Probiotics as male and female fertility enhancers

Dr. Stefi Kalli, Clinical Dietitian-Nutritionist

Scientific evidence throughout the years, have suggested the existence of an extensive microbiome in the human body that promotes health and normal physiology, while specifically present in male and female reproductive tracts. The natural microbiome acts as a key regulator of reproductive health by maintaining a balanced microenvironment, fertility and normal reproductive function, while in contrast, dysbiosis may alter fertility dynamics and reproductive function. In this context, probiotic treatment is becoming a sensible option to regulate host metabolism that in turn is correlated with reproductive function, as well as promoting epithelial barrier function, an immunomodulatory effect and cell membrane integrity that are all a prerequisite for successful reproduction.

In women, altered vaginal and endometrial microbiome has been related to infertility and poorest pregnancy outcomes. The dysbiotic non-Lactobacillus-dominant (NLD) microbiota combined with reduced relative abundance of Lactobacillus spp has been associated with lower implantation rates, reduced ongoing pregnancy and live birth rates. In the natural vaginal flora of healthy women the most represented species are Lactobacillus crispatus, gasseri, iners and jensenii. Lactobacilli can play a key role in changing the balance of the environment in the reproductive system in favor of successful implantation and pregnancy. This is true even for women undergoing assisted reproduction, as high abundance of specific Lactobacillus species seems to be beneficial in both IVF and ICSI. Lactobacillus crispatus can stabilize the vaginal microflora to improve the pregnancy success rate and increase the implantation rate during IVF-ET. Lactobacillus plantarum can also reduce the release of proinflammatory cytokines during infections which are preventable causes of infertility. In addition, the administration of Lactobacillus rhamnosus during pregnancy may prevent or treat inflammation that occurs in premature labor. According to another randomized controlled study, intravaginal lactobacilli supplementation before embryo transfer in the frozen-thaw cycle did not improve the biochemical and clinical pregnancy rate in the general population, but significantly reduced the miscarriage rate. It is thus evident that a strong correlation between a healthy microbiome and female fertility as also the anticipated reproductive outcomes, thus probiotic treatment can be beneficial for female reproductive health, fertility, as well as in terms of reproductive outcome.

In men, a rich microbiome exists in semen and possibly in the prostate also. Seminal microbiome is correlated with sperm quality and particularly with sperm concentration, motility, morphology and viability. Lactobacillus spp is the most prevalent in the semen and thought to originate from either the genital tract or from other urogenital tissues. Probiotic supplementation with Lactobacillus rhamnosus and Bifidobacterium longum is associated with improvements in semen quality parameters such as motility, viability and reduced DNA fragmentation in the nuclear genetic material. In addition, it has been shown that probiotic supplementation prevents chronic bacterial prostatitis, reduces the inflammatory processes involved in prostatitis, and supports antiproliferative and apoptotic events in cases of prostate cancer.

Nutrition can affect the proportion of the different species in the body by altering the concentration of Lactobacillus species. The general guideline is to include foods with a high content of probiotics and prebiotics to your daily diet, while sometimes additional supplementation is beneficial in order to establish a healthy microbiome, optimal fertility dynamics in both men and women and overall a better state for successful reproduction.

  • Fermented foods and beverages such as yogurt, kombucha, kefir, kimchi, pickles, and fermented cheeses.
  • Foods that are rich in prebiotics including onions, garlic, bananas, chicory root, artichokes.
  • Prebiotics added to foods or supplements that include galacto- oligosaccharides (GOS), fructo-oligosaccharides (FOS), oligofructose (OF), chicory fiber, and inulin.
  • Targeted probiotic and prebiotic supplementation according to the needs of each individual.

In any case, if you or anyone you know can benefit from this information, it is important to add that they must consult  their doctor or a specialist before undergoing any type of supplementation.

References

  1. Blancafort, C., & Llácer, J. (2023). Can probiotics enhance fertility outcome? Capacity of probiotics as a single intervention to improve the feminine genital tract microbiota in non-symptomatic reproductive-aged women. Frontiers in Endocrinology, 13, 1081830.
  2. Feng T, Liu Y. (2022)  Microorganisms in the reproductive system and probiotic’s regulatory effects on reproductive health. Comput Struct Biotechnol J, 20, 1541-1553.
  3. Thanaboonyawat, I., Pothisan, S., Petyim, S., & Laokirkkiat, P. (2023). Pregnancy outcomes after vaginal probiotic supplementation before frozen embryo transfer: a randomized controlled study. Scientific Reports, 13(1), 11892.
  4. Farahani, L., Tharakan, T., Yap, T., Ramsay, J. W., Jayasena, C. N., & Minhas, S. (2021). The semen microbiome and its impact on sperm function and male fertility: a systematic review and meta‐analysis. Andrology, 9(1), 115-144.

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