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Given their lack of procreative ability, little consideration has previously been given to the resultant vaginal microbiome (<jats:styled-content style=\"fixed-case\">VM<\/jats:styled-content>). Uterine transplantation (<jats:styled-content style=\"fixed-case\">UT<\/jats:styled-content>x) now offers the opportunity to restore these women's reproductive potential. The structure of the <jats:styled-content style=\"fixed-case\">VM<\/jats:styled-content> is associated with clinical and reproductive implications that are intricately intertwined with the process of <jats:styled-content style=\"fixed-case\">UT<\/jats:styled-content>x. Consideration of how vaginal restoration methods impact <jats:styled-content style=\"fixed-case\">VM<\/jats:styled-content> is now warranted and assessment of the <jats:styled-content style=\"fixed-case\">VM<\/jats:styled-content> in future <jats:styled-content style=\"fixed-case\">UT<\/jats:styled-content>x procedures is essential to understand the interrelation of the <jats:styled-content style=\"fixed-case\">VM<\/jats:styled-content> and clinical and reproductive outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>The vaginal microbiome has numerous implications for clinical and reproductive outcomes in the context of uterine 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