The Microbiome and Fertility

Host Dawn Davenport, Executive Director of Creating a Family, the national infertility & adoption education and support nonprofit, interviews Dr. Jason M. Franasiak, Associate Chair, Society for Reproductive Endocrinology and Infertility, Board Cert. Reproductive Endocrinologist with RMA New Jersey; and Dr. Erin Wolff, former Assistant Clinical Investigator with the National Institute for Health and now Chief Medical Officer at Celmatix.

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What is the human biome? Microbes: Bacteria, yeast, and what else?
We think of the human biome primarily in the gut—the intestines. We also know that the vagina has a biome. What other places in the body do we have a large population of beneficial bacteria?
Does the microbiome extend up the reproductive tract or is it only in the vagina?
Is an imbalance in the vaginal microbiome called vaginosis?
How common is bacterial vaginosis?
What are the symptoms of an unbalanced microbiome in the vagina and it is always reaching the level of being diagnosed as bacterial vaginosis?
Is what is considered a healthy balance the same for everyone? Does it vary by ethnicity?
How does the vaginal biome affect conception with the sperm getting to the egg?
How does the biome affect implantation?
How does the biome affect the ability to carry a pregnancy to term?
Why does a vaginal imbalance result in a significant increase risk of pre-term birth?
Are there ramifications to the children who are born to a woman with vaginosis? Chorioamnionitis inflammation during pregnancy.
Does the intestinal microbiome affect fertility? Weight is such an important factor in fertility. Is there evidence that a disturbed gut biome will result in obesity?
Causes:
- What causes a disturbance of the healthy vaginal microbiome? Diet, number of sexual partners, stress, antibiotic use, vaginal piercings, douching?
- Will antibiotics affect the vaginal biome?
- How can infertility medications affect the vaginal microbiome?
How to restore a healthy vaginal biome? How to treat a disturbed vaginal or reproductive tract biome. I would like to address both proactive preventative measures, as well as treatment options once it is out of whack.
How to maintain a heathy vaginal microbiome?
- Impact of vaginal lactobacilli on conception or pregnancy.
- Probiotics? Pill form vs. administered vaginally vs. naturally occurring in food
- Do cultures that have a lot of fermented food have a healthier biome?
- Do you recommend a diet rich in fermentable carbohydrates, or prebiotics? What would this include?
- What type of diet (food to encourage and foods to avoid) are recommended for establishing a healthy vaginal and gut biome? Avoid refined carbohydrates, limit sugar, excessive alcohol. Pre-biotic foods?
Home remedies for vaginosis:
- Douching with: Hydrogen Peroxide. Yogurt. Apple cider vinegar
- Taking orally:
  - Tree Tea Oil
  - Garlic
  - Fenugreek
  - Coconut Oil
- What other treatment options are available to restore a healthy balance? Antibiotic?
Any evidence that the gut or reproductive tract biome in males affect fertility?