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Prebiotics and female fertility

A new word after probiotics — so what is it, and how does it help with having a baby?

Dr. Patsama VichinsartvichaiMClinEmbryol, EFOG-EBCOG, EFRM-ESHRE/EBCOG.

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Several months ago I posted an article about probiotics. Today there is a new word — prebiotics. So what is it, and how does it help you ladies with having a baby?

What are prebiotics?

These are substances the human body cannot digest or absorb in the digestive tract, so they reach the large intestine unchanged. They are an important food source for probiotics — the bacteria or microorganisms in the gut that are of benefit to the human body — and they help the digestive system work normally. They are classed as functional food.

The text slide “Prebiotics คืออะไร?” — what are prebiotics? — carrying the same wording as the paragraph above.
The text slide “Prebiotics คืออะไร?” — what are prebiotics? — carrying the same wording as the paragraph above.

Foods that contain prebiotics

Found in certain vegetables, fruits and grains, such as:

  • onion
  • garlic
  • soybeans
  • red beans
  • chicory root
  • artichoke
  • asparagus
  • banana
  • apple
The slide “อาหารที่มี Prebiotics” — foods that contain prebiotics — with drawings of onion, a bowl of soybeans, bananas, a purple onion, asparagus, artichoke, apple and garlic.
The slide “อาหารที่มี Prebiotics” — foods that contain prebiotics — with drawings of onion, a bowl of soybeans, bananas, a purple onion, asparagus, artichoke, apple and garlic.

What are probiotics?

These are small bacteria or microorganisms, counted among the good and useful ones. Specialists in the digestive tract define probiotics as “living microorganisms which, once eaten, bring good health in a variety of conditions; they tolerate acid and alkali, can attach to the surface of the intestinal lining and produce substances that oppose or eliminate other microorganisms, and can bring benefit to health.” In a suitable amount they support the working of the body's various systems. Besides the digestive tract, the intestine and the vagina, they can also be found in certain foods.

The text slide “Probiotics คืออะไร?” — what are probiotics? — carrying the same wording as the paragraph above.
The text slide “Probiotics คืออะไร?” — what are probiotics? — carrying the same wording as the paragraph above.

Foods that contain probiotics

Found in foods such as:

  • fermented milk drinks
  • yoghurt
  • kimchi
  • pickled cucumber
  • miso
  • fermented tea
The slide “อาหารที่มี Probiotics” — foods that contain probiotics — with drawings of yoghurt, kimchi, miso soup, pickled cucumber and kombucha.
The slide “อาหารที่มี Probiotics” — foods that contain probiotics — with drawings of yoghurt, kimchi, miso soup, pickled cucumber and kombucha.

What prebiotics + probiotics are good for

Prebiotics are classed as functional food because they are good for health: they stimulate the activity and encourage the growth of probiotic microorganisms, such as the lactic acid bacteria — lactobacillus and bifidobacteria.

When prebiotics and probiotics work together they are called synbiotics, and the body gains a great deal: the person's health improves, the growth of microorganisms in the digestive tract is stimulated to the right level, and the probiotics carry out their breakdown work within a competitive microbial ecosystem. What follows from that is:

The equation slide — Prebiotics + Probiotics = Synbiotics, with broccoli standing in for the prebiotics and bacteria for the probiotics.
The equation slide — Prebiotics + Probiotics = Synbiotics, with broccoli standing in for the prebiotics and bacteria for the probiotics.
  • The lactic acid the microorganisms make inhibits the growth of bacteria that cause disease (pathogens) and produce toxins, such as Clostridium perfringens and Salmonella, and helps prevent and reduce the symptoms of infection in the digestive tract.
  • Lowers the level of cholesterol, phospholipid and triglyceride in the blood: Lactobacillus acidophilus, a microorganism of the bifidobacteria group living in the intestine, helps break cholesterol down and blocks its absorption through the intestinal wall.
  • Makes the absorption of food in the intestine work better and eases constipation, because the organic acids that bifidobacteria produce stimulate the intestine to contract and add moisture to the stool, so it passes more easily.
  • Increases the absorption of calcium in the digestive system.
  • Can produce vitamin B1, vitamin B2, vitamin B6, vitamin B12, nicotinic acid and folic acid, which play an important part in treating allergy and in building up the development of the immune system.

Prebiotics + probiotics and female fertility

Studies have found that taking prebiotics and probiotics helps reduce inflammation and lets ovulation happen normally, because:

  • It brings the working of the granulosa cells back to normal and reduces inflammation.
  • It supports the growth of the follicles and of the egg cells.
  • It lets the hormone system and the immune system work normally.
The slide “Prebiotics + probiotics กับระบบสืบพันธุ์สตรี” — prebiotics + probiotics and the female reproductive system — listing the same three points as above.
The slide “Prebiotics + probiotics กับระบบสืบพันธุ์สตรี” — prebiotics + probiotics and the female reproductive system — listing the same three points as above.

The article also carries two mechanism diagrams, with their labels in English. This is what the text in them says.

The first diagram — running from *Consequences of Stress* to *Impacts on homeostasis of gut microbiome diversity*, then branching into *Modulation of gut-brain axis*, *Function of the hypothalamic-adrenal-gonadal (HPG) axis*, *Clinical and reproductive implications* and *Infertility*, with a line from *Therapeutics significance of probiotics-microbes* barring that path and pointing on to *Mechanism of Probiotic on Reproductive Physiology by Activation of Signaling Pathways*.
The first diagram — running from Consequences of Stress to Impacts on homeostasis of gut microbiome diversity, then branching into Modulation of gut-brain axis, Function of the hypothalamic-adrenal-gonadal (HPG) axis, Clinical and reproductive implications and Infertility, with a line from Therapeutics significance of probiotics-microbes barring that path and pointing on to Mechanism of Probiotic on Reproductive Physiology by Activation of Signaling Pathways.
The table inside the first diagram — the mechanism of probiotics on reproductive physiology through activation of signaling pathways.
SCFAsActivation of cAMP signaling pathwaysActivation of PPARγ signaling pathwaysFollicle growth and maturationModulating endocrine and immune system
Regulated metabolism↑ GPR41/43 mRNA expression and P4 and E2 synthesisModulation hypothalamopituitary-ovary axis / follicular rupture during ovulation and corpus luteum formation↑ erα and vtg · ↑ cyp19a expressionpro and pre-inflammatory cytokines · estrogens deconjugates β-glucuronidase
The second diagram — *undigested polysaccharides* become *SCFA* at the gut wall, acting through *GPR41* and *GPR43*, with up-arrows on *PYY* and *GLP1*; then “*SCFAs enter the systemic circulation and interact with cell receptors in peripheral tissues*”. At the fat tissue the labels read *HSL* down and *Lypolisis* down, *PPAR-γ* up along with *Adipogenesis* and *Leptin*, *ANGPTL* down, *LPL* up and *FFA Uptake* up. On the brain side it reads *Hypothalamopituitary-ovary axis : PPAR signaling pathway*, beside it *Reduce the secretion of proinflammatory cytokines and chemokines*, and at the ovary “*Increases follicle development and the LH surge, ovulation and corpus luteum formation, and steroidogenesis*”.
The second diagram — undigested polysaccharides become SCFA at the gut wall, acting through GPR41 and GPR43, with up-arrows on PYY and GLP1; then “SCFAs enter the systemic circulation and interact with cell receptors in peripheral tissues”. At the fat tissue the labels read HSL down and Lypolisis down, PPAR-γ up along with Adipogenesis and Leptin, ANGPTL down, LPL up and FFA Uptake up. On the brain side it reads Hypothalamopituitary-ovary axis : PPAR signaling pathway, beside it Reduce the secretion of proinflammatory cytokines and chemokines, and at the ovary “Increases follicle development and the LH surge, ovulation and corpus luteum formation, and steroidogenesis”.

In short

You could say it makes you healthy from the inside — and fertility comes along with it.

With my best wishes — Dr. Patsama Vichinsartvichai · 4 September 2023

References

  1. Rani, K., Kaur, G., & Ali, S. A. (2023). Probiotic-prebiotic therapeutic potential: A new horizon of microbial biotherapy to reduce female reproductive complications. PharmaNutrition, 24, 100342. https://doi.org/10.1016/j.phanu.2023.100342
  2. ศูนย์ข้อมูลยาโรงพยาบาลบำรุงราษฎร์. (2562). โพรไบโอติกส์และพรีไบโอติกส์ ต่างกันอย่างไร? สืบค้น 23 พฤษภาคม 2565, จาก https://www.bumrungrad.com/th/health-blog/july-2019/probiotics-and-prebiotics
  • prebiotics
  • probiotics
  • synbiotics
  • functional food
  • gut microbiome
  • inflammation
  • ovulation
  • female fertility