endometriosis the relationship between the increase of Enterococcus spp, members of Enterobacteriaceae family and decrease of lactobacilli was significant (p < .05). Staphylococcus aureus was isolated from the cervix of 3 women with endometriosis. Cervical and endometrial bacteria were very similar.
Conclusion: Considering the decrease of lactobcilli and increase of other bacteria in people with endometriosis, it was recommended to use Lactobacillus and other probiotics for the prevention and even treatment of people with this disease. Keywords: Endometriosis; Enterobacteriaceae; Infertility; Lactobacillus; Bacteria.