Discussion
GARDNERELLA, ADVERSE EVENT, MISCARRIAGE
A lactobacilli-predominant vaginal and endometrial environment has been associated with a higher pregnancy rateOne meta-analysis suggested that probiotics could reduce the amount of abnormal microbiota (Gardnerella and Atopobium) and increase the quantity of the We conducted a post hoc subgroup analysis to further explore pregnancy outcomes. Among the women who were diagnosed with BV, the clinical pregnancy rate, and the live birth rate were higher but did not reach statistical significance. Nevertheless, the increased live birth rate was clinically significant. The Subgroup analysis in the blastocyst group found that the live birth rate was higher in the study group (We transferred the blastocyst on day 6 of lactobacilli supplementation, while another study transferred fresh embryos on day 3Despite the comparable pregnancy rate, we observed a statistically significant reduction in the miscarriage rate in the study group. This was consistent with Moreno et al., who reported a decreased miscarriage rate from 60 to 16.7% in the probiotic supplement groupNo patients in our study group had an adverse event related to the lactobacilli supplementation. This is in line with an earlier report of 50 pregnant women diagnosed with BV and treated with This study is the first single-center, randomized controlled trial comparing the pregnancy outcome of ET in the frozen-thaw cycles between the Lactobacilli supplementation and a control group. No placebo group was one of the limitations of this study. Nevertheless, the study group demonstrated good compliance with the protocol. A wet smear was performed to diagnose BV in all participants, enabling the estimation of BV prevalence in infertile Thai women. Lactobacilli supplementation, therefore, may be beneficial for this specific group. However, we were not able to evaluate the health of the vaginal or endometrial microbiome, which has been associated with endometrial receptivity and the pregnancy rate