A groundbreaking study published in Gut Microbes has unveiled the role of a specific gut microbe in progesterone metabolism, offering new insights into female fertility and potential avenues for improving assisted reproductive treatments. Progesterone is a vital hormone for successful embryo implantation and maintaining pregnancy. Its insufficient levels are known to contribute to IVF treatment failure and early miscarriage, making the hormone’s regulation crucial in fertility care.
In traditional IVF treatments, progesterone supplementation is often required to support luteal function or prepare the endometrium for embryo transfer. However, absorption rates vary widely among individuals, particularly with oral progesterone, leading some patients to fail in achieving adequate blood and tissue levels despite standard or increased doses. This discrepancy raises the risk of implantation failure and miscarriage.
In this new study, researchers identified the gut bacterium Clostridium innocuum in the microbiota of infertile women undergoing IVF treatment. This microbe disrupts the metabolism of progesterone, converting it into epipregnanolone, a neurosteroid with minimal progestogenic effects. This process reduces the bioavailability of progesterone, impairing its crucial role in fertility.
Further experiments in mice revealed that targeting and suppressing C. innocuum with antibiotics could increase progesterone levels. In contrast, prolonged exposure to this bacterium resulted in disrupted estrous cycles and follicular development, mirroring issues such as follicular arrest and anovulation commonly seen in women.
These findings not only open the door to new medical strategies for treating infertility but also highlight the significant impact of gut microbiota on reproductive health. Moving forward, the research team plans to apply these discoveries in clinical settings, aiming to advance personalized, precision medicine in fertility treatments.
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