Why Vaginal Microbiome Matters For Fertility

A healthy vaginal microbiome is one of the most overlooked, yet powerful factors in fertility. This delicate ecosystem, dominated by protective Lactobacillus bacteria, helps maintain an optimal pH, prevents harmful pathogens from taking over, and creates the conditions sperm need to survive and reach the egg. But when this balance shifts, even slightly, it can quietly derail conception efforts. Disruptions in vaginal pH or bacterial balance have been linked to reduced sperm motility, failed embryo implantation, and even higher miscarriage rates. Understanding and supporting your vaginal microbiome is an essential (and often missing) step for anyone trying to conceive, especially after 40.

More and more research in recent years highlights the significant impact our vaginal microbiome has on fertility. The vaginal pH, which should ideally be between 3.5 – 4.2, is a key indicator of vaginal health. Disruptions in the microbiome, such as a loss of Lactobacillus dominance and an increase in microbial diversity, can lead to vaginal dysbiosis. Dysbiosis raises vaginal pH and creates an environment hospitable to harmful bacteria, which can negatively impact sperm motility, embryo transfer outcomes, and increase the risk of miscarriage.

Risks Associated with Vaginal Dysbiosis:

  1. Increased Risk of Miscarriage: Research shows that low levels of Lactobacillus bacteria are linked to higher rates of miscarriage. 
  2. Impact on Sperm: A healthy vaginal microbiome is necessary for sperm motility and survival. Elevated pH and presence of pathogens reduce the ability of the sperm to reach the egg.
  3. IVF and Embryo Transfer: Dysbiosis before IVF treatment significantly decreases success rates. Vaginal health is crucial for successful embryo implantation and pregnancy outcomes.

Testing 

To assess vaginal microbiome health, several testing options are available: Evvy, Fertilysis, and Invivo offer detailed insights into your microbiome.

Using pH test strips is also an easy and cost-effective way to quickly and regularly assess your vaginal health.

Treating Vaginal Dysbiosis

Treating high vaginal pH and restoring a healthy microbiome is essential for fertility and overall health. Here are some methods:

  • Boric Acid Suppositories: Help regulate pH levels and reduce harmful bacteria (before ovulation only when TTC).
  • Lactobacilli-Rich Foods: Incorporate fermented foods like sauerkraut and kimchi to support Lactobacillus dominance.
  • Targeted Lactobacillus Supplements: A healthy vaginal microbiome is dominated by L. crispatus, along with other key species like L. gasseri, L. iners, and L. jensenii. Look for supplements that include these strains to support vaginal health and optimal fertility (healthy vaginas are typically over 90% L. crispatus).
  • Gentle Hygiene: Clean yourself with water only.
  • Organic Cotton Underwear: Ensure breathability and non-toxic materials.
  • Regular Menstrual Product Changes: Minimize the risk of infections and maintain a healthy pH.

Maintaining a healthy pH and supporting Lactobacillus dominance is key to optimizing reproductive health, as ongoing research continues to underscore the significant role of the vaginal microbiome in fertility.

Supporting your vaginal microbiome is just one piece of the fertility puzzle—especially after 40. In my Fertile After 40 Masterclass, you’ll learn how to optimize your hormones, gut and vaginal health, nutrition, and lifestyle to create the ideal conditions for conception. With step-by-step guidance and evidence-based strategies, you’ll gain the confidence and tools to improve your chances of a successful pregnancy.

References:

PMID: 35090453, 37110417, 22222853, 37780845

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