{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T17:54:44Z","timestamp":1770918884453,"version":"3.50.1"},"reference-count":32,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,6,26]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Differences in the profile of the vaginal microbiota (VMB) have been associated with pregnancy rates after medical assisted reproduction (MAR) such as in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI). Monitoring the VMB profile of IVF patients creates an opportunity to identify the best window for IVF treatment and embryo transfer. The ReceptIVFity test is a predictive test that assesses the chances of becoming pregnant in women undergoing IVF treatment based on the VMB composition. A VMB profile dominated by beneficial strains, most notably <jats:italic>Lactobacillus<\/jats:italic> species, is associated with increased pregnancy chances. However, to date, limited evidence is available on the effect of active modification strategies to facilitate the modulation of the VMB profile to help restore a VMB dominated by <jats:italic>Lactobacillus<\/jats:italic> species.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>This is a randomised, placebo-controlled, double-blind intervention study. The study will involve 1:1 randomisation to one of the two arms: oral probiotic or placebo. Vaginal and rectal swabs will be collected at intake and 4, 6 and 8 weeks after the start of the treatment. Our objective is to determine if oral probiotic treatment improves the VMB profile of IVF patients from a low to a medium\/high ReceptIVFity score, compared with placebo treatment. Secondary outcomes are: the potential of the bacterial strains in the oral probiotic to be detected in the vaginal tract and\/or in the gut, and if the treatment leads to an increased ongoing pregnancy rate after IVF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>Ethical approval was obtained by the local medical ethical review committee at the Maastricht University Medical Centre. Findings from this study will be published in a peer-reviewed scientific journal and presented at one or more scientific conferences.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>CCMO NL81210.068.22, registered 25 September 2023.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-096959","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T16:31:29Z","timestamp":1752510689000},"page":"e096959","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["ProVag: the effect of oral probiotics on the vaginal microbiota composition in women receiving medical assisted reproduction in a Dutch fertility clinic \u2013 protocol of a randomised, placebo-controlled, double-blind study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0574-6570","authenticated-orcid":false,"given":"Ashlee","family":"van Haren","sequence":"first","affiliation":[{"name":"Obstetriscs and Gynaecology, Maastricht University Medical Centre+, Maastricht, Netherlands"},{"name":"GROW\u2014Research Institute for Oncology and Reproduction, Maastricht University Faculty of Health Medicine and Life Sciences, Maastricht, Limburg, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9953-0495","authenticated-orcid":false,"given":"S A","family":"Morre","sequence":"additional","affiliation":[{"name":"GROW\u2014Research Institute for Oncology and Reproduction, Maastricht University Faculty of Health Medicine and Life Sciences, Maastricht, Limburg, Netherlands"},{"name":"Department of Genetics and Cell Biology, Maastricht University, Institute for Publich Health Genomics, Maastricht, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Stolaki","sequence":"additional","affiliation":[{"name":"Probiotics, Winclove BV, Amsterdam, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"de Jonge","sequence":"additional","affiliation":[{"name":"ARTPred BV, Oude Meer, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7650-8837","authenticated-orcid":false,"given":"Linda","family":"Stevens Brentjens","sequence":"additional","affiliation":[{"name":"Obstetriscs and Gynaecology, Maastricht University Medical Centre+, Maastricht, Netherlands"},{"name":"GROW\u2014Research Institute for Oncology and Reproduction, Maastricht University Faculty of Health Medicine and Life Sciences, Maastricht, Limburg, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ron","family":"van Golde","sequence":"additional","affiliation":[{"name":"Obstetriscs and Gynaecology, Maastricht University Medical Centre+, Maastricht, Netherlands"},{"name":"GROW\u2014Research Institute for Oncology and Reproduction, Maastricht University Faculty of Health Medicine and Life Sciences, Maastricht, Limburg, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,7,8]]},"reference":[{"key":"2025080306102728000_15.7.e096959.1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.10.011210"},{"key":"2025080306102728000_15.7.e096959.2","unstructured":"WHO . 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