The efficacy of microbiome transplantation in treating vaginosis and its impact on vaginosis recurrence: a meta-analysis of randomized controlled trials.

OBJECTIVES: Bacterial vaginosis (BV) is a recurrent condition with significant health implications. Microbiome transplantation has emerged as a potential treatment strategy. This meta-analysis assesses its efficacy in treating vaginosis and preventing recurrence. METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating microbiome transplantation for vaginosis treatment were conducted. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated for short- and long-term efficacy. Sensitivity and publication bias analyses were performed. RESULTS: In the short-term follow-up, microbiome transplantation significantly reduced vaginosis recurrence (pooled RR = 0.628, 95% CI: 0.543-0.726, p < 0.001). However, heterogeneity was moderate (I² = 60.8%). Sensitivity analyses confirmed the robustness of findings. Long-term follow-up results showed a pooled RR of 0.746 (95% CI: 0.670-0.831, p < 0.001), though with higher heterogeneity (I² = 72.8%). After sensitivity adjustments, meta-analysis yielded a pooled RR of 0.865 (95% CI: 0.735-1.019, p = 0.083), suggesting reduced long-term efficacy. No significant publication bias was detected. CONCLUSIONS: Microbiome transplantation effectively reduces short-term vaginosis recurrence. However, long-term efficacy diminishes upon sensitivity adjustment, necessitating further investigation.