Metagenomic bacterial microbiome analysis of vaginal, cervical and endometrial samples in patients with adenomyosis obtained during the window of implantation

Adenomyosis is a chronic gynecological condition affecting a substantial portion of women of reproductive age, leading to symptoms like abnormal uterine bleeding, chronic pelvic pain, dysmenorrhea and infertility. Recent research suggests that disruptions in the microbiota of the reproductive tract may contribute to gynecological conditions pathophysiology. The microbiome of patients with adenomyosis is poorly understood. Previous studies have mostly focused on vaginal microbiome, whereas the endometrial microbiome has rarely been studied and never in the time of window of implantation, the period of peak endometrial receptivity. The meaning of the bacterial colonizers of reproductive tract and their effect on endometrial receptivity or exacerbation of disease symptoms remains unclear but could be associated to aberrant local metabolic conditions or modified host immune response.