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The reproductive tract microbiome • 1. The female reproductive tract is NOT sterile! 2. Vaginal bacteria ascend from the vagina to the endometrium 3. The biomass is significantly lower in the upper compartments compared to the vagina • Do bacteria, even in low numbers, play a physiological or pathological role for human reproduction?? • Do bacteria, even in low numbers, play a physiological or pathological role for human reproduction?? Frequency of abnormal vaginal microbiota in IVF patients Bacterial vaginosis (Nugent score): 21% (27/130) Abnormal vaginal microbiota diagnosis by ROC‐curve (qPCR G. vaginalis and/or A. vaginae): 28% (36/130) Sensitivity: 93% AARHUS UNIVERSITY DEPARTMENT OF CLINICAL MEDICINE Specificity: 93% Abnormal vaginal microbiota may be associated with poor reproductive outcomes: a prospective study in IVF patients. Haahr T, Jensen JS, Thomsen L, Duus L, Rygaard K, Humaidan P. Hum Reprod. 2016 Apr;31(4):795-803. doi: 10.1093/humrep/dew026. Epub 2016 Feb 23. PETER HUMAIDAN PETER.HUMAIDAN@MIDT.RM.DK PROFESSOR 58 PRECONGRESS COURSE 09 I VIENNA, AUSTRIA – 23 JUNE 2019 61