{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T08:57:18Z","timestamp":1790585838795,"version":"4.1.0"},"reference-count":15,"publisher":"PAGEPress Publications","issue":"3","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Ital Urol Androl"],"abstract":"<jats:p>Objectives: To evaluate the efficacy of a specific synbiotic formulation in improving genital environment, sperm quality, and reproductive outcomes in infertile couples with a history of persistent post-antibiotic dysbiosis.\nMethods: This prospective, single-arm pilot study enrolled 33 infertile couples who had completed antibiotic therapy at least three months prior without success in conceiving. Couples received the synbiotic treatment for 90 days. A strategic sexual behavior protocol (barrier contraception for the first 45 days) was adopted. Primary endpoints were changes in Sperm DNA Fragmentation (DFI via Sperm Chromatin Dispersion - SCD test), vaginal pH, and spontaneous pregnancy rates.\nResults: At T1 (90 days), a significant reduction in mean Sperm DFI was observed (from 32.4% +\/- 6.1% to 16.8% +\/- 4.2%, p &lt; 0.001). Female partners showed a significant decrease in vaginal pH (from 5.2 +\/- 0.4 to 4.1 +\/- 0.2, p &lt; 0.001) and restoration of vaginal Lactobacillus dominance. The cumulative spontaneous pregnancy rate was 33.3% (11\/33), with 10 pregnancies reaching full term and 1 early miscarriage.\nConclusions: Modulation of the Gut-Gonad Axis via synbiotics represents a promising restorative strategy, overcoming the \"biological stasis\" often observed after antimicrobial treatments.<\/jats:p>","DOI":"10.4081\/aiua.2026.15197","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T08:19:16Z","timestamp":1790583556000},"source":"Crossref","is-referenced-by-count":0,"title":["Clinical efficacy of a specific synbiotic formulation in restoring fertility in couples with persistent post-antibiotic dysbiosis: a pilot study"],"prefix":"10.4081","volume":"98","author":[{"given":"Andrea","family":"Fabiani","sequence":"first","affiliation":[{"name":"Urology Unit, Surgery Department, Macerata Civic Hospital, AST Marche Macerata"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Scarano","sequence":"additional","affiliation":[{"name":"Urology Unit, Ospedale degli Infermi, Rimini"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Filosa","sequence":"additional","affiliation":[{"name":"Pathology Clinic Unit, AST Ancona, Jesi"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2549","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"253667","doi-asserted-by":"crossref","unstructured":"1. Sun H, Gong TT, Jiang YT, et al. Global, regional, and national prevalence and disability-adjusted life-years for infertility in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Aging (Albany NY) 2019;11:10952-91.","DOI":"10.18632\/aging.102497"},{"key":"253668","doi-asserted-by":"crossref","unstructured":"2. Sirota I, Zarek SM, Segars JH. Potential Influence of the Microbiome on Infertility and Assisted Reproductive Technology. Semin Reprod Med 2014; 32:35-42.","DOI":"10.1055\/s-0033-1361821"},{"key":"253669","unstructured":"3. Skafte-Holm A, Humaidan P, Bernabeu S, et al. The vaginal microbiome and assisted reproduction: a systematic review and metaanalysis. Fertil Steril 2023; 119:595-604."},{"key":"253670","doi-asserted-by":"crossref","unstructured":"4. Ashonibare G, Morgan K, Ononuju I, Ayodeji A. The gut microbiota- gonadal axis: A review of the bidirectional communication between the gut microbiome and the gonads. Front Immunol 2024; 15:1345678.","DOI":"10.3389\/fimmu.2024.1346035"},{"key":"253671","unstructured":"5. Qi X, Zhang C, Li SY, et al. Impact of Gut Microbiome on Reproductive Health. Metabolites 2025; 15:12-25."},{"key":"253672","doi-asserted-by":"crossref","unstructured":"6. Koort KJ, Salumets A, Saare M. Lactobacillus-dominated vaginal microbiome and reproductive health. Acta Obstet Gynecol Scand 2023; 102:670-82.","DOI":"10.1111\/aogs.14598"},{"key":"253673","unstructured":"7. Lundy SD, Vij SC. Male fertility and the semen microbiome. Microbiol Spectr 2024; 12:e02345-23."},{"key":"253674","doi-asserted-by":"crossref","unstructured":"8. Huda MN, Al-Arabi S, Rashid M. Synbiotics and Reproductive Health: A Comprehensive Review. Nutrients 2024; 16:245-60.","DOI":"10.3390\/nu16223955"},{"key":"253675","unstructured":"9. Haahr T, Jensen JS, Thomsen L, et al. Synbiotics for restoring vaginal health after antibiotic treatment: a randomized clinical trial. Reprod Biomed Online 2023; 47:103245."},{"key":"253676","unstructured":"10. Amory JK. Spermatogenesis and its relevance to modern male contraception. Fertil Steril 2021; 115:1345-52."},{"key":"253677","unstructured":"11. World Health Organization. WHO laboratory manual for the examination and processing of human semen. 6th ed. Geneva: World Health Organization; 2021."},{"key":"253678","doi-asserted-by":"crossref","unstructured":"12. Fernandez JL, Muriel L, Rivero MT, et al. The sperm chromatin dispersion test: a simple method to determine sperm DNA fragmentation. Fertil Steril 2003; 80:810-6.","DOI":"10.1002\/j.1939-4640.2003.tb02641.x"},{"key":"253679","unstructured":"13. Tremellen K, Pearce K. Gut-derived endotoxaemia and sperm DNA fragmentation: the role of synbiotics. Reprod Biomed Online 2020; 40:850-62."},{"key":"253680","unstructured":"14. Reid G. Oral probiotics for vaginal health: where do we stand? J Clin Gastroenterol 2016; 50:S177-80."},{"key":"253681","doi-asserted-by":"crossref","unstructured":"15. Borges S, Silva J, Teixeira P. The role of lactobacilli and probiotics in maintaining vaginal health. Arch Gynecol Obstet 2014; 289:479-89.","DOI":"10.1007\/s00404-013-3064-9"}],"container-title":["Archivio Italiano di Urologia e Andrologia"],"original-title":[],"link":[{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/download\/15197\/14525","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/download\/15197\/14525","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T08:19:25Z","timestamp":1790583565000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/view\/15197"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":15,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,9,25]]}},"URL":"https:\/\/doi.org\/10.4081\/aiua.2026.15197","relation":{},"ISSN":["2282-4197","1124-3562"],"issn-type":[{"value":"2282-4197","type":"electronic"},{"value":"1124-3562","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9,28]]}}}