Fertibiome (Ligilactobacillus salivarius) for IVF Preparation
Direct Recommendation
Oral Ligilactobacillus salivarius CECT5713 (the strain in Fertibiome) is safe for women preparing for IVF and should be administered at 3 × 10⁹ CFU once daily, starting at least 2-6 months before the planned IVF cycle. 1, 2
Safety Profile
General Safety in Reproductive-Age Women
Probiotics containing lactobacilli are generally safe for healthy, immunocompetent women of reproductive age, with the overwhelming evidence suggesting safety in the general population. 3
Ligilactobacillus salivarius specifically has demonstrated safety in clinical trials involving couples with unexplained infertility, with no serious adverse events reported during 6-month supplementation periods. 1, 2
Minor gastrointestinal side effects (bloating, cramping, abdominal discomfort) may occur but are typically mild and self-limited. 4
Critical Safety Exclusions
Do not use probiotics if the patient has any of the following conditions:
- Immunocompromised status (HIV, chemotherapy, immunosuppressive medications) due to documented risk of bacteremia and sepsis from probiotic organisms. 4
- Central venous catheters (increased risk of line-associated infections). 4
- Cardiac valvular disease (risk of endocarditis from bacteremia). 4
- Damaged intestinal mucosa or short-gut syndrome (increased bacterial translocation risk). 4
- Severe acute pancreatitis (associated with increased mortality in this specific population). 4
Dosing Protocol for IVF Preparation
Recommended Regimen
Administer 3 × 10⁹ CFU of Ligilactobacillus salivarius CECT5713 orally once daily, starting 2-6 months before the planned IVF cycle and continuing until pregnancy is confirmed or the IVF cycle is completed. 1, 2
Route of Administration
Oral administration is the preferred and evidence-based route for Ligilactobacillus salivarius CECT5713, as this strain has been specifically studied via oral supplementation with demonstrated efficacy in improving pregnancy rates. 1, 2
While vaginal probiotics are used for treating bacterial vaginosis, oral administration of L. salivarius CECT5713 has shown superior evidence for fertility outcomes, achieving a 48.1% pregnancy success rate compared to 20.0% in placebo groups. 1
Duration Considerations
Minimum treatment duration should be 2 months to allow adequate time for microbiome modulation and immunological profile improvement. 2
Optimal duration appears to be 6 months based on studies showing progressive improvement in urogenital microbiome composition and resolution of dysbiosis in 67% of couples by 6 months. 2
Continue supplementation through the IVF cycle until pregnancy is confirmed, as the probiotic effects on vaginal and endometrial microbiome require ongoing maintenance. 1
Mechanism and Expected Benefits
Microbiome Modulation
L. salivarius CECT5713 improves vaginal microbiome composition by increasing Lactobacillus abundance and decreasing pathogenic bacteria, which is associated with better reproductive outcomes. 1, 2
The strain modulates both vaginal and seminal microbiomes, suggesting benefits for both partners in couples with unexplained infertility. 2
Uterine microbiome changes have been documented with oral L. salivarius supplementation, potentially improving endometrial receptivity for embryo implantation. 2
Immunological Effects
Oral administration improves both vaginal and systemic immunological profiles, which may enhance implantation success and pregnancy maintenance. 1, 2
The probiotic modulates the uterine immune environment, potentially creating more favorable conditions for embryo implantation. 2
Clinical Efficacy
Pregnancy success rates increased from 20% to 48.1% in couples with unexplained infertility who received L. salivarius CECT5713 compared to placebo before IVF. 1
Both pregnancy and delivery ratios improved in couples undergoing assisted reproductive treatments after 6 months of supplementation. 2
Important Caveats and Pitfalls
Product-Specific Considerations
Efficacy and safety findings are strain-specific and should not be generalized to other probiotic products or even other strains of Ligilactobacillus salivarius. 3
Verify that the product contains the specific strain CECT5713 (also known as PS11610 in some studies), as different strains may have different effects. 1, 2
The probiotic market suffers from inadequate regulation, with products potentially containing contaminants or lacking stated bacterial strains, so choose products with verified quality control and ATCC deposition. 4
Timing Considerations
Do not expect immediate effects—microbiome modulation requires at least 2-3 months of consistent supplementation. 2
Starting supplementation too close to the IVF cycle (less than 2 months before) may not provide adequate time for beneficial microbiome changes. 2
Conflicting Evidence
One study using intravaginal probiotics (not L. salivarius CECT5713) showed no benefit in recurrent implantation failure cases, highlighting that route of administration and specific strain selection matter. 5
The evidence base for L. salivarius CECT5713 is still preliminary, with the strongest study being a 2025 randomized controlled trial in 70 couples, so larger confirmatory studies are needed. 1
Partner Involvement
Consider supplementation for both partners in couples with unexplained infertility, as studies showing the best outcomes included treatment of both male and female partners. 2
Male partners may benefit from once-daily dosing (versus twice-daily for females in some protocols), though the optimal male dosing is less well-established. 2
Pregnancy Safety
Lactobacillus species are considered safe throughout pregnancy, with extensive human data showing no teratogenic effects. 6
If pregnancy occurs during supplementation, continuation is safe and may provide additional benefits for maintaining a healthy vaginal microbiome during pregnancy. 6, 7
Probiotics are compatible with breastfeeding, though most systemic antibiotics and probiotics are present in breast milk and could theoretically alter infant intestinal flora. 6