Therapeutic potential of gut microbiome interventions in reproductive disorders

The gut microbiome has literally become the master controller of the whole body's physiological balance, and its impact has even reached reproductive health, placing fertility, metabolism, and immunity among the impacted areas. A gut-reproductive axis has been proposed and is gaining support from an ever-increasing body of evidence complicated, twoway communication network between the microbes and the metabolites, the immune mediators, and the endocrine pathway. An imbalance in gut flora, which is called dysbiosis, can block the regulatory and signalling mechanisms and eventually result in an increase in the incidence of different reproductive disorders such as polycystic ovary syndrome (PCOS), endometriosis, recurrent pregnancy loss in women, and infertility in men. All these reproductive disorders have been associated with microbial imbalance and immune dysfunction. The review through its signalling pathways reveals the mechanistic interplay of gut microbiota with reproductive physiology and especially emphasizes pathways of shortchain fatty acid signalling, lipopolysaccharide-induced inflammation, and sex steroid metabolism modulation as the main ones. Furthermore, it evaluates both established and emerging microbiome-targeted interventions, including dietary modulation, prebiotics, probiotics, synbiotic, and faecal microbiota transplantation (FMT), as potential therapeutic strategies. The review discusses potentially utilizing gut microbiota modulation to enhance reproductive homeostasis based on preclinical and human investigations. Altering the gutreproductive axis represents a new option for non-invasive interventions to improve fertility, decrease pregnancy complications, and may be used to treat reproductive disease.