The Microbiome Connection
In the early days of Acubalance adopting low-level laser therapy (aka photobiomodulation) as part of our fertility and well-being approach, I was interested in what possible mechanisms were involved that could increase fertility and pregnancy rates. My interest in LLLT / laser acupuncture being applied to my fertility patients quickly grew into a passion of mine and some may think it is an obsession now based on the number of high quality laser systems Acubalance now owns and the number of updates and improvements I have made to our Laser Baby Program.
I have been working with LLLT/Photobiomodulation for embryo quality by optimizing both egg and sperm quality and uterine receptivity. I have learned that applying light therapy to different areas of the body, in addition to the ovaries, may have some benefit to overall well-being and fertility.
The mechanism hypothesized for how laser is optimizing fertility and increased pregnancy rates includes, but is not limited to, the following:
- Increases mitochondrial function and cellular ATP (energy) to repair the effects of aging and wear & tear;
- Regulates inflammation;
- Defending cells against damage caused by oxidative stress (follicles and sperm);
- Improving blood circulation which can benefit ovaries, testes, and uterine receptivity;
- Speed tissue healing;
- Normalizes and softens scar tissue and adhesions (from earlier surgeries or infections);
- Decreases stress and promote parasympathetic relaxation response;
- Decreases edema;
- Increase in IVF Implantation;
- Enhance nutritional absorption (Co Q10 absorption – Synergistic effect with LLLT);
- Improved gut microbiome health;
- Increased brain well-being.
In this post, I will focus on the gut microbiome and how I think it may impact well-being and be beneficial to reproductive health. A big thank you to Acubalance’s naturopathic physicians, Dr. Kali MacIsaac and Dr. Ashley Damm, for contributing to this article on the gut microbiome and how we can assess it and treat it from a functional medicine approach, and how it may play a role in reproductive health.
Back in the nineties, Dr. Toshio Oshiro MD Ph.D., a pain specialist and surgeon in Japan, did a series of studies demonstrating low-level therapy (LLLT) for fertility could improve both pregnancy rates and live birth rates for women who previously had unsuccessful ART (assisted reproductive technique) cycles. He believed the mechanism at play was the increased blood flow to the ovaries from his photobiomodulation treatments around the neck and upper abdomen. I believe, unbeknownst to him, the location he treated on the abdomen to engage the relaxation response for increased blood flow also was reaching the gut microbiome and positively impacting fertility.
Then there was also the group of practitioners using the Giga laser in Norway sharing their pregnancy success by applying the laser therapy over the full abdomen above the ovaries, uterus, and intestines. Originally I suspected they claimed to have better results than Dr. Oshiro’s approach because of the laser system they used:
- Had a larger area covered with Giga laser than the laser Oshiro used
- More powerful lasers and more laser diodes and more treatment time so more photons to the body.
- They applied light directly over the ovaries. Oshiro did not use a laser directly over the ovaries.
- The frequency of treatment was 3 times per week whereas Oshiro was 1-2 times per week.
Based on the above, I suspected the Giga laser group, in addition to increasing blood flow, may have the added benefit of improved mitochondrial function of the follicles, softening adhesions and scar tissue in the abdomen, and the systemic effect of regulation of chronic systemic inflammation. Now, I also think with the placement of the Giga laser’s large laser surface area (500cm2) over the abdomen, that the photobiomodulation treatments likely had a positive impact on the gut microbiome which can improve general well-being and I speculate fertility too.
What is the gut microbiome?
Our guts are home to millions of microscopic bacteria collectively called the gut microbiome. Some of these bacteria are essential for our well-being by helping us digest the food we eat and store energy.
The gut microbiome is responsible for a variety of crucial functions in the body, particularly due to its communication with the immune and neuroendocrine systems. These beneficial bacteria aid in the digestion of food, helps the body absorb nutrients (especially B vitamins) and minerals, regulate blood sugar and fat storage, and keep a healthy metabolism. All of these functions influence your risk of obesity, metabolic diseases such as type 2 diabetes, and cardiovascular and neurodegenerative diseases.
These friendly bacteria can help regulate our metabolism and therefore protect us against diseases such as:
- Skin conditions (eczema, psoriasis, and rosacea)
- Gut health (inflammatory bowel disease)
- Mental health (depression and anxiety)
- Autoimmune Diseases
- Dementia & Alzheimer’s disease and Parkinson’s
So how does this apply to reproductive health and fertility optimization?
Research in the area of the reproductive microbiome has exploded since 2016. First, we now recognize that our gynaecological tissues actually have microbiomes. Until the completion of the Human Microbiome Project in 2016, we had erroneously believed that gynecological tissues such as the uterus and fallopian tubes were sterile. We now know that (estimates vary) between 56-98% of the human body is actually non-human (mostly bacterial) cells, and the reproductive tissues are no exception. Second, we are starting to categorize the makeup of these microbiomes, and research is identifying patterns that are conducive to important clinical outcomes – like whether an embryo will implant after an IVF transfer, or whether a patient will be diagnosed with premature ovarian failure.
We are starting to understand from this research that the microbiomes of the reproductive tissues in both men and women play a role in nearly every single step of the reproductive process. There are healthy, commensal bacterial populations in follicular fluid, which impact egg quality and ovulatory function, in the fallopian tubes, the uterus, the cervix, and the vagina, and in the testes and seminal fluid too. These healthy bacteria not only help facilitate reproductive functions, but they interact with the gametes throughout their lifespans in those tissues.
Research is starting to show that the interaction between a couple’s microbiomes (seminal fluid and vaginal, for example, in heterosexual couples) determines which sperm is allowed to fertilize the egg, and microbiome compatibility likely plays a large role in couples experiencing unexplained infertility. Both heterosexual and same-sex couples influence each others’ microbiomes, as do environmental factors such as the type of underwear and clothing we choose to wear on our bodies, the soaps we select, our hygiene practices and especially our diets, etc.
There has been an association between the uterine microbiome and implantation failure so now we are wondering if the gut microbiome can impact the vaginal and uterine environment. While studies continue to determine if there is any connection, I recommend we be proactive and heal our microbiome since it can have such an impact on overall well-being. There are now published studies on using low-level laser therapy (photobiomodulation) to treat the gut microbiome and seeing positive clinical outcomes in Parkinson’s patients.
There is a microbiome gut-brain relationship where they communicate via neurons (nerve cells). This gut microbiome is also connected to the body’s immune system and has an ability to manage inflammation. I discuss in my brain photobiomodulation blog how LLLT has been shown to improve the function of neurons and therefore strengthen the communication between our enteric (gut) nervous system and our central (brain) nervous system. Photobiomodulation can improve our well-being and fertility by reducing inflammation in our digestive system and supporting an environment where our microbiome can help us thrive.
A systematic review came out in 2020 exploring the role of the uterine microbiome and embryo implantation. Defined as chronic endometritis, “CE”, is a persistent inflammatory condition of the endometrial lining, and its pathogenesis is largely thought to be due to an imbalance of the endometrial microbiome. Several studies have found CE to be cured with antibiotic cycles, further supporting the role of the microbiome in its etiology.
“Several studies have found that chronic endometritis (CE) is highly prevalent among women suffering from unexplained infertility (from 40.7 to 55.7%), recurrent IVF failures (from 13.95 to 57.55%), and repeated early pregnancy loss (from 42.9 to 56%). Importantly, adequate therapy of CE can lead to a complete normalization of endometrial histology and to the restoration of the reproductive function in women with CE.”
One of the major takeaways from this systematic review was that the predominant types of bugs found in CE were coming from the intestinal flora – Enterococcus faecalis, Escherichia coli, and Streptococcus. Additionally, lipopolysaccharide, an endotoxin for gram-negative bacteria and known indicator for leaky gut, maybe a trigger and mediator of chronic endometritis.
Dr. Felice Gersh MD, OGYN, gave a presentation at the 2019 Integrative Fertility Symposium titled OVERCOMING PCOS BY ADDRESSING THE COMPLEX ROLES OF ENDOCRINE DISRUPTORS, THE GUT MICROBIOME, AND THE CIRCADIAN RHYTHM. It is just another example and growing data about how our gut microbiome can impact our reproductive health and why I am interested in assessing the microbiome through tests and supporting it through diet, supplements, herbs, and photobiomodulation (low-level lasers).
Several studies have found this to be a curable condition with the rebalance of the microbiome. Your gut health and microbiome is a foundational piece of health, healing, and prevention. Our team has seen shifts in clinical pictures with microbiome assessment and treatment.
Let’s use the gut microbiome as an example. At Acubalance, we do comprehensive stool and microbiome analysis. This gives us a great overview of:
- Bad bugs – cause problems like diarrhea, inflammation, heartburn etc.
- Normal bugs – interact with our immune system, keep things balanced, and produce essential factors of a healthy gut lining
- Opportunistic bugs – bugs that are part of our normal microbiome, but when overgrown may be problematic in some cases. Certain opportunistic bugs have also been correlated with autoimmune conditions, small intestinal bacterial overgrowth, urinary tract infections, and more.
- Intestinal health – how many digestive enzymes are you producing? How reactive is your immune system? How is your estrobolome? Any blood in your stool?
Other interesting findings from this paper were the role of inflammation and blood flow at the level of the endometrium. These are two aspects that laser, acupuncture, and target nutrition and supplement are excellent at supporting.
I personally had the opportunity to talk to Dr. Ann Liebert after her presentation I attended on Transcranial and remote photobiomodulation treatment for the clinical signs and symptoms of Parkinson’s disease; The microbiome connection. She shared how photobiomodulation impacted the gut microbiome in a number of experiments and case studies by altering the balance of “good” vs “bad” bacteria and increased diversity. Her human study where participants received 12 treatments of LLLT caused a change in the microbiome of Parkinson disease participants. During my conversation with Dr. Liebert she discussed how her laser approach was able to produce more dopamine and serotonin in the gut. And the downstream effect is more dopamine and serotonin in the brain, which increases mobility, and decreases the cognitive impairments or deficits with Parkinson’s. In general, it makes the patient feel better because they have this influx of feel-good hormones. I share this to inform you of growing support for the ability of photobiomodulation to positively impact the gut microbiome and how this can have a positive systemic effect on your body.
How can you best support a healthy reproductive microbiome? Depending on your individual makeup, we may need to do a protocol involving things like oral and vaginal/topical probiotics and washes, and specific low-level laser therapy approach.