Application of Lactobacillus Salivarius CECT5713 in Infertility of Unknown Origin

Sponsor
Universidad Complutense de Madrid (Other)
Overall Status
Completed
CT.gov ID
NCT04446572
Collaborator
Bisearch Life (Other), Centro de Diagnóstico Médico. Ayuntamiento de Madrid. (Other)
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Study Details

Study Description

Brief Summary

In this study, we aimed to assess the cervicovaginal environment (pH, Nugent score, soluble immune factors and bacterial profile) in women with reproductive failure because of either repetitive abortion or infertility of unknown origin and compare it to that of healthy fertile women. The second objective was to evaluate the ability of Lactobacillus salivarius CECT5713 to modulate such parameters and to increase pregnancy rates in women with reproductive failure. The administration of L. salivarius CECT5713 (~9 log10 colony-forming units (CFU)/day) for 6 months or until a diagnosis of pregnancy to women with reproductive failure resulted in an overall successful (term) pregnancy rate of 56%.

Condition or Disease Intervention/Treatment Phase
  • Biological: Lactobacillus salivarius CECT5713
Phase 2

Detailed Description

In this study, we aimed to assess the cervicovaginal environment (pH, Nugent score, soluble immune factors and bacterial profile) in women with reproductive failure because of either repetitive abortion or infertility of unknown origin and compare it to that of healthy fertile women. The second objective was to evaluate the ability of Lactobacillus salivarius CECT5713 to modulate such parameters and to increase pregnancy rates in women with reproductive failure. Vaginal pH and Nugent score were higher in women with reproductive failure than in fertile women. Differences were also noted regarding soluble immune factors transforming growth factor beta (TGF-β) and vascular endothelial growth factor (VEGF). Their concentrations in cervicovaginal lavage samples were reduced by about one-half in women with reproductive failure compared to fertile women. Lactobacilli were detected in a higher proportion, and at a higher concentration and having different species profile, in fertile women than in women with repetitive abortion or infertility. The study of the vaginal microbiome revealed that samples from fertile women were characterized by the high abundance of Lactobacillus sequences, while in about one third of samples from women with reproductive failure DNA from this genus was practically absent while there was an abundance of that of Gardnerella and Bifidobacterium. Lactobacillus salivarius CECT5713 seemed to be a suitable candidate to modulate the cervicovaginal microbiota because of its acidifying capacity, adhesion to vaginal cells and co-aggregation with vaginal pathogens. The administration of L. salivarius CECT5713 (~9 log10 CFU/day) for 6 months or until a diagnosis of pregnancy to women with reproductive failure resulted in an overall successful (term) pregnancy rate of 56%. In addition, the probiotic intervention modified significantly key microbiological, biochemical and immunological parameters in women who got pregnant being their post-intervention values similar or close to those of fertile women. The high concentrations of L. salivarius and the detection of L. salivarius DNA in vaginal samples confirmed that the probiotic was able to reach the vaginal mucosa. In conclusion, L. salivarius CECT5713 has proved to be a good candidate to improve reproductive success in women with reproductive failure.

Study Design

Study Type:
Interventional
Actual Enrollment :
58 participants
Allocation:
Non-Randomized
Intervention Model:
Parallel Assignment
Intervention Model Description:
Volunteers were classified into 3 groups. All women in the RA group (n = 21) had a history of recurrent miscarriage with three or more pregnancy losses during the first 12 weeks of pregnancy. All women of the INF group (n = 23) had a history of infertility (inability to conceive) despite being the recipients of assisted-reproduction techniques (ART) for at least three times, including two cycles, at least, of in vitro fertilization (IVF). Finally, the control group (n = 14) included fertile women having at least two children after uncomplicated term pregnancies. Starting at day 0, women of the RA and INF groups consumed (oral route) a daily sachet with ~50 mg of freeze-dried probiotic (~9 log10 CFU of L. salivarius CECT5713) for 6 months or until a diagnosis of pregnancy (whatever happened first).Volunteers were classified into 3 groups. All women in the RA group (n = 21) had a history of recurrent miscarriage with three or more pregnancy losses during the first 12 weeks of pregnancy. All women of the INF group (n = 23) had a history of infertility (inability to conceive) despite being the recipients of assisted-reproduction techniques (ART) for at least three times, including two cycles, at least, of in vitro fertilization (IVF). Finally, the control group (n = 14) included fertile women having at least two children after uncomplicated term pregnancies. Starting at day 0, women of the RA and INF groups consumed (oral route) a daily sachet with ~50 mg of freeze-dried probiotic (~9 log10 CFU of L. salivarius CECT5713) for 6 months or until a diagnosis of pregnancy (whatever happened first).
Masking:
None (Open Label)
Primary Purpose:
Basic Science
Official Title:
Application of Lactobacillus Salivarius CECT5713 to Achieve Term Pregnancies in Women With Repetitive Abortion or Infertility of Unknown Origin by Microbiological and Immunological Modulation of the Vaginal Ecosystem
Actual Study Start Date :
Oct 16, 2018
Actual Primary Completion Date :
Nov 29, 2019
Actual Study Completion Date :
Nov 29, 2019

Arms and Interventions

Arm Intervention/Treatment
Experimental: Repetitive Abortion (RA) group

Starting at day 0, women of the RA (n=21) group consumed (oral route) a daily sachet with ~50 mg of freeze-dried probiotic (~9 log10 CFU of L. salivarius CECT5713) for 6 months or until a diagnosis of pregnancy (whatever happened first).

Biological: Lactobacillus salivarius CECT5713
Starting at day 0, women of the RA and INF groups consumed (oral route) a daily sachet with ~50 mg of freeze-dried probiotic (~9 log10 CFU of L. salivarius CECT5713) for 6 months or until a diagnosis of pregnancy (whatever happened first).

Experimental: Infertility (INF) group

Starting at day 0, women of the INF group (n=23) consumed (oral route) a daily sachet with ~50 mg of freeze-dried probiotic (~9 log10 CFU of L. salivarius CECT5713) for 6 months or until a diagnosis of pregnancy (whatever happened first).

Biological: Lactobacillus salivarius CECT5713
Starting at day 0, women of the RA and INF groups consumed (oral route) a daily sachet with ~50 mg of freeze-dried probiotic (~9 log10 CFU of L. salivarius CECT5713) for 6 months or until a diagnosis of pregnancy (whatever happened first).

No Intervention: Control group

The control group (n = 14) included fertile women having at least two children after uncomplicated term pregnancies.

Outcome Measures

Primary Outcome Measures

  1. Pregnancies and successful pregnancies [6 months]

    Total number of pregnancies and number of pregnancies with delivery of a healthy baby

Secondary Outcome Measures

  1. Modification of the vaginal microbiota [6 months]

    Variation in the concentration of lactobacilli and other bacteria in cervicovaginal lavage samples

  2. Vaginal immunomodulation [6 months]

    Variation in the concentration of TGF-β and VEGF in cervicovaginal lavage

Eligibility Criteria

Criteria

Ages Eligible for Study:
33 Years to 41 Years
Sexes Eligible for Study:
Female
Accepts Healthy Volunteers:
No
Inclusion Criteria:
  • Recurrent miscarriage with three or more pregnancy losses during the first 12 weeks of pregnancy (RA group)

  • Infertility (inability to conceive) despite being the recipients of ART for at least three times, including two cycles, at least, of in vitro fertilization (IVF) (INF group).

  • Fertile women having at least two children after uncomplicated term pregnancies (Control group).

Exclusion Criteria:
  • Antiphospholipid syndrome

  • Hormonal therapy, antibiotics or probiotics in the 4 weeks previous to sampling.

  • Lactose intolerance or cow's milk protein allergy (RA and INF groups)

Contacts and Locations

Locations

Site City State Country Postal Code
1 Dpt. Nutricion, Bromatologia y Tecnologia de los Alimentos Madrid Spain 28040

Sponsors and Collaborators

  • Universidad Complutense de Madrid
  • Bisearch Life
  • Centro de Diagnóstico Médico. Ayuntamiento de Madrid.

Investigators

  • Principal Investigator: Juan M Rodríguez, PhD, Complutense University Madrid

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
Juan M. Rodríguez, Professor, Universidad Complutense de Madrid
ClinicalTrials.gov Identifier:
NCT04446572
Other Study ID Numbers:
  • PREPROBIFERT01
First Posted:
Jun 25, 2020
Last Update Posted:
Jun 26, 2020
Last Verified:
Jun 1, 2020
Individual Participant Data (IPD) Sharing Statement:
Yes
Plan to Share IPD:
Yes
Studies a U.S. FDA-regulated Drug Product:
No
Studies a U.S. FDA-regulated Device Product:
No
Keywords provided by Juan M. Rodríguez, Professor, Universidad Complutense de Madrid
Additional relevant MeSH terms:

Study Results

No Results Posted as of Jun 26, 2020