Harnessing vaginal inflammation and microbiome: a machine learning model for predicting IVF success.

Journal: NPJ biofilms and microbiomes
Published Date: Jun 5, 2025

Abstract

Humans are the only species with a commensal Lactobacillus-dominant vaginal microbiota. Reproductive tract microbes have been linked to fertility outcomes, as has intrauterine inflammation, suggesting immune response may mediate adverse outcomes. In this pilot study, we compared vaginal microbiota composition and immune marker concentrations between patients with unexplained or male factor infertility (MFI), as a control. We applied a supervised machine learning algorithm that integrated microbiome and inflammation data to predict pregnancy outcomes.Twenty-eight participants provided vaginal swabs at three IVF cycle time points; 18 achieved pregnancy. Pregnant participants had lower microbial diversity and inflammation. Among them, MFI cases had higher diversity but lower inflammation than those with unexplained infertility. Our model showed the highest prediction accuracy at time point 2 of the IVF cycle. These findings suggest that vaginal microbiota and inflammation jointly impact fertility and can inform predictive tools in reproductive medicine.

Authors

  • Ofri Bar
    Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA. ofri.bar@mail.huji.ac.il.
  • Stylianos Vagios
    Department of Obstetrics & Gynecology, Tufts University Medical Center, Boston, MA, USA.
  • Omer Barkai
    Harvard Medical School, Boston, MA, USA.
  • Joseph Elshirbini
    Ragon Institute of MGH, MIT, and Harvard, Massachusetts General Hospital, Cambridge, MA, USA.
  • Irene Souter
    Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Jiawu Xu
    Ragon Institute of MGH, MIT, and Harvard, Massachusetts General Hospital, Cambridge, MA, USA.
  • Kaitlyn James
    Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA.
  • Charles Bormann
    Massachusetts General Hospital, Boston, Massahusetts.
  • Makiko Mitsunami
    Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Harvard Medical School, Massachusetts General Hospital Fertility Center, Boston, MA, USA.
  • Jorge E Chavarro
    Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Harvard Medical School, Massachusetts General Hospital Fertility Center, Boston, MA, USA.
  • Philipp Foessleitner
    Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA.
  • Douglas S Kwon
    Harvard Medical School, Boston, MA, USA.
  • Moran Yassour
    Department of Microbiology and Molecular Genetics, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
  • Caroline Mitchell
    Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA.

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