Interaction Between Endometriosis and Bacteria in Infertile Women at Arash Women's General Hospital in Tehran

Background: Endometriosis is a common disorder that affects 20 - 50% of infertile women. The disease correlates with the presence of lactobacilli and changes in the number of Gram-negative and Gram-positive bacteria. Objectives: This article aims to investigate the interaction between endometriosis and certain bacteria. Methods: One hundred women between 18 and 40 years of age referred to the IVF department of Arash Women's Hospital in Tehran were studied. Fifty of them were diagnosed with endometriosis, while the rest were referred for investigation or freezing of their gametes or embryos. Specimens were collected from endometrial tissue and the cervix using swabs. These specimens were used for cultures and real-time PCR to quantify Lactobacillus. Results: Seventeen different Gram-positive and Gram-negative bacteria, as well as three yeasts, were isolated from women with and without endometriosis. The highest prevalence was related to Enterococcus faecalis, followed by Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, E. faecium, Proteus mirabilis, Edwardsiella tarda, and Citrobacter spp. In cases with endometriosis, the relationship between the increase of Enterococcus spp., members of the Enterobacteriaceae family, and the decrease of lactobacilli was significant (P < 0.05). Staphylococcus aureus was isolated from the cervix of three women with endometriosis. The bacterial profiles of the cervix and endometrium were very similar. Conclusions: Considering the decrease of lactobacilli and the increase of other bacteria in people with endometriosis, it is recommended to use Lactobacillus and other probiotics for the prevention and even treatment of this disease.