BONUS 230: Uterine Microbiome 101

October 25, 2019

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Today’s bonus episode guest is Dr. Allison Rodgers. She is board certified in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility and has been practicing medicine since 2004. Dr. Rodgers currently practices at the Fertility Centers of Illinois. Her personal experiences with both secondary infertility and pregnancy loss have given her a unique insight into reproductive medicine in order to help you beat infertility.

Episode Sponsor:

Fertility Centers of Illinois

Dr. Rodgers begins by answering six listener questions. The full questions are read on the air, but here are brief summaries:

  • Sam asks about the key questions she should ask at the initial consultation about IVF with a fertility specialist.
  • Amy had a recent failed FET with a PGS-tested embryo. She asks about changes in medications, doses, and transfer dates, based on her body’s limited response to estrogen.
  • Anna has had several normal losses and is pursuing IVF now. She asks about her non-correlative AMH and FSH numbers and if a protocol change might be in order.
  • Latasha has one daughter but has had five subsequent losses around 8.5 weeks. She asks for advice and about the possibility of a clotting disorder and an autoimmune disorder.
  • Shannon has diminished ovarian reserve and egg quality issues. With her first IVF upcoming, she asks about the clinical significance of her conflicting lab results.
  • Jennifer asks about three-person IVF, which isn’t currently available in the U.S. She wants to know Dr. Rodgers’ opinion, whether the procedure will become commonplace, and if it poses potential complications for the baby.

Dr. Rodgers and Heather continue the episode by discussing what you need to know about the emerging science around the uterine microbiome:

  • The traditional thinking is that the vagina has bacteria but the uterus doesn’t. However, I understand this isn’t true. Let’s start with a history of investigations into reproductive-associated microbiomes.
  • Tell us about vaginal versus uterine microbiota.
  • How does the uterine microbiome potentially play a role in recurrent implantation failure and miscarriages?
  • Specifically, how is uterine microbiota linked to the following conditions:
    • Endometriosis
    • Adenomyosis
    • Endometrial hyperplasia and endometrial cancer
    • Chronic endometritis
    • Pregnancy complications
  • What are the challenges when analyzing uterine microbiota?
  • You talked about the test you currently use, but are there any tests still in development that might impact the future of endometrial evaluation?
  • Can you explain in detail several studies about the uterine microbiome and what the results showed?
  • When uterine microbiota is discovered, what is the treatment and patient prognosis?
  • Tell us some specific success stories of patients who previously had recurrent implantation failure or miscarriages and went on to have a live birth after the discovery of uterine microbiota.
  • Is there anything else you’d like to add?
  • What words of hope would you offer to patients who have a history of recurrent implantation failure or miscarriages?

Have a question you want Dr. Rodgers to answer next time she’s on? Click here.

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