Uso de probióticos en mujer con esterilidad de origen desconocido y fallos implantatorios tras fertilización in vitro

Jorge Cea García, Belén García Monte, Mª del Pilar Lara de la Rosa

Resumen


Varios estudios han sugerido que la microbiota endometrial humana está relacionada con el éxito de la implantación embrionaria. La presencia de una microbiota no dominada por lactobacilos se ha asociado con una disminución significativa en tasas de implantación, de embarazo, de embarazo evolutivo y de recién nacido en casa. El objetivo fue aporta información sobre el posible beneficio de la microbiota endometrial dominada por lactobacilos en mujer con fallos implantatorios tras fertilización in vitro y establecer una estrategia efectiva de tratamiento para el endometrio disbiótico. Se presenta el caso de una mujer de 37 años diagnosticada de una esterilidad de origen desconocido con el antecedente de dos fallos implantatorios tras fertilización in vitro-inyección intracitoplasmática de espermatozoides. La paciente fue diagnosticada mediante biopsia y cultivo endometriales de endometritis crónica por Streptococcus spp. Tras haber sido tratada con antibióticos orales y, finalmente, con terapia adyuvante con probióticos orales, que contenían varias especies de lactobacilos, logró restablecer una microbiota endometrial normal consiguiendo una gestación en el siguiente ciclo de fertilización in vitro-inyección intracitoplasmática de espermatozides y manteniendo los probióticos orales durante toda la gestación. Se concluye que puede ser importante la evaluación de la receptividad endometrial no sólo en la morfología y niveles moleculares, sino también desde el punto de vista microbiológico en pacientes infértiles con fallos implantatorios. La recuperación de la microbiota no dominada por lactobacilos podría beneficiar la implantación embrionaria.

Recibido: 4 de Abril de 2020.
Aceptado: 20 de Agosto de 2020.
Publicado online: 17 de Septiembre de 2020


Palabras clave


Esterilidad; endometrio; endometritis; lactobacillus; probióticos

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Referencias


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