How vaginal microbiome testing can support complex fertility challenges

A guest blog authored by Rachel Sherriff

If you are navigating fertility struggles or recurrent miscarriage, you've likely been told everything looks 'normal', yet something still isn't working. In my experience, as founder of a holistic fertility clinic in Surrey, I understand that fertility isn't just about ticking boxes on standard tests, it's about piecing together the whole picture, including what's often missed.

One of the most overlooked aspects of reproductive health is the vaginal microbiome, the delicate balance of bacteria and microbes that help maintain a healthy uterine and vaginal environment. Disruptions in this ecosystem, such as an overgrowth of harmful bacteria or persistent low-grade infections, can impact implantation, increase miscarriage risk, and hinder conception.

At my clinic we routinely offer vaginal microbiome testing as part of a more advanced, holistic fertility approach. This kind of testing gives us insight into a woman’s vaginal flora, inflammation markers, and the presence of bacteria linked to conditions like Bacterial Vaginosis (BV) or Endometritis, often without obvious symptoms. By identifying these issues, we can work to treat them properly and support a healthier environment for implantation and pregnancy.

My top tips for supporting your vaginal microbiome:

A lactobacillus dominant vaginal microbiome has been linked to improved pregnancy outcomes, including IVF outcomes, therefore its worth investing in improving your vaginal microbiome if you are trying to conceive.

Look after your nutrition:

Avoiding excessive simple carbohydrates and alcohol can support the vaginal microbiome. Sugary and processed foods will feed pathogenic bacteria that can live in the vagina. Ideally we need to nurture the good bacteria, lactobacilli. 

My favourite ‘good’ bacteria promoting foods are:

• Flaxseed powder
• Fermented foods such as kefir, kimchi and kombucha
• Berries such as blueberries, raspberries.
• Broccoli
• Artichokes, onions, leeks, chives and garlic
• A diverse mix of fruit and vegetables both raw and cooked

Hygiene practice tips:

• Avoid perfumed sprays and douches as chemicals can disturb the microbiome and alter the pH of the vagina.
• Avoid the use of G-string underwear as the contact between the anus and the vagina may aid the migration of bacteria.
• Choose breathable natural fibres to improve air flow in the area.
• After using the toilet, wipe away from the vagina.
• Change tampons and vaginal cups after bowel movements.
• Sterilise vaginal cups by boiling instead of only washing them in cold water. Having two is good practice.
• Avoid using soap in the vagina, wash with water only.

Other lifestyle tips to consider:

• Be aware that antibiotics can impact the vaginal microbiome. Whilst taking antibiotics, consider using lactobacillus probiotics and eating fermented foods.
• Choose lubricants that are unscented and pH balanced.
• Clean sex toys between use and try to avoid using vaginally and anally without first cleaning to prevent cross contamination.
• Cigarette smoking directly secretes nicotine into the vagina and impacts negatively on the vaginal microbiome.
• Saliva and semen can both alkalise the vagina which may worsen symptoms of Bacterial Vaginosis (BV) and other conditions associated with a lack of acidity.
• If possible, avoid tampons and use organic unbleached cotton tampons and pad.

Signs and symptoms that it maybe worth investing in a vaginal microbiome test!

• Recurrent infections such as thrush, Bacterial Vaginosis (BV) or cystitis
• Recurrent unsuccessful IVF where no other cause can be identified
• Recurrent miscarriage that cannot be explained
• ‘Unexplained Infertility’
• Symptoms of vaginal itching, redness, irritation, abnormal discharges such as ones that are discoloured or smelly.

Consider the use of a good vaginal probiotic too, ideally one that is dominant in Lactobacillus crispatus, such as Pelvic Relief’s Ultimate V, or Ultimate UT (also containing D mannose) if Urinary Tract Infections (UTIs) are experienced too.

Final thoughts

I recommend a thorough, integrative approach when it comes to fertility struggles, considering specific investigations and tests where appropriate. We have been using vaginal microbiome testing within our clinic for the last few years and it has helped with many of our success stories.

About the author

Rachel Sherriff is the Founder of The Fertility Suite, following her own journey with fertility struggles that led to her wanting to understand more about what could be done to support her own fertility and IVF cycle.

The Fertility Suite is a holistic fertility clinic based in Oxted, Surrey offering Fertility Acupuncture, Reflexology and functional medicine. Rachel and her team of 5 are passionate about helping couples to either get pregnant naturally or, if IVF is needed, helping them to prepare for the best possible outcome.

They also work online globally with couples to offer advice and guidance. Rachel has featured widely in various media publications, is passionate about fertility education and hosts The Fertility Suite Podcast which aims to share knowledge from fertility experts.