The rise in infertility rates has prompted research into the impact of vaginal microbiota on female fertility and assisted reproduction technology (ART) success. Our study compares the vaginal microbiome of fertile and infertile women and explores its influence on ART outcomes. We analyzed vaginal secretions from 194 infertile women and 100 healthy controls at Shanghai Changzheng Hospital using polymerase chain reaction (PCR) to amplify the 16S rRNA V3-V4 region. A machine learning model predicted infertility based on genus abundances, and the PICRUSt algorithm predicted metabolic pathways related to infertility and ART outcome. The results showed women with infertility exhibited a significantly different vaginal microbial composition compared to healthy women, with the infertility group showing higher microbial diversity. Burkholderia, Pseudomonas, and Prevotella levels were significantly elevated in the vaginal microbiota of the infertility group, while Bifidobacterium and Lactobacillus abundances were reduced. Recurrent implantation failure (RIF) within the infertile population showed even higher diversity of vaginal microbiota, with specific genera such as Mobiluncus, Peptoniphilus, Prevotella, and Varibaculum being more abundant. Eleven metabolic pathways were associated with RIF and infertility, with Prevotella demonstrating stronger correlations. The present study provides insights into the differences in vaginal microbiome between healthy and infertile women, offering a new understanding of how vaginal microbiota may impact infertility and ART outcomes. Our findings underscore the significance of specific microbial taxa in women with RIF, suggesting avenues for targeted interventions to enhance embryo transplantation success rates.

Keywords: Lactobacillus; Assisted reproductive technology; Infertility; Pregnancy outcome; Vaginal microbiome.

© The Author(s) 2025. Published by Oxford University Press and Science Press on behalf of the Beijing Institute of Genomics, Chinese Academy of Sciences / China National Center for Bioinformation and Genetics Society of China.

不孕率的上升促使了关于阴道微生物群对女性生育能力和辅助生殖技术（ART）成功率影响的研究。我们的研究比较了育龄妇女和不育妇女的阴道菌群，并探讨其对ART结果的影响。我们使用聚合酶链反应（PCR）扩增16S rRNA V3-V4区域，分析了上海长征医院194名不孕女性和100名健康对照组的阴道分泌物。基于属水平丰度构建了一个机器学习模型预测不育，并利用PICRUSt算法预测与不育及ART结果相关的代谢途径。结果显示，不育妇女的阴道微生物组成显著不同于健康女性，且不育组表现出更高的微生物多样性。不育组中Burkholderia、Pseudomonas和Prevotella水平明显升高，而Bifidobacterium和Lactobacillus丰度降低。在不孕人群中，反复植入失败（RIF）显示出阴道微生物组成的更高多样性，某些特定属如Mobiluncus、Peptoniphilus、Prevotella和Varibaculum更为丰富。与RIF和不育相关的11条代谢途径中，Prevotella表现出更强的相关性。本研究提供了健康女性和不孕女性之间阴道菌群差异的见解，为了解阴道微生物如何影响不育及ART结果提供了新的理解。我们的发现强调了特定微生物类群在RIF妇女中的重要性，为提高胚胎移植成功率提出了有针对性干预的新途径。

关键词：Lactobacillus；辅助生殖技术；不孕症；妊娠结局；阴道菌群。

© The Author(s) 2025. Oxford University Press和Science Press代表中国科学院北京基因组研究所/国家生物信息中心及遗传学会发布。