Vaginal microbiome changes with levonorgestrel intrauterine system placement

Janet C. Jacobson, David K. Turok, Amna Dermish, Ingrid E. Nygaard, Matthew L. Settles

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objective To investigate changes in female genital tract bacterial ecology associated with levonorgestrel intrauterine system (LNG IUS) use. Study Design Study participants were regularly cycling Caucasian women without recent history of pregnancy or exogenous hormone use. Vaginal, cervical and uterine samples were obtained at nine time intervals, from 1 week before to 12 weeks after LNG IUS placement. Replicate paired vaginal and cervical specimens were collected to determine the consistency of specimen collection and processing. Results A total of 406 samples from 11 women were available for analysis after DNA extraction, amplification and species identification. Of the 355 bacterial species or genera detected, Lactobacillus crispatus was most prevalent representing 48.9% of over 6 million total reads. L. crispatus reads of replicate vaginal samples were not significantly different [odds ratio (OR) 0.79, 0.36-1.73]. In addition, L. crispatus reads of vaginal and cervical samples from the same visit were not significantly different (OR 0.69, 0.31-1.51). Compared to sampling visits prior to LNG IUS placement, sampling visits after LNG IUS insertion were more likely to have L. crispatus reads greater than 50% of total reads (OR 2.13, 1.01-4.48). Of the 63 uterine samples demonstrating bacteria, Burkholderia genus proteobacteria, a common environmental contaminant, were most prevalent both before and after LNG IUS insertion accounting for 48.0% of all uterine sample reads. Conclusion The vaginal microbiome changes very little in response to LNG IUS placement. Further study is needed to place this finding in context with clinical outcomes. Implications There do not appear to be any clinically important differences in the vaginal microbiome in response to insertion of the LNG IUS.

Original languageEnglish (US)
Pages (from-to)130-135
Number of pages6
JournalContraception
Volume90
Issue number2
DOIs
StatePublished - Jan 1 2014

Fingerprint

Levonorgestrel
Microbiota
Odds Ratio
Burkholderia
Specimen Handling
Proteobacteria
Reproductive History
Ecology
Hormones
Bacteria
Lactobacillus crispatus
DNA

Keywords

  • Contraception
  • IUD
  • Intrauterine Device
  • Microflora
  • Reproductive-aged female

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Vaginal microbiome changes with levonorgestrel intrauterine system placement. / Jacobson, Janet C.; Turok, David K.; Dermish, Amna; Nygaard, Ingrid E.; Settles, Matthew L.

In: Contraception, Vol. 90, No. 2, 01.01.2014, p. 130-135.

Research output: Contribution to journalArticle

Jacobson, Janet C. ; Turok, David K. ; Dermish, Amna ; Nygaard, Ingrid E. ; Settles, Matthew L. / Vaginal microbiome changes with levonorgestrel intrauterine system placement. In: Contraception. 2014 ; Vol. 90, No. 2. pp. 130-135.
@article{cee54ab2475b415595f76bce0dfce189,
title = "Vaginal microbiome changes with levonorgestrel intrauterine system placement",
abstract = "Objective To investigate changes in female genital tract bacterial ecology associated with levonorgestrel intrauterine system (LNG IUS) use. Study Design Study participants were regularly cycling Caucasian women without recent history of pregnancy or exogenous hormone use. Vaginal, cervical and uterine samples were obtained at nine time intervals, from 1 week before to 12 weeks after LNG IUS placement. Replicate paired vaginal and cervical specimens were collected to determine the consistency of specimen collection and processing. Results A total of 406 samples from 11 women were available for analysis after DNA extraction, amplification and species identification. Of the 355 bacterial species or genera detected, Lactobacillus crispatus was most prevalent representing 48.9{\%} of over 6 million total reads. L. crispatus reads of replicate vaginal samples were not significantly different [odds ratio (OR) 0.79, 0.36-1.73]. In addition, L. crispatus reads of vaginal and cervical samples from the same visit were not significantly different (OR 0.69, 0.31-1.51). Compared to sampling visits prior to LNG IUS placement, sampling visits after LNG IUS insertion were more likely to have L. crispatus reads greater than 50{\%} of total reads (OR 2.13, 1.01-4.48). Of the 63 uterine samples demonstrating bacteria, Burkholderia genus proteobacteria, a common environmental contaminant, were most prevalent both before and after LNG IUS insertion accounting for 48.0{\%} of all uterine sample reads. Conclusion The vaginal microbiome changes very little in response to LNG IUS placement. Further study is needed to place this finding in context with clinical outcomes. Implications There do not appear to be any clinically important differences in the vaginal microbiome in response to insertion of the LNG IUS.",
keywords = "Contraception, IUD, Intrauterine Device, Microflora, Reproductive-aged female",
author = "Jacobson, {Janet C.} and Turok, {David K.} and Amna Dermish and Nygaard, {Ingrid E.} and Settles, {Matthew L.}",
year = "2014",
month = "1",
day = "1",
doi = "10.1016/j.contraception.2014.04.006",
language = "English (US)",
volume = "90",
pages = "130--135",
journal = "Contraception",
issn = "0010-7824",
publisher = "Elsevier USA",
number = "2",

}

TY - JOUR

T1 - Vaginal microbiome changes with levonorgestrel intrauterine system placement

AU - Jacobson, Janet C.

AU - Turok, David K.

AU - Dermish, Amna

AU - Nygaard, Ingrid E.

AU - Settles, Matthew L.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Objective To investigate changes in female genital tract bacterial ecology associated with levonorgestrel intrauterine system (LNG IUS) use. Study Design Study participants were regularly cycling Caucasian women without recent history of pregnancy or exogenous hormone use. Vaginal, cervical and uterine samples were obtained at nine time intervals, from 1 week before to 12 weeks after LNG IUS placement. Replicate paired vaginal and cervical specimens were collected to determine the consistency of specimen collection and processing. Results A total of 406 samples from 11 women were available for analysis after DNA extraction, amplification and species identification. Of the 355 bacterial species or genera detected, Lactobacillus crispatus was most prevalent representing 48.9% of over 6 million total reads. L. crispatus reads of replicate vaginal samples were not significantly different [odds ratio (OR) 0.79, 0.36-1.73]. In addition, L. crispatus reads of vaginal and cervical samples from the same visit were not significantly different (OR 0.69, 0.31-1.51). Compared to sampling visits prior to LNG IUS placement, sampling visits after LNG IUS insertion were more likely to have L. crispatus reads greater than 50% of total reads (OR 2.13, 1.01-4.48). Of the 63 uterine samples demonstrating bacteria, Burkholderia genus proteobacteria, a common environmental contaminant, were most prevalent both before and after LNG IUS insertion accounting for 48.0% of all uterine sample reads. Conclusion The vaginal microbiome changes very little in response to LNG IUS placement. Further study is needed to place this finding in context with clinical outcomes. Implications There do not appear to be any clinically important differences in the vaginal microbiome in response to insertion of the LNG IUS.

AB - Objective To investigate changes in female genital tract bacterial ecology associated with levonorgestrel intrauterine system (LNG IUS) use. Study Design Study participants were regularly cycling Caucasian women without recent history of pregnancy or exogenous hormone use. Vaginal, cervical and uterine samples were obtained at nine time intervals, from 1 week before to 12 weeks after LNG IUS placement. Replicate paired vaginal and cervical specimens were collected to determine the consistency of specimen collection and processing. Results A total of 406 samples from 11 women were available for analysis after DNA extraction, amplification and species identification. Of the 355 bacterial species or genera detected, Lactobacillus crispatus was most prevalent representing 48.9% of over 6 million total reads. L. crispatus reads of replicate vaginal samples were not significantly different [odds ratio (OR) 0.79, 0.36-1.73]. In addition, L. crispatus reads of vaginal and cervical samples from the same visit were not significantly different (OR 0.69, 0.31-1.51). Compared to sampling visits prior to LNG IUS placement, sampling visits after LNG IUS insertion were more likely to have L. crispatus reads greater than 50% of total reads (OR 2.13, 1.01-4.48). Of the 63 uterine samples demonstrating bacteria, Burkholderia genus proteobacteria, a common environmental contaminant, were most prevalent both before and after LNG IUS insertion accounting for 48.0% of all uterine sample reads. Conclusion The vaginal microbiome changes very little in response to LNG IUS placement. Further study is needed to place this finding in context with clinical outcomes. Implications There do not appear to be any clinically important differences in the vaginal microbiome in response to insertion of the LNG IUS.

KW - Contraception

KW - IUD

KW - Intrauterine Device

KW - Microflora

KW - Reproductive-aged female

UR - http://www.scopus.com/inward/record.url?scp=84904250736&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84904250736&partnerID=8YFLogxK

U2 - 10.1016/j.contraception.2014.04.006

DO - 10.1016/j.contraception.2014.04.006

M3 - Article

C2 - 24835828

AN - SCOPUS:84904250736

VL - 90

SP - 130

EP - 135

JO - Contraception

JF - Contraception

SN - 0010-7824

IS - 2

ER -