Effect of laparoscopic niche resection on vaginal microbiota and its relation to pregnancy rate

Laparoscopic niche resection resulted in a more than 10-fold reduction in niche volume. However, no significant changes in vaginal microbiota were observed postoperatively. Notably, women who experienced the largest reduction in niche volume also demonstrated a favourable shift in their microbiome profile, which is associated with improved fertility.Postoperatively, the highest pregnancy rate (90 %) was observed in women with Lactobacillus crispatus-dominant microbiota (p = 0.78). These results provide valuable insights into the pathophysiology of uterine niches and suggest potential therapeutic approaches for women experiencing niche-related infertility, however lager studies are needed to confirm these findings.