Mapping the role of vaginal bacterial composition in the success rate of IVF
Working on new techniques to enable better and faster diagnostics is what medical microbiologist Dries Budding does best. These new techniques include the IS-pro technology, which maps bacteria from almost all types of samples in just a few hours. A technology that among other things is revolutionizing the world of reduced fertility.
The development of the IS-Pro technology formed the basis for Budding to found his own company inBiome in 2019. This technology can rapidly detect bacterial DNA and has been used in several applications over recent years. One of these applications is a diagnostic test for women who want to undergo IVF treatment. The chance of success of IVF treatment can be predicted based on the composition of the vaginal bacteria.
The real world
“We licensed this predictive test to the company ARTPred”, Budding says. ARTPred is a company that focuses on reproductive health. This also includes the so-called ReceptIVFity project, which brought the test to the market under the same name. “In my role as Chief Technology Officer within ARTPred, I am in charge of developing and improving prediction algorithms based on the vaginal bacterial composition via the IS-Pro technology.”
Before the test was brought to the market, it was preceded by several clinical studies. “We made the transition from the laboratory to the real world. The test reached our target group: women who want to undergo IVF. In practice, several IVF centres observed a relative increase in the chances of success of about 28% by only making the ReceptIVFity test part of the standard IVF care. A real breakthrough.”
Furthermore, an unfavourable profile appears to be able to recover spontaneously over time. After confirmation that the unfavourable profile has improved, those women also have an increased chance of becoming pregnant. “But practice can be stubborn sometimes”, Budding emphasizes. "Due to all kinds of variables the test sometimes functions less precisely than compared to a controlled study setting.”
A large data analysis
The role of key variables that can cause changes in the vaginal microbiota had to be documented. “For these variables you can think, for example, of the ethnicity of the woman in question, whether a woman has been pregnant before or not, and combinations of these”, Budding explains. But technical variables also play a role: “For example, women who puzzle out the knowledge they get from the ReceptIVFity test themselves, the time at which the sample is taken, or the influence of transport fluids.
“We had to establish the impact of these variables, and that required a large data analysis. We did not have time for this ourselves and we were looking for outside specialist expertise. I was aware of the bioinformatic knowledge that Omnigen possesses, so we decided to enlist Omnigen's help”, Budding says. "Together we drew up a plan so Omnigen could get started."
The precision of the diagnostic IVF test has been determined from the statistical analyses in all kinds of different selection groups. It was examined to what extent the prediction of the test corresponded with the outcome of the IVF treatment and where there are still possibilities for refinement. “All kinds of interesting insights emerged from these analyses. It appears that the test can be improved by considering factors such as ethnicity and previous pregnancies. It also seems that the results of the test may be different in clinics where women take the sample themselves.”
Budding will build on these results through ARTPred and together with the Erasmus Medical Center, to further refine the diagnostic IVF test and make it even more efficient. And as far as the future is concerned, there certainly will be another collaboration with Omnigen in the pipeline according to Budding. “It was a pleasant collaboration with good communication. That is indispensable, especially when it comes to such highly technical issues.”
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