GUT MICROBIOME CHARACTERISTICS AND MARKERS OF INTESTINAL PERMEABILITY IN WOMEN WITH PRIMARY OVARIAN INSUFFICIENCY

Interactions between the gut microbiome and the reproductive system have recently been recognized as a potential mechanism involved in the development of primary ovarian insufficiency (POI). However, the contribution of alterations in the taxonomic and functional composition of the gut microbiome, as well as intestinal permeability, to the pathogenesis of POI remains insufficiently understood. The purpose – To evaluate the taxonomic and functional characteristics of the gut microbiome in women with primary ovarian insufficiency. Materials and methods. This prospective cohort study included 51 women of reproductive age, comprising 28 patients with primary ovarian insufficiency and 23 healthy women serving as controls. The study protocol was approved by the Ethics Committee of the Shupyk National Healthcare University of Ukraine (Protocol No. 6/2025-11, June 12, 2025), and written informed consent was obtained from all participants. Women aged 18–40 years with confirmed POI were enrolled in the study group. Serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, and anti-Müllerian hormone (AMH) concentrations were measured using electrochemiluminescence immunoassay. Ultrasonographic assessment included antral follicle count (AFC), ovarian volume, and endometrial thickness. Gut microbiome composition was analyzed by 16S rRNA gene sequencing, while serum LBP concentration was determined using enzyme-linked immunosorbent assay (ELISA). Statistical analyses were performed using IBM SPSS Statistics version 27.0. Results. Women with POI exhibited significantly higher serum FSH and LH concentrations, lower estradiol and AMH levels, and markedly reduced AFC, ovarian volume, and endometrial thickness compared with controls (all p<0.001). Although no significant differences in alpha diversity were observed, patients with POI demonstrated a significantly lower relative abundance of Actinobacteriota,Akkermansia muciniphila, Faecalibacterium prausnitzii, and butyrate-producing bacteria. Serum LBP concentration was significantly higher in the POI group than in healthy controls (19.05±4.36 vs. 11.46±2.40 μg/mL; p=0.006). Conclusions. Primary ovarian insufficiency is associated with alterations in functionally important components of the gut microbiome, reduced abundance of bacteria involved in maintaining intestinal barrier integrity, and elevated serum LBP concentration as a marker of intestinal permeability.

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