{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:35:15Z","timestamp":1787016915562,"version":"build-2736575974"},"reference-count":121,"publisher":"American Society for Microbiology","issue":"4","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100004329","name":"Javna Agencija za Raziskovalno Dejavnost RS","doi-asserted-by":"publisher","award":["P3-0083"],"award-info":[{"award-number":["P3-0083"]}],"id":[{"id":"10.13039\/501100004329","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2026,4,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Adenomyosis is a chronic gynecological condition affecting a substantial portion of women of reproductive age. With symptoms including abnormal uterine bleeding, chronic pelvic pain (CPP), dysmenorrhea, and infertility, poor response to symptomatic treatment and unfavorable outcomes of assisted reproductive technologies, it remains a significant diagnostic and therapeutic challenge. Here, we analyzed microbial compositions of the reproductive tract of women with adenomyosis (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 33) in comparison with healthy controls (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 31). Vaginal, cervical, and endometrial samples were collected using minimally invasive transcervical sampling techniques on the 22nd day of the menstrual cycle, during the so-called window of implantation. 16S rRNA was amplified and recorded using the next generation sequencing. Bioinformatic and statistical analysis focused on quantitative taxonomical characterization of the specimens\u2019 microbiomes. Vaginal bacterial microbiome composition was consistent across the three anatomical sites. Compared with the control group, adenomyosis was associated with\n                      <jats:italic toggle=\"yes\">Lactobacillus iners,<\/jats:italic>\n                      whereas\n                      <jats:italic toggle=\"yes\">Lactobacillus gasseri<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Gardnerella vaginalis<\/jats:italic>\n                      were negatively associated with adenomyosis and its clinical symptoms.\n                      <jats:italic toggle=\"yes\">G. vaginalis<\/jats:italic>\n                      , typically considered a pathogen, was highlighted as an important dominant microbiome replacement for lactobacilli, more so in healthy women than in women with adenomyosis.\n                      <jats:italic toggle=\"yes\">Anaerococcus prevotii<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">Peptoniphilus grossensis,<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Peptrostreptococcus anaerobius<\/jats:italic>\n                      also showed weak correlation to adenomyosis. Differences in taxa abundance were detected in association with adenomyosis clinical symptoms.\n                      <jats:italic toggle=\"yes\">L. iners<\/jats:italic>\n                      was associated with dysmenorrhea, heavy menstrual bleeding (HMB), as well as CPP.\n                      <jats:italic toggle=\"yes\">Prevotella disiens, Prevotella timonesis,<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Dialister micraerophilus<\/jats:italic>\n                      were associated with dysmenorrhea and\n                      <jats:italic toggle=\"yes\">Peptoniphilus grossensis<\/jats:italic>\n                      with HMB, respectively.\n                      <jats:italic toggle=\"yes\">L. gasseri<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">L. jensenii<\/jats:italic>\n                      appeared to anticorrelate with these symptoms.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>IMPORTANCE<\/jats:title>\n                    <jats:p>\n                      Adenomyosis poorly responds to treatment and assisted reproductive technologies. Here, we report a comprehensive 16S rRNA-based analysis of vaginal, cervical, and endometrial samples, obtained minimally invasively (transcervically) in a cohort of Caucasian women during the receptive phase of endometrium. Results revealed the least invasive option, vaginal microbiome sampling, reliably predicts the microbiome compositions of cervix and endometrium. We showed substantial variation in microbial composition of adenomyosis patients.\n                      <jats:italic toggle=\"yes\">L. iners<\/jats:italic>\n                      , a species with specific functional traits, was consistently associated with adenomyosis presence and related symptoms. This finding suggests microbiome remodeling as a viable novel therapeutic option for adenomyosis. Furthermore, our findings indicate that the pathogenic role of\n                      <jats:italic toggle=\"yes\">G. vaginalis<\/jats:italic>\n                      may be context-dependent. Ongoing genomic and ecological profiling is essential to clarify\n                      <jats:italic toggle=\"yes\">Gardnerella's<\/jats:italic>\n                      dual commensal-pathogenic nature. Previous adenomyosis studies have mostly focused on the vaginal microbiome, whereas the endometrial microbiome has rarely been studied and never in the time of window of implantation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.02791-25","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T14:01:25Z","timestamp":1771423285000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":1,"title":["Bacterial microbiome analysis of vaginal, cervical, and endometrial samples in patients with adenomyosis during the window of implantation"],"prefix":"10.1128","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5421-5726","authenticated-orcid":false,"given":"Nika","family":"Troha","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05njb9z20","id-type":"ROR","asserted-by":"publisher"}],"name":"Faculty of Medicine, University of 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