Which vaginal probiotic for low lactobacillus?

[warrior101]

I had my EMMA results back, and my consultant has advised I start a vaginal probiotic.

I was just wondering if anyone had any recommendations on which one to buy and where I can buy from?

Also, has anyone who introduced probiotics actually had any success following multiple failures.

Hi,

Do you need a course of antibiotics or just the probiotics?

I wrote a post on the importance of the microbiome here: https://www.reddit.com/r/infertility/comments/rwsxwy/theuterineemicrobiomeemmaaliceemenstrualfluid/?utmmsource=share&utmmedium=iossapp&utm_name=iossmf

Here are my recommendations about probiotics:

Vaginal probiotics:

Canesflor is the easiest to get hold of in the Uk but I feel there are better ones.

Florafemme, this is the ultimate vagina probiotic, it has 72 billion bacteria in it and lots of different strains. It is expensive and you only get 6 in a packet so I would recommend doing it straight after the course of antibiotics and then do one packet before a transfer.
https://florafemme.com

Physioflor
This has Lactobacillus Crispatus in it which is felt to be a very good strain of lactobacillus
https://www.sanareva.co.uk/physioflor-vaginal-flora-natural-probiotic-7-capsules.html?queryID=7ba247daa28306736d35e5cc6b5bb8fb&objectID=22151&indexName=productionenngbproducts

Vagibiom
This also has l crispus as well as some other strains
https://www.ebay.co.uk/itm/Vaginal-Probiotic-Suppository-30-Natural-Vaginal-pH-Odor-Control-No-Parabens-/283702366882?mkcid=16&mkevt=1&_trksid=p2349624.m46890.l49286&mkrid=711-127632-2357-0

Gynolact, this one is good as it has 3 different strains in it
https://www.pharmasana.co.uk/gynolact-vaginaltabletten-8-st-03034436

Oral probiotics (take one of these daily moving forward)

Bio.me.femme
https://www.supplementhub.co.uk/products/bio-me-femme-v-60-capsules

Optibac for women, you can get this from a lot of places, I've even seen it at tesco.

Femdophilus - there are 2 strengths I get the strongest. You can get from Amazon.

Feel free to come and join us on the ERA EMMA ALICE thread.

I went for canesflor from boots.

@Gardenlady543 I don't know if you will see thos ppst after such a long time but was interested in your post. I have been taking 6 months of canesflor only to find out this week that I still have zero lactobacillus via emma test results. I need to do something different before a final fet.
How many of these other vaginal probiotics did you use at any one time?
Re flora femme, do you know if you can use more/for longer than the instructions say? I have also been warned to make sure none of these contain progesterone and I can't find the ingredients list in flora femme. I think I emailed them but haven't heard back yet. Thank you! 😊

@Prayformiracles I don't think any of the vaginal probiotics I've used have progesterone in them, it's a prescribed medication so unlikely to be found in these kind of products. Did you read the post:

www.reddit.com/r/infertility/s/BM5HBcNK2u

Have you tried using an acid product like balance activ when taking the vaginal
Probiotics?

What about avoiding things that can increase the pH: semen, water (baths and swimming), soap?

@Gardenlady543 thank you for your reply. Yes I have read the post and I think im doing everything. Back in December I took two types of antibiotics to clear some stuff up. I have used balance activ and that helped my vaginal ph. And continued with vaginal and oral probiotocs. I did invivo vaginal microbiome test three times and the third time that finally showed lactobacillus in vagina yet at same time I had/have none in uterus shown via emma tests. I also did alice and that came back normal. I am going to do era and nk too but we are delaying that til we try to improve lactobacillus but of course there is a chance it just won't get better :( I take lots of precautions: i dont swim or use spas etc, i use a non spermicide condom for extra precaution for bacteria, don't use soap products on / in vagina, don't douche etc etc. The only thing Consultant can suggest is taking two vaginal probiotics per day every single day (apart from during bleed) for another month or so and retest EMMA. It feels canesflor may not be the answer for me after 6 months use (10 consecutive days per month minimum for past 6 months) so hoping to get hold of some other probiotics. Perhaps a combination of two or three of them per day. Any other thoughts based on my story much appreciated. Thank you 😊

@Prayformiracles did they find any dysbiotic bacteria in your recent test to target antibiotics at? Canesflor isn't a great product, there are better products with more strains in (canesflor only has one) and a higher amount of bacteria, flora femme being the best one I found, you can also get vagibiom on eBay it has the acid product in it and contains l. Crispatus, which a number of studies have used in the treatment arm so there is evidence that works. I also used gynolact which you can order online, it comes from Germany I believe. I mixed and matched a lot as I figured my body would decide which strains it liked.

@Gardenlady543 did all this achieve to increase your lactobacilis?
I'm going to purchase all of these too though I don't know how well eBay sellers store Medicines as opposed to a pharmacy but probably overthinking this.
I also hope i dont overdose on lactobacillus if i use flora femme daily for next 6 weeks til i retest emma but i imagine that wont happen with lactobacillus currently being zero.
The only thing I haven't looked into is fertylisis but if I understand correctly they check the same stuff as emma alice era do?
Thank you 😊

@Prayformiracles yes I ended up with a good result from fertilysis after having 0% lactobacillus twice. I have a baby now, I took a vaginal probiotic every day in my FET except the day before and day of the transfer, then continued daily until the 8 week scan. I also took doxycycline 200mg twice a day for 3 days starting two days before the transfer. The seller on eBay is the company that makes the product although it looks like there is only one left and it's a 5 pack. So you may want to just order flora femme, they only sell them in packs of 6 and they're expensive so I would mix and match. I would use one a day at a crucial point, eg once a day after your period has ended in a FET with an acid product like balance activ at the same time.

@Gardenlady543 congratulations! So pleased for you. I also have a little girl. When I had her a few years ago I had 95% lactobacillus. I tried for number two and it didn't work but hadn't done the emma alice tests again, my Consultant assumed I'd be fine without them. So I then did an additional 3 collections last year and resulted with having one precious final embryo in the freezer. So trying to get everything right for this last chance.

If i am to use flora femme during fet i would want to use florafemme during era too, to make sure I don't react badly. I read a few horrid reviews on Amazon about people reacting badly to it. I'm really tired of worrying about what the right thing to do is all the time/ the correct course of action.

Why did you take doxycycline as well? Was this recommended by your clinic? As it is an antibiotic that can also potentially decrease lactobacillus.

I haven't continued taking balance activ since my vaginal ph was in normal range. I didn't know you could take it at same time as vaginal probiotic so I was using balance activ for a few days then using the probiotic. But my Consultant wants me to take probiotic without any breaks apart from when bleeding, until the next emma repeat test.

@Prayformiracles it's used a lot in USA prophylactically for the microbiome, some people say doxycycline helps with implantation too, I searched regimes and did the shortest course I found. If your pH is an optimal pH then that suggests you have good levels of lactobacillus vaginal because it's the lactobacillus that makes the acid, the acid is then needed for the bacteria to adhere to the vaginal wall. So that's why I use it at the same time as the probiotics when I had none.

@Gardenlady543 thank you. Are you in USA? I'm in UK. Can't seem to get hold of florafemme as they won't deliver to uk. And physioflor vaginal is unavailable everywhere. But I have ordered vagibiom, gynolact, gynophilus, probiofem - basically anything I could find that wasn't purely just plantarum/canesflor. My vaginal lactobacillus recently showed decent levels of crispatus but they don't offer a %. I might occasionally use the balance activ to keep it 'balanced'. I really hope and pray the lactobacillus will improve in the uterus too because I honestly don't know what else I can try.

@Prayformiracles I'm in the uk, I ordered flora femme off their website in the past do they definitely not deliver to the uk?

@Gardenlady543 I have double checked as I ordered so many things yesterday. I am also going direct to their website. It says chose another payment method (not paypal) and when I try to do so it just pops up with the same message again. Amazon states currently unavailable. Nevermind. I could perhaps ask someone my husband knows in USA to order but I wonder how long it will take and if it will still be worth doing time-wise.

@Prayformiracles can you do the shipping when you use PayPal? That's how I paid in the past.

@Gardenlady543 not sure what you mean? It currently doesn't let me proceed to payment. I don't think i even saw the bits about shipping. I just go to basket and proceed to payment then I get the weird message pop up.

@Prayformiracles that didn't happen when I tried I could just click to pay with PayPal, maybe contact the website?

@Gardenlady543 I just tried again and it got me to another payment page to pay with credit card (not paypal) and it states there that merchant only ships to u.s.
Thanks for kindly trying to help me with this though x

Hi @Gardenlady543 hope you are keeping well. I think I would like to use vagibiom twice a day every day. But my Consultant can't advise on how much is the right amount/too much. Do you have any idea if twice daily would be too much or even harmful in any other way?
I posted a new post about this on mumsnet ivf but didn't get any response. So hope you don't mind me asking you. Thank you 😊

@Prayformiracles I would probably use once a day because it has the acid product and then use a different probiotic to make up to twice a day, if that's what you're doing. So a probiotic without acid in the morning and then vagibiom at night for example.

@Gardenlady543 wow, love your post! When would you recommend I take flora femme during my cycle when conceiving naturally? Around ovulation or around implantation etc?

@Gardenlady543 I should add my issues are recurrent early miscarriages

@User06489 I would check the pH regularly with something like this, amzn.eu/d/bLPbaTf if it goes up and you notice a fishy smell then you should speak with your GP about antibiotics for bacterial vaginosis. You can use vaginal probiotics once or twice a week to help maintain the normal microbiome. I wouldn't use them when menstruating and would avoid at ovulation and when semen is around because those times you will naturally have a higher pH.

@Gardenlady543 thank you that makes sense. Though the other one I bought was gynolact which also contains lactic acid so may have to look into what else...

Igenomix who conduct the emma test advised me against flora femme simply because it didn't solely contain lactobacillus but also contained other probiotics. But I know it worked for you so that's great! X

@Prayformiracles oh that's interesting, do you have the updated list they send out with their Emma Alice result to share? Flora femme was on the one they sent for the USA region when I did the test.

@Gardenlady543 I will attach it (I had already previously scribbled on it)