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Disclaimer: This information is for educational purposes only and should not be interpreted as medical advice.
When you're trying to conceive, every symptom can feel loaded. If you've dealt with recurrent bacterial vaginosis (BV) or yeast infections, you may be wondering whether they could be getting in the way of pregnancy. The honest answer is that the research points to a connection worth paying attention to, and the good news is that a healthy vaginal environment is something you can actively support.
How the Vaginal Microbiome Affects Fertility
Your vaginal microbiome is the first environment sperm encounter on their way to the egg. When it's balanced and Lactobacillus-dominant, it helps protect the reproductive tract. When it's out of balance, that protection weakens. If you're new to this topic, start with my full guide to the vaginal microbiome and recurrent vaginal infections.
What the Research Suggests
Studies have found that an imbalanced vaginal microbiome is more common in women experiencing infertility, and that it is associated with lower success rates in some fertility treatments. It's important to note that this is an association. Researchers are still working to understand exactly how much of a role the microbiome plays and in which women.
Bacterial Vaginosis and Infertility
BV is the infection most often linked to fertility challenges. It's especially common, and it frequently returns after standard treatment.
Why BV May Make Conception Harder
Inflammation: An imbalanced microbiome can create a more inflammatory environment in the reproductive tract.
Higher pH: A less acidic environment may be less welcoming to sperm.
Ascending bacteria: Imbalance may make it easier for bacteria to travel upward toward the uterus.
Pregnancy risks: BV has also been associated with a higher risk of complications once pregnant, which is one more reason to address it before conception.
What About Yeast Infections?
Yeast infections are uncomfortable, but they haven't been shown to cause infertility the way chronic imbalance and certain other infections may. Still, the discomfort can make intimacy painful, and recurring yeast often points to underlying issues like blood sugar swings or gut imbalance that are also worth addressing when you're trying to conceive.
Other Infections That Can Affect Fertility
Some infections cause no obvious symptoms but can affect fertility if left untreated. Chlamydia and gonorrhea are the best-known examples, since they can lead to scarring of the fallopian tubes. If you've been trying to conceive without success, ask your provider about STI screening, even if you feel fine.
Ureaplasma and Mycoplasma: The Infections Most Panels Miss
Ureaplasma and Mycoplasma are tiny bacteria that come up often in conversations about unexplained infertility, yet they usually aren't included in routine screening. Standard STI panels and basic vaginal swabs typically don't test for them, so you may need to ask for them specifically.
What Are Ureaplasma and Mycoplasma?
Ureaplasma (U. urealyticum and U. parvum) and Mycoplasma hominis are commonly found in the genital tract. Many women carry them with no symptoms at all.
Mycoplasma genitalium is different. It is considered a sexually transmitted infection and can cause cervicitis and pelvic inflammatory disease.
How They May Affect Fertility
Research has linked these organisms to inflammation of the cervix and uterine lining (endometritis). Some studies also associate them with lower implantation rates, pregnancy loss, and preterm birth, and M. genitalium has been associated with tubal factor infertility. The evidence is still mixed, and researchers continue to debate whether treating them when there are no symptoms improves outcomes. That's why this is a conversation to have with a provider who knows your full history.
Symptoms and Testing
Often there are no symptoms at all. When they do show up, they can include:
Unusual vaginal discharge
Pelvic pain or pain with sex
Spotting between periods
Burning with urination
Testing is usually done with a PCR or culture from a vaginal or cervical swab, and urine may be used for M. genitalium. Because these organisms can pass between partners, your provider may also discuss testing or treating your partner to prevent reinfection.
A Note on Treatment
Treatment is with prescription antibiotics, and the right choice depends on the organism. I don't recommend self-treating, partly because M. genitalium has growing antibiotic resistance. Since antibiotics can also reduce beneficial Lactobacillus, supporting your microbiome afterward is an important part of recovery, which is where the strategies below come in.
Supporting Your Vaginal Microbiome When Trying to Conceive
While you work with your healthcare provider on any active infection, these root-cause strategies can help support long-term balance.
Nutrition Foundations
Build balanced meals with protein, fiber, and healthy fats to keep blood sugar steady
Eat a variety of plant foods to feed beneficial gut bacteria
Include fermented foods if you tolerate them
Cover key nutrients like zinc, vitamin D, iron, and B vitamins, ideally guided by testing
Daily Habits
Skip douching and scented feminine products
Choose breathable cotton underwear
Manage stress and prioritize sleep, both of which influence hormones and immune function
A Note on Probiotics
Certain Lactobacillus strains have been studied for vaginal health, but the strain, dose, and timing matter. Check with a practitioner before starting one, especially while you're actively trying to conceive.
When to Talk to Your Provider
Reach out to your healthcare provider if you have recurring infections, unusual discharge or odor, pelvic pain, or if you've been trying to conceive for 12 months (6 months if you're over 35). This post is for educational purposes and isn't a substitute for medical advice, diagnosis, or treatment.
Your Next Step
Vaginal health is just one piece of the fertility picture. Hormones, nutrition, stress, and overall health all play a role, and both partners matter. For more preconception tips, grab the TTC Checklist here.
Ready to Build a Stronger Foundation for Conception?
As a Board-Certified Holistic Nutritionist and Women’s Hormone Health Practitioner, I help couples uncover what may be standing in the way of pregnancy and create a personalized, root-cause plan to prepare their bodies for conception.
Apply to work together here and let's talk about your fertility goals.