{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T19:43:46Z","timestamp":1790451826530,"version":"4.1.0"},"reference-count":79,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T00:00:00Z","timestamp":1617321600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The use of probiotics in reproductive-related dysbiosis is an area of continuous progress due to the growing interest from clinicians and patients suffering from recurrent reproductive microbiota disorders. An imbalance in the natural colonization sites related to reproductive health\u2014vaginal, cervicovaginal, endometrial, and pregnancy-related altered microbiota\u2014could play a decisive role in reproductive outcomes. Oral and vaginal administrations are in continuous discussion regarding the clinical effects pursued, but the oral route is used and studied more often despite the need for further transference to the colonization site. The aim of the present review was to retrieve the standardized protocols of vaginal probiotics commonly used for investigating their microbiota modulation capacities. Most of the studies selected focused on treating bacterial vaginosis (BV) as the most common dysbiosis; a few studies focused on vulvovaginal candidiasis (VVC) and on pretreatment during in vitro fertilization (IVF). Vaginal probiotic doses administered were similar to oral probiotics protocols, ranging from \u2265107 CFU\/day to 2.5 \u00d7 1010 CFU\/day, but were highly variable regarding the treatment duration timing. Moderate vaginal microbiota modulation was achieved; the relative abundance of abnormal microbiota decreased and Lactobacillus species increased.<\/jats:p>","DOI":"10.3390\/jcm10071461","type":"journal-article","created":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T04:13:51Z","timestamp":1617336831000},"page":"1461","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":73,"title":["Vaginal Probiotics for Reproductive Health and Related Dysbiosis: Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3717-9852","authenticated-orcid":false,"given":"Ana","family":"L\u00f3pez-Moreno","sequence":"first","affiliation":[{"name":"Department of Microbiology, Faculty of Pharmacy, Campus of Cartuja, University of Granada, 18071 Granada, Spain"},{"name":"Instituto de Nutrici\u00f3n y Tecnolog\u00eda de los Alimentos, INYTA-Granada, 18100 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3204-9787","authenticated-orcid":false,"given":"Margarita","family":"Aguilera","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Pharmacy, Campus of Cartuja, University of Granada, 18071 Granada, Spain"},{"name":"Instituto de Nutrici\u00f3n y Tecnolog\u00eda de los Alimentos, INYTA-Granada, 18100 Granada, Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria, Ibs-Granada, 18012 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.rbmo.2017.04.005","article-title":"What Fertility Specialists Should Know about the Vaginal Microbiome: A Review","volume":"35","author":"Menabrito","year":"2017","journal-title":"Reprod. Biomed. Online"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.maturitas.2017.06.025","article-title":"Estrogen-Gut Microbiome Axis: Physiological and Clinical Implications","volume":"103","author":"Baker","year":"2017","journal-title":"Maturitas"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1016\/j.eimc.2018.11.009","article-title":"Vaginosis. Vaginal Microbiota","volume":"37","author":"Vazquez","year":"2019","journal-title":"Enf. Infec. Microbiol. Clin."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1210\/jc.2017-02153","article-title":"Gut Microbial Diversity in Women With Polycystic Ovary Syndrome Correlates With Hyperandrogenism","volume":"103","author":"Torres","year":"2018","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_5","first-page":"271","article-title":"Influence of the Microbiota and Probiotics in Obesity","volume":"30","author":"Benaiges","year":"2018","journal-title":"Clin. Investig. Arterioscler."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1080\/19490976.2017.1345414","article-title":"Using Probiotics in Clinical Practice: Where Are We Now? A Review of Existing Meta-Analyses","volume":"8","author":"Rondanelli","year":"2017","journal-title":"Gut Microbes"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Aguilera, M., G\u00e1lvez-Ontiveros, Y., and Rivas, A. (2020). Endobolome, a New Concept for Determining the Influence of Microbiota Disrupting Chemicals (MDC) in Relation to Specific Endocrine Pathogenesis. Front. Microbiol., 11.","DOI":"10.3389\/fmicb.2020.578007"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2204","DOI":"10.1038\/s41598-019-39700-6","article-title":"The Endobiota Study: Comparison of Vaginal, Cervical and Gut Microbiota Between Women with Stage 3\/4 Endometriosis and Healthy Controls","volume":"9","author":"Ata","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"103599","DOI":"10.1016\/j.micpath.2019.103599","article-title":"Vaginal Microbiota of Asymptomatic Bacterial Vaginosis and Vulvovaginal Candidiasis: Are They Different from Normal Microbiota?","volume":"134","author":"Pramanick","year":"2019","journal-title":"Microb. Pathog."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Garcia-Grau, I., Perez-Villaroya, D., Bau, D., Gonzalez-Monfort, M., Vilella, F., Moreno, I., and Simon, C. (2019). Taxonomical and Functional Assessment of the Endometrial Microbiota in A Context of Recurrent Reproductive Failure: A Case Report. Pathogens, 8.","DOI":"10.3390\/pathogens8040205"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.ajog.2020.01.031","article-title":"The First Glimpse of the Endometrial Microbiota in Early Pregnancy","volume":"222","author":"Moreno","year":"2020","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/s40168-017-0268-4","article-title":"A Critical Assessment of the \u201cSterile Womb\u201d and \u201cin Utero Colonization\u201d Hypotheses: Implications for Research on the Pioneer Infant Microbiome","volume":"5","author":"Arrieta","year":"2017","journal-title":"Microbiome"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1038\/s41586-019-1451-5","article-title":"Human Placenta Has No Microbiome but Can Contain Potential Pathogens","volume":"572","author":"Lager","year":"2019","journal-title":"Nature"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"5478","DOI":"10.1073\/pnas.0508035103","article-title":"Gene Expression Patterns in Human Placenta","volume":"103","author":"Sood","year":"2006","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"503648","DOI":"10.1155\/2012\/503648","article-title":"Vaginal Impact of the Oral Administration of Total Freeze-Dried Culture of LCR 35 in Healthy Women","volume":"2012","author":"Bohbot","year":"2012","journal-title":"Infect. Dis. Obstet. Gynecol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"79","DOI":"10.4103\/0971-5916.162127","article-title":"Evaluation of Profertility Effect of Probiotic Lactobacillus plantarum 2621 in a Murine Model","volume":"142","author":"Bhandari","year":"2015","journal-title":"Indian J. Med. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.ejogrb.2012.10.031","article-title":"Bacterial Vaginosis and Infertility: Cause or Association?","volume":"167","author":"Salah","year":"2013","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1809","DOI":"10.1093\/humrep\/det096","article-title":"Risks Associated with Bacterial Vaginosis in Infertility Patients: A Systematic Review and Meta-Analysis","volume":"28","author":"Meys","year":"2013","journal-title":"Hum. Reprod."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1196\/annals.1335.032","article-title":"Endometriosis and Inflammation in Infertility","volume":"1034","author":"Halis","year":"2004","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Zhang, J., Sun, Z., Jiang, S., Bai, X., Ma, C., Peng, Q., Chen, K., Chang, H., Fang, T., and Zhang, H. (2019). Probiotic Bifidobacterium Lactis V9 Regulates the Secretion of Sex Hormones in Polycystic Ovary Syndrome Patients through the Gut-Brain Axis. mSystems, 4.","DOI":"10.1128\/mSystems.00017-19"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1053\/siny.2002.0121","article-title":"Infection and Prematurity and the Role of Preventive Strategies","volume":"7","author":"Romero","year":"2002","journal-title":"Semin. Neonatol."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Basavaprabhu, H.N., Sonu, K.S., and Prabha, R. (2020). Mechanistic Insights into the Action of Probiotics against Bacterial Vaginosis and Its Mediated Preterm Birth: An Overview. Microb. Pathog., 141.","DOI":"10.1016\/j.micpath.2020.104029"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1016\/j.fertnstert.2018.04.041","article-title":"Relevance of Assessing the Uterine Microbiota in Infertility","volume":"110","author":"Moreno","year":"2018","journal-title":"Fertil. Steril."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1186\/1745-6215-12-239","article-title":"A Randomised Controlled Trial of Probiotics for the Prevention of Spontaneous Preterm Delivery Associated with Bacterial Vaginosis: Preliminary Results","volume":"12","author":"Moreira","year":"2011","journal-title":"Trials"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/S0958-6946(01)00138-8","article-title":"Oral Administration of the Probiotic Combination Lactobacillus Rhamnosus GR-1 and L. Fermentum RC-14 for Human Intestinal Applications","volume":"12","author":"Gardiner","year":"2002","journal-title":"Int. Dairy J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1177\/1756283X10373814","article-title":"Use of Probiotics in Gastrointestinal Disorders: What to Recommend?","volume":"3","author":"Verna","year":"2010","journal-title":"Ther. Adv. Gastroenterol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1038\/s41575-020-0344-2","article-title":"The International Scientific Association for Probiotics and Prebiotics (ISAPP) Consensus Statement on the Definition and Scope of Synbiotics","volume":"17","author":"Swanson","year":"2020","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.fshw.2015.06.002","article-title":"New Perspectives on Probiotics in Health and Disease","volume":"4","author":"Daliri","year":"2015","journal-title":"Food Sci. Hum. Wellness"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"S129","DOI":"10.1093\/cid\/civ085","article-title":"Risk and Safety of Probiotics","volume":"60","author":"Doron","year":"2015","journal-title":"Clin. Infect. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1038\/s41564-018-0202-y","article-title":"Recognizing the Reagent Microbiome","volume":"3","author":"Lager","year":"2018","journal-title":"Nat. Microbiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/S0924-8579(00)00322-8","article-title":"The Use of Probiotics in Medical Practice","volume":"16","author":"Mombelli","year":"2000","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1038\/s41577-018-0013-7","article-title":"Diverse Developmental Pathways of Intestinal Intraepithelial Lymphocytes","volume":"18","author":"McDonald","year":"2018","journal-title":"Nat. Rev. Immunol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1097\/OLQ.0b013e3182267ac4","article-title":"Effects of Bacterial Vaginosis-Associated Bacteria and Sexual Intercourse on Vaginal Colonization with the Probiotic Lactobacillus Crispatus CTV-05","volume":"38","author":"Ngugi","year":"2011","journal-title":"Sex. Transm. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1093\/cid\/civ974","article-title":"Prevention of Infectious Mastitis by Oral Administration of Lactobacillus salivarius PS2 During Late Pregnancy","volume":"62","author":"Arroyo","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"5345","DOI":"10.2147\/DDDT.S89214","article-title":"Efficacy and Safety of a Vaginal Medicinal Product Containing Three Strains of Probiotic Bacteria: A Multicenter, Randomized, Double-Blind, and Placebo-Controlled Trial","volume":"9","author":"Tomusiak","year":"2015","journal-title":"Drug Des. Dev. Ther."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1002\/rmb2.12250","article-title":"A Pilot Study and Case Reports on Endometrial Microbiota and Pregnancy Outcome: An Analysis Using 16S RRNA Gene Sequencing among IVF Patients, and Trial Therapeutic Intervention for Dysbiotic Endometrium","volume":"18","author":"Kyono","year":"2019","journal-title":"Reprod. Med. Biol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1016\/j.ajog.2016.09.075","article-title":"Evidence That the Endometrial Microbiota Has an Effect on Implantation Success or Failure","volume":"215","author":"Moreno","year":"2016","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"4680","DOI":"10.1073\/pnas.1002611107","article-title":"Vaginal Microbiome of Reproductive-Age Women","volume":"108","author":"Ravel","year":"2011","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/2049-2618-2-18","article-title":"The Vaginal Microbiota of Pregnant Women Who Subsequently Have Spontaneous Preterm Labor and Delivery and Those with a Normal Delivery at Term","volume":"2","author":"Romero","year":"2014","journal-title":"Microbiome"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1016\/j.ajog.2004.01.002","article-title":"Bacterial Vaginosis, the Inflammatory Response and the Risk of Preterm Birth: A Role for Genetic Epidemiology in the Prevention of Preterm Birth","volume":"190","author":"Romero","year":"2004","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., and PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med., 6.","DOI":"10.1371\/journal.pmed.1000097"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1016\/j.theriogenology.2010.01.003","article-title":"Method Agreement Analysis: A Review of Correct Methodology","volume":"73","author":"Watson","year":"2010","journal-title":"Theriogenology"},{"key":"ref_43","unstructured":"Canese, K. (2021, January 20). An Updated PubMed Is on Its Way. NLM Technical Bulletin. March\u2013April, Available online: https:\/\/www.nlm.nih.gov\/pubs\/techbull\/ma19\/ma19_pubmed_update.html."},{"key":"ref_44","unstructured":"Higgins, J.P.T., and Green, S. (2011). Cochrane Handbook for Systematic Reviews of Interventions, John Wiley & Sons Ltd.. Available online: https:\/\/handbook-5-1.cochrane.org\/."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"L\u00f3pez-Moreno, A., and Aguilera, M. (2020). Probiotics Dietary Supplementation for Modulating Endocrine and Fertility Microbiota Dysbiosis. Nutrients, 12.","DOI":"10.3390\/nu12030757"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1111\/j.1469-0691.2007.01688.x","article-title":"Probiotics for the Treatment of Women with Bacterial Vaginosis","volume":"13","author":"Falagas","year":"2007","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1111\/j.1471-0528.2004.00329.x","article-title":"The Effectiveness of Live Lactobacilli in Combination with Low Dose Oestriol (Gynoflor) to Restore the Vaginal Flora after Treatment of Vaginal Infections","volume":"112","author":"Ozkinay","year":"2005","journal-title":"Br. J. Obstet. Gynaecol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"7976","DOI":"10.1038\/s41598-020-64705-x","article-title":"Impact of a Lactobacilli-Containing Gel on Vulvovaginal Candidosis and the Vaginal Microbiome","volume":"10","author":"Oerlemans","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1111\/j.1469-0691.2008.02112.x","article-title":"Effectiveness of Lactobacillus-Containing Vaginal Tablets in the Treatment of Symptomatic Bacterial Vaginosis","volume":"15","author":"Mastromarino","year":"2009","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Bisanz, J.E., Seney, S., McMillan, A., Vongsa, R., Koenig, D., Wong, L., Dvoracek, B., Gloor, G.B., Sumarah, M., and Ford, B. (2014). A Systems Biology Approach Investigating the Effect of Probiotics on the Vaginal Microbiome and Host Responses in a Double Blind, Placebo-Controlled Clinical Trial of Post-Menopausal Women. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0104511"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Bradshaw, C.S., Pirotta, M., De Guingand, D., Hocking, J.S., Morton, A.N., Garland, S.M., Fehler, G., Morrow, A., Walker, S., and Vodstrcil, L.A. (2012). Efficacy of Oral Metronidazole with Vaginal Clindamycin or Vaginal Probiotic for Bacterial Vaginosis: Randomised Placebo-Controlled Double-Blind Trial. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0034540"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/S1472-6483(10)61301-6","article-title":"Does Intravaginal Probiotic Supplementation Increase the Pregnancy Rate in IVF-Embryo Transfer Cycles?","volume":"11","author":"Gilboa","year":"2005","journal-title":"Reprod. Biomed. Online"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"The Human Microbiome Project Consortium (2012). Structure, Function and Diversity of the Healthy Human Microbiome. Nature, 486, 207\u2013214.","DOI":"10.1038\/nature11234"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"The Human Microbiome Project Consortium (2012). A Framework for Human Microbiome Research. Nature, 486, 215\u2013221.","DOI":"10.1038\/nature11209"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1016\/j.cell.2014.07.019","article-title":"SnapShot: The Human Microbiome","volume":"158","author":"Knight","year":"2014","journal-title":"Cell"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Shao, X., Cheng, H., Zhou, J., Zhang, J., Zhu, Y., Yang, C., Di Narzo, A., Yu, J., Shen, Y., and Li, Y. (2020). Prenatal Exposure to Ambient Air Multi-Pollutants Significantly Impairs Intrauterine Fetal Development Trajectory. Ecotoxicol. Environ. Saf., 201.","DOI":"10.1016\/j.ecoenv.2020.110726"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"D\u2019Argenio, V. (2018). The Prenatal Microbiome: A New Player for Human Health. High-Throughput, 7.","DOI":"10.3390\/ht7040038"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1128\/CMR.00075-15","article-title":"The Human Microbiome during Bacterial Vaginosis","volume":"29","author":"Onderdonk","year":"2016","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Gao, C.-J., and Kannan, K. (2020). Phthalates, Bisphenols, Parabens, and Triclocarban in Feminine Hygiene Products from the United States and Their Implications for Human Exposure. Environ. Int., 136.","DOI":"10.1016\/j.envint.2020.105465"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1097\/OLQ.0b013e318156a5d0","article-title":"A Delicate Balance: Risk Factors for Acquisition of Bacterial Vaginosis Include Sexual Activity, Absence of Hydrogen Peroxide-Producing Lactobacilli, Black Race, and Positive Herpes Simplex Virus Type 2 Serology","volume":"35","author":"Cherpes","year":"2008","journal-title":"Sex. Transm. Dis."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1111\/1471-0528.14390","article-title":"Why Do Lactobacilli Dominate the Human Vaginal Microbiota?","volume":"124","author":"Witkin","year":"2017","journal-title":"Br. J. Obstet. Gynaecol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1016\/S1472-6483(10)61683-5","article-title":"Vaginal Lactobacilli, Probiotics, and IVF","volume":"11","author":"Verstraelen","year":"2005","journal-title":"Reprod. Biomed. Online"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"225","DOI":"10.3389\/fpubh.2020.00225","article-title":"Genital Micro-Organisms in Pregnancy","volume":"8","author":"Bagga","year":"2020","journal-title":"Front. Public Health"},{"key":"ref_64","first-page":"7571954","article-title":"Potential of Maintaining a Healthy Vaginal Environment by Two Lactobacillus Strains Isolated from Cocoa Fermentation","volume":"2018","author":"Freire","year":"2018","journal-title":"BioMed Res. Int."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1111\/j.1574-695X.2001.tb00531.x","article-title":"Probiotic Lactobacillus Dose Required to Restore and Maintain a Normal Vaginal Flora","volume":"32","author":"Reid","year":"2001","journal-title":"FEMS Immunol. Med. Microbiol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/S0928-8244(02)00465-0","article-title":"Oral Use of Lactobacillus Rhamnosus GR-1 and L. Fermentum RC-14 Significantly Alters Vaginal Flora: Randomized, Placebo-Controlled Trial in 64 Healthy Women","volume":"35","author":"Reid","year":"2003","journal-title":"FEMS Immunol. Med. Microbiol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1089\/1096620041224166","article-title":"Nucleic Acid-Based Diagnosis of Bacterial Vaginosis and Improved Management Using Probiotic Lactobacilli","volume":"7","author":"Reid","year":"2004","journal-title":"J. Med. Food"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1186\/s13568-018-0679-z","article-title":"Bacteriocin Production of the Probiotic Lactobacillus Acidophilus KS400","volume":"8","author":"Gaspar","year":"2018","journal-title":"AMB Express"},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"McMillan, A., Rulisa, S., Gloor, G.B., Macklaim, J.M., Sumarah, M., and Reid, G. (2018). Pilot Assessment of Probiotics for Pregnant Women in Rwanda. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0195081"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1080\/08910600902907475","article-title":"Oral Use of Probiotics as an Adjunctive Therapy to Fluconazole in the Treatment of Yeast Vaginitis: A Study of Nigerian Women in an Outdoor Clinic","volume":"21","author":"Anukam","year":"2009","journal-title":"Microbial Ecol. Health Dis."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Sniffen, J.C., McFarland, L.V., Evans, C.T., and Goldstein, E.J.C. (2018). Choosing an Appropriate Probiotic Product for Your Patient: An Evidence-Based Practical Guide. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0209205"},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Sivamaruthi, B.S., Kesika, P., and Chaiyasut, C. (2019). Effect of Probiotics Supplementations on Health Status of Athletes. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16224469"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/s10815-011-9694-6","article-title":"The Dynamics of the Vaginal Microbiome during Infertility Therapy with in Vitro Fertilization-Embryo Transfer","volume":"29","author":"Hyman","year":"2012","journal-title":"J. Assist Reprod. Genet."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/j.jfda.2018.12.011","article-title":"Next Generation Probiotics in Disease Amelioration","volume":"27","author":"Chang","year":"2019","journal-title":"J. Food Drug Anal."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1016\/j.envpol.2016.08.039","article-title":"Bisphenol A Alters Gut Microbiome: Comparative Metagenomics Analysis","volume":"218","author":"Lai","year":"2016","journal-title":"Environ. Pollut."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"17057","DOI":"10.1038\/nmicrobiol.2017.57","article-title":"Next-Generation Probiotics: The Spectrum from Probiotics to Live Biotherapeutics","volume":"2","author":"Marchesi","year":"2017","journal-title":"Nat. Microbiol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"fnz025","DOI":"10.1093\/femsle\/fnz025","article-title":"Vaginal Microbiota Transplantation for the Treatment of Bacterial Vaginosis: A Conceptual Analysis","volume":"366","author":"Ma","year":"2019","journal-title":"FEMS Microbiol. Lett."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1177\/1073110519897731","article-title":"Vaginal Microbiota Transplantation: The Next Frontier","volume":"47","author":"DeLong","year":"2019","journal-title":"J. Law Med. Ethics"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1038\/s41591-019-0600-6","article-title":"Vaginal Microbiome Transplantation in Women with Intractable Bacterial Vaginosis","volume":"25","author":"Cohen","year":"2019","journal-title":"Nat. Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/7\/1461\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:33:34Z","timestamp":1760362414000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/7\/1461"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,2]]},"references-count":79,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,4]]}},"alternative-id":["jcm10071461"],"URL":"https:\/\/doi.org\/10.3390\/jcm10071461","relation":{"has-preprint":[{"id-type":"doi","id":"10.20944\/preprints202103.0424.v1","asserted-by":"object"}]},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,2]]}}}