The findings, published in Cell, suggest that maintaining a healthy gut microbiota could be critical for preventing immune-related pregnancy complications. 

Scientists have known that the gut microbiota can influence immune function, but it’s not well understood how gut microbes shape immune responses and how microbiota-derived metabolites regulate immune cells.

So, Julia Brown at Weill Cornell Medicine in New York and her colleagues studied how the gut microbiota influences maternal-fetal immune tolerance using mice and human data.

Immune imbalance

In pregnant mice, the gut became more “leaky” and the composition of gut bacteria changed. These shifts were linked to alterations in immune cells in the intestine. Mice without gut bacteria or with disrupted gut bacteria after treatment with the antibiotic vancomycin had higher rates of fetal death and abnormal immune signals in the placenta and uterus. 

In these animals, placentas had more immune cells that attack fetal cells and higher levels of inflammatory molecules, resulting in increased pregnancy loss. Key immune cells that typically help suppress harmful immune responses in the placenta were fewer or less effective in mice lacking gut microbes. 

However, microbial metabolites derived from the amino acid tryptophan helped these immune cells work properly, the researchers found.

Pregnancy loss

Tissue from women with recurrent miscarriages showed similar immune problems, with key immune cells and gut-derived metabolites being disrupted. The findings suggest that these problems can contribute to recurrent pregnancy loss in humans, the researchers say.

Although the study shows that gut bacteria help train immune cells during pregnancy, more research is needed to understand how other body microbes contribute and exactly how these immune signals affect fetal health.

More studies are also needed to see how these results apply to people, the authors say. “Our mouse study may provide insights into specific immune pathways that are perturbed due to loss of vancomycin-sensitive gut bacteria and microbiota-derived tryptophan derivatives; this, however, needs to be further validated in controlled human studies.”

In the first part, she focuses on preeclampsia and placental complications: according to the evidence presented, dysbiosis can shift circulating metabolites—particularly glucose—with downstream effects on the activity of natural killer (NK) cells, which are essential for proper placental vascularization. When these cells are not adequately activated, placental vascular development may be impaired, increasing the risk of adverse outcomes, including miscarriage—an effect observed mainly in preclinical models.

In the second part, attention turns to the newborn’s earliest life stages and the impact of maternal antibiotic use: while often necessary, antibiotics may disrupt the maternal microbiota and reduce the production and transfer of immunoglobulin A (IgA) into breast milk, weakening a key line of protection for the neonate’s still-immature gut. In the absence of IgA, bacteria such as Enterobacteriaceae (for example, Escherichia coli) may cross a fragile intestinal barrier, enter systemic circulation, and contribute to sepsis.

Among possible mitigation strategies, Rescigno mentions adding fermented milk to support IgA development and considering antibiotic options that do not deplete bacterial groups (such as Clostridiaceae) involved in driving IgA responses.

The findings, published in Cell Host & Microbe, suggests that dietary fiber is a potential fertility-support strategy.

Recent research has indicated that the microbiota plays a key role in reproduction by supporting growth, development, and egg production. In humans, changes to the microbiota caused by antibiotics, diet or conditions such as obesity are linked to reproductive problems, but the exact reasons remain unclear. 

Sarah Munyoki at the University of Pittsburgh School of Medicine in Pennsylvania and her colleagues set out to examine how gut microbes and diet during early life affect fertility in mice.

Ovarian health

In normal mice, the gut microbiota shifts after birth, especially during weaning, becoming richer and more complex. Early on, the gut is dominated by bacteria adapted to breast milk, but after weaning, microbes that break down solid food and produce beneficial compounds such as short-chain fatty acids (SCFAs) expand. Female mice raised without gut microbes showed disruptions in ovarian development that coincided with this microbiota transition, the researchers found.

Compared to mice with a healthy microbiota, female mice raised without microbes had fewer litters and fewer pups per litter, and they stopped reproducing earlier in life. By puberty, germ-free mice began losing follicles much faster than mice with a healthy microbiota, with poor progression to later stages and higher rates of follicle death. 

The ovaries of germ-free mice showed damage, with signs of tissue scarring. Genetic analysis revealed that key genes for maintaining and activating ovarian follicles—the reserve needed for producing eggs—were less active than in mice with a healthy microbiota.

Improving fertility

Giving germ-free female mice normal gut microbes either at birth  or at weaning restored the follicles to normal levels and reversed tissue damage. This recovery matched a return of normal gut bacteria diversity and production of SCFAs. Just giving germ-free mice SCFAs in drinking water starting at weaning rescued ovarian health, at least in part.

Finally, the researchers fed mice different diets starting at weaning. High-fat, low-fiber diets caused the biggest loss of ovarian follicles and altered ovarian gene activity, while adding fiber helped protect ovaries, even in high-fat conditions. Fiber also improved gut bacteria, boosted SCFAs levels, and reduced inflammation in ovaries. 

The findings suggest that dietary fiber during early life protects fertility by supporting healthy gut microbes and preventing ovarian damage caused by high-fat diets, the authors say. “Future studies should examine the relationship between diet, microbiota, and ovarian reserve in individuals with reproductive disorders and assess the efficacy of microbiota-directed interventions in improving fertility outcomes.”

The findings, published in Cell Host & Microbe, indicate that gut microbes can interact with genetics and hormone metabolism to influence pregnancy outcomes.

Recent studies have suggested that a mother’s gut bacteria can affect pregnancy health, but while vaginal bacteria have been linked to early birth, the impact of gut microbes is less clear. 

Some gut bacteria can break down hormones such as estradiol, which helps maintain pregnancy and trigger labor, suggesting that interactions between gut bacteria, genetics, and hormones may influence preterm birth risk.

So, researchers led by Zelei Miao at Westlake University in Hangzhou, China, analyzed 5,313 pregnant Chinese women to understand how gut bacteria and genetics influence preterm birth.

Microbial risk score

The team collected stool and blood samples from about 4,200 women, along with clinical and lifestyle data. The overall composition of gut bacteria was linked to how long pregnancies lasted and whether babies were born prematurely. 

These findings were confirmed in a second group of about 1,000 pregnant women, suggesting that the maternal gut microbiota plays an important role in pregnancy outcomes. 

By combining information from several gut bacteria linked to preterm birth, the researchers developed a “microbial risk score”, finding that women with higher risk scores were more likely to deliver early than those with lower risk scores. While both a mother’s genes and gut bacteria influenced risk, the gut microbiota had a stronger impact on predicting early delivery.

Predicting preterm birth

Next, the researchers combined the microbial risk score, the genetic risk, and other risk factors such as age to create a model that could predict preterm birth more accurately than conventional methods alone. 

Women with higher levels of Clostridium innocuum bacteria had an increased risk of preterm birth, which was amplified in those with higher genetic susceptibility. Further analyses showed that C. innocuum can degrade estradiol—a hormone essential for pregnancy. 
“These findings point to future strategies to prevent and mitigate preterm birth by specifically monitoring C. innocuum levels during early pregnancy and developing interventions targeting estradiol metabolism,” the authors say.

This practical manual, authored by Dr. Franco Vicariotto, Gynecologist at Humanitas San Pio X in Milan, provides a structured overview of the current scientific landscape, focusing on:

• Evidence-based insights into menopausal alterations of the intestinal and vaginal microbiota.
• The mechanisms and clinical applications of probiotics, prebiotics, synbiotics, and postbiotics.
• A synthesis of key clinical studies and their implications for gynecological practice.

Download the instant book

The female microbiota exhibits unique characteristics: it is estimated that nearly 9% is located in organs exclusive to women, such as the vagina, uterus, and breast, and—according to recent findings—also in the ovaries and fallopian tubes. Beyond this localization, the estrobolome plays a pivotal role by regulating estrogen circulation and influencing hormonal balance.

Nutrition emerges as a key modulator, shaping not only the gut microbiota but also the vaginal microbiota. This occurs through indirect pathways—such as inflammation, hormonal regulation, and microbial transfer—as well as direct effects, with growing evidence pointing to the role of specific fats, vitamins, and minerals like calcium.

In light of these insights, fostering multidisciplinary collaboration—particularly between gynecologists and nutritionists—is essential to developing prevention and treatment strategies that are truly personalized. The overarching message is clear: there is no single formula or quick fix. Instead, advancing women’s health requires integrating diverse strands of scientific evidence to build tailored approaches that respond to each woman’s individual needs.

The findings, published in Cell Reports, suggest that the maternal oral microbiota plays a key role in influencing infant gut health and disease risk.

Babies get much of their first gut bacteria from their mothers—through birth, breastfeeding, and close contact. These microbes come from various parts of the mother’s body, and if harmful bacteria are passed to the baby, they may raise the risk of gut inflammation and disease. However, how exactly these bacteria persist in the infant gut, and how they contribute to disease, is still unclear.

Researchers led by Masafumi Haraguchi at University of Michigan in Ann Arbor set out to investigate how mothers with an imbalanced mouth microbiota influence the community of gut microbes in their offspring.

Immune imprinting

The researchers caused gum disease in mother mice, which led to the growth of a harmful oral bacterium called Klebsiella aerogenes. This bacterium was passed to the mice’s pups and colonized their guts during the first weeks of life. However, the microbe disappeared as the pups’ guts became more diverse with age. 

Klebsiella aerogenes changed the pups’ immune environment in the gut, increasing certain immune cells that can cause inflammation. The early exposure to the bacterium also affected how genes related to inflammation and metabolism work in the gut, the researchers found.

Compared to pups born to healthy mothers, those born to mothers with oral infections showed worse symptoms and inflammation when their guts were challenged. This increased risk appears to come from the early “immune imprinting” caused by exposure to the mother’s oral bacteria. 

Mouth health

Even after the harmful bacteria disappeared as the pups grew, some immune imbalances persisted into adulthood, making the animals susceptible to gut inflammation. 

“Our results provide compelling evidence that maternal oral health, particularly the presence of oral dysbiosis, significantly influences the development of gut microbiota and the immune system in offspring, ultimately impacting health outcomes from infancy through adulthood,” the researchers say.

Although it’s unclear whether the effects observed in mice translate to humans, the authors add, the findings highlight the importance of good oral health in mothers during pregnancy and early childcare to support healthy gut development and prevent immune-related gut problems.

The findings, published in mBio, indicate that managing gut health might be important for fertility treatments. Identifying specific gut bacteria and metabolites could help predict and improve IVF outcomes, the researchers say.

In IVF, after an egg is fertilized by sperm outside the body, the resulting embryo is transferred into the uterus through a process called frozen embryo transfer. Previous studies suggested that vaginal and gut bacteria can affect pregnancy outcomes, and oral microbes may also impact pregnancy by spreading bacteria or inflammation. However, it’s still unclear how microbes in the gut, vagina, and mouth influence IVF success. 

So, researchers led by Zhao Zhang at Southern Medical University Affiliate Dongguan People’s Hospital in Guangdong, China, looked at the types of bacteria living in the gut, mouth, and vagina at different times in 59 people undergoing frozen embryo transfer during IVF.

Pregnancy outcomes

In the gut, the researchers found common bacteria such as Bacteroidota, Firmicutes, and Proteobacteria, with some differences in specific bacteria between those who had successful or unsuccessful outcomes of frozen embryo transfer. In the mouth, bacteria such as Haemophilus, Streptococcus, and Neisseria were common, and certain bacteria also differed between successful and unsuccessful pregnancies. 

In the vagina, the dominant bacteria were Lactobacillus and others such as Gardnerella and Streptococcus, but the vaginal microbiota seemed less linked to outcomes than previously thought. No major differences were found in the overall number or diversity of gut bacteria between successful and unsuccessful pregnancies. 

Next, the team used computer models to find specific gut bacteria that could help predict the success of frozen embryo transfer in IVF, showing good accuracy in distinguishing between successful and unsuccessful cases. Two types of gut microbes, Anaerococcus and Negativicoccus, were identified as potential predictors of success.

Clinical prediction

The researchers also analyzed blood samples and found many differences in microbial metabolites between the success and failure groups. Some metabolites linked to success were tied to beneficial gut bacteria, while others more common in failures were associated with other types of bacteria. 

Although more research is needed to confirm these findings and better understand how microbiotas affect IVF success, the findings suggest that the presence of certain gut bacteria can help doctors better predict and improve the success of IVF. 

“Targeting microbiota-associated metabolic pathways may serve as a potential strategy to enhance [frozen embryo transfer] success rates and provide new biomarkers for clinical prediction and intervention,” the authors say.

Infertility affects one in eight couples worldwide, representing a significant clinical concern. Multiple factors, including genetic, environmental, and lifestyle, contribute to female infertility. Despite its high prevalence, effective preventive measures are still limited. 

Emerging evidences support the role of the gut microbiota also in fertility. At the same time, diet influences the diversity and abundance of the gut microbiota. The Mediterranean diet, for example, has been linked to a positive impact on reproductive health, with a higher ratio of pregnancies and live births. In contrast, the Western diet is associated with worse fertility. 

Given the relationship between gut microbiota composition and dietary patterns, it is important to use standardised indices to assess their impact. Among these, the recently developed dietary index for gut microbiota (DI-GM) addresses inconsistency in previous indices. To do that, DI-GM evaluates the influence of diet on the gut microbiota through 14 components identified as beneficial or unfavourable to gut health, effectively capturing the relationship between dietary quality and gut microbiota diversity. A lower DI-GM score has already been associated with a higher risk of certain conditions, such as diabetes, stroke, etc. However, its correlation with infertility remains unclear. 

This study involved over 3.000 women (18-45 years) over two years, collecting information about diet, nutritional status, health, and lifestyle.  These data were then correlated with the DI-GM score (ranging from 0 to 13) and fertility status, with infertility defined as the absence of ability to conceive after at least one year of unprotected intercourse.

Participant characteristics

Out of the 3.053 participants, 370 were infertile. About the infertile group:

• Women in this group were generally older, with higher body mass index (BMI), higher income, and with common features, such as being married, smoking, cardiovascular and metabolic conditions (hypertension, dyslipidemia, diabetes, etc.)
• The average DI-GM value was significantly lower in this group
• Participants with lower DI-GM also showed higher triglyceride levels and fasting plasma glucose (FPG), but lower high-density lipoprotein cholesterol (HDL-C)

Correlation between DI-GM and infertility

DI-GM scores demonstrated a strong negative, though non-linear, association with infertility risk. Indeed, a lower score was linked to a higher risk. 

• Below the threshold (score of ≤8), identified as the inflexion point, each unit increase in DI-GM was associated with a 14% reduction in the risk of infertility, supporting the hypothesis that gut-friendly dietary patterns support reproductive health.
• Above that value (>8), higher scores correlated with an increment of 197% relative increase of infertility risk, suggesting harmful consequences of extreme diets
• The association between DI-GM scores and the risk of female infertility is confirmed when considering demographic, socioeconomic status, lifestyle and health factors. 

“As a new dietary quality index that reflects gut microbiota diversity, further research and interventions using DI-GM could help develop strategies to prevent and reduce the risk of female infertility.”

During Vitafoods Europe, held recently in Barcelona, Spain, MicrobiomePost sat down with Ana Nunes, Business Unit Director at Zinereo. In this interview, she discusses Zinereo Pharma’s positioning, explaining how the company is developing clinically validated probiotic solutions, with a special focus on fertility and women’s health.

How did Zinereo Pharma come to life, and what sets the company apart in the growing field of microbiome-based healthcare?

Zinereo Pharma was born at the intersection of pharmaceutical heritage and biotechnological innovation. Established as one of the companies of the Zendal Group, was founded with a clear and focused mission: to develop microbiome-based solutions that are clinically proven to address specific health challenges and manufactured to the highest pharmaceutical standards. 

Safety, efficacy and quality are the cornerstones of everything we do. Our journey began with the acquisition of a former AstraZeneca manufacturing site in O Porriño, northern Spain. Within this facility, we constructed a second, fully independent plant — dedicated exclusively to the production of probiotics. This specialized unit operates under GMP certification, with strict segregation protocols designed to prevent cross-contamination, ensuring the highest levels of product quality and safety throughout the entire manufacturing process.

The Zendal Group further strengthened this foundation through the acquisition of two key companies: Bialactis, an expert in probiotics, and Probisearch, a spin-off from the Complutense University of Madrid, operating as a clinical research organisation (CRO). Probisearch focuses on the isolation of new probiotic strains and conducts clinical trials on finished products — providing rigorous scientific validation and enabling the development of a product portfolio driven by both innovation and scientific evidence.

What truly sets Zinereo Pharma apart is our commitment to applying the same degree of rigor, traceability and clinical validation to probiotics as one would expect from any pharmaceutical product. This is not just a principle; it is part of who we are — embedded in our DNA.

This scientific mindset is also encapsulated in our brand signature: “life for LIFE”. It expresses the idea that something as small as a probiotic — a microscopic, living organism — can profoundly impact human health, animal wellbeing and even planetary balance. 

Could you share some recent scientific insights or breakthroughs regarding probiotics and female fertility? Why is this topic becoming so relevant today?

The relationship between microbiome and fertility has become one of the promising frontiers in reproductive medicine. Increasingly, we understand that dysbiosis — a microbial imbalance in the urogenital tract — is associated with repeated implantation failure (RIF), recurrent pregnancy loss (RPL), and low IVF success rates, especially in cases classified as “idiopathic infertility”.

The female reproductive tract, when healthy, is typically dominated by Lactobacillus species, which lower pH and protect against pathogens. But in up to 40% of women undergoing ART, this balance is disrupted, favoring species like Gardnerella vaginalis, Prevotella, and Atopobium vaginae that trigger inflammation and compromise endometrial receptivity.

Meanwhile, the male reproductive tract also plays a crucial role. The absence of Lactobacilli and overrepresentation of pro-inflammatory microbes such as Prevotella have been linked to altered sperm parameters, DNA fragmentation and oxidative stress.

At Zinereo Pharma, these insights have driven the development of Fertibiome®, a probiotic solution based on Ligilactobacillus salivarius PS11610 — a strain with proven antimicrobial and immunomodulatory activity, now supported by both clinical data and a retrospective study.

In the Profec I prospective clinical trial (Iniesta et al., Am J Reprod Immunol, 2022), 17 couples with idiopathic infertility received Fertibiome® over six months. Results included:

• 88.9% resolution of dysbiosis in couples who completed the intervention
• 44.4% pregnancy rate, with several spontaneous conceptions
• Significant immunological shifts from a proinflammatory to an anti-inflammatory profile at both systemic and uterine levels

Complementing this, the 2025 retrospective study (Raimundo et al., Nutrients) evaluated 694 IVF patients at a fertility clinic in Lisbon over a two-year period. The group taking Fertibiome® for at least one month before embryo transfer showed:

• A significant increase in live births in frozen embryo transfer cycles:
  26.4% with Fertibiome® vs. 17.9% without (p = 0.034)
• Higher biochemical pregnancy rates:
  42.6% vs. 34% (p = 0.071)
• Statistically significant benefit particularly in women under 37

Mechanistically, L. salivarius PS11610  its though that it acts by:

• Re-establishing Lactobacillus dominance in the vaginal and endometrial microbiota
• Modulating the uterine immune microenvironment
• Reducing pro-inflammatory cytokines such as IL-12p40 and IFN-λ1
• Enhancing endometrial receptivity and epithelial integrity

The strain is recognised by EFSA as QPS (Qualified Presumption of Safety), and has demonstrated both safety and stability when administered orally.

The topic of microbiome and fertility is now gaining urgency: not only because over 48 million couples are affected globally, but because conventional treatments are invasive, costly, and often fail to address the root cause. Fertibiome® offers a non-invasive alternative — aligned with the body’s own microbial defences and reproductive physiology. Currently a second clinical trial is being conducted both in Portugal and Spain, targeting 120 couples, to have deep information. At Zinereo, we see this as a new tool in infertility, where microbiome modulation is central to reproductive fertility techniques  success.

What do we currently understand about the relationship between the microbiome and fertility outcomes in women, and how is this shaping product development at Zinereo?

Our understanding of fertility has evolved significantly in recent years. Today, it is well established that the composition and balance of the vaginal and endometrial microbiota plays a role in implantation, pregnancy outcomes, and the success of assisted reproductive technologies. A healthy reproductive tract is typically dominated by Lactobacillus species, which maintain low pH, reinforce epithelial barrier integrity, and regulate immune responses. 

In contrast, dysbiosis — often characterised by the proliferation of anaerobic bacteria such as Gardnerella, Atopobium, and Prevotella — disrupts this balance. It can promote chronic inflammation, impair endometrial receptivity, and contribute to repeated implantation failure (RIF) and recurrent pregnancy loss (RPL).

This connection is especially relevant in cases of idiopathic infertility, where traditional diagnostic methods fail to identify a cause. Thanks to next-generation sequencing and metagenomic analysis, we now understand that many of these cases are in fact microbiome-related — and that modulating the reproductive microbiota can directly improve outcomes.

At Zinereo Pharma, this insight has become a key driver of our product development strategy — particularly in the area of women’s health, which is one of our core commitments and fastest-growing therapeutic domains. We see probiotics as new tools for solving complex biological challenges with measurable clinical impact.

This philosophy shaped the development of Fertibiome®, designed to:

• Restore microbial balance and Lactobacillus dominance
• Correct dysbiosis
• Shift the uterine immune profile from pro-inflammatory to receptive

Importantly, Fertibiome® takes a couple-centred approach, recognizing that male urogenital dysbiosis also contributes to infertility. The seminal microbiota, too, affects sperm function, DNA integrity, and oxidative stress. Addressing both partners is essential. The outcomes of our Profec I prospective trial and the recent retrospective study published have confirmed that microbiome modulation improves real-world IVF outcomes. In frozen embryo transfers, for example, women who took Fertibiome® achieved a live birth rate of 26.4%, compared to 17.9% in the control group — a statistically significant increase. By investing deeply in the science of microbiome and focusing on women’s health as a strategic priority, we aim to deliver transformative, evidence-based solutions for some of life’s most important moments.

What are the key scientific and technical considerations when developing probiotics specifically for women’s health?

Developing probiotics for women’s health involves a targeted, evidence-based approach that reflects the complexity of the female microbiome. Key scientific and technical considerations include:

• Strain specificity and clinical relevance: probiotic effects are strain specific. The selection must be based on clinical evidence showing benefits for uti & vaginal health, such as maintaining a low pH, inhibiting pathogens, modulating local immunity, and promoting mucosal integrity. Strains like Ligilactobacillus salivarius PS11610 are chosen not only for their origin and safety profile, but also for their proven efficacy in restoring microbial balance, as demonstrated by clinical trials

• Vaginal tropism and epithelial adhesion: strains must demonstrate the ability to reach, colonize, and persist in the vaginal environment. Adhesion to vaginal epithelial cells is crucial for competitive exclusion of pathogens and for sustained benefit beyond short-term use.

• Synergistic formulation: clinically effective probiotic formulations often include complementary compounds—such as specific vitamins, minerals, and bioactive plant extracts—that work synergistically with the probiotic strains. By targeting multiple mechanisms simultaneously, these formulations offer broader and more sustained benefits, particularly in the management and prevention of recurrent vaginal and urinary tract infection

• Preventive approach to recurrent conditions: infections such as bacterial vaginosis, candidiasis, or UTIs are often driven by dysbiosis. A preventive probiotic strategy aims to maintain a resilient, balanced microbiota—minimizing the need for antibiotics and reducing recurrence.

• Clinical validation: efficacy must be demonstrated through well-designed human clinical trials that are published in peer-reviewed journals and conducted in line with regulatory and ethical standards. These studies should evaluate not only safety and tolerability, but also clinically relevant endpoints—such as recurrence rates of infections, changes in vaginal microbiota composition or reproductive outcomes.

Probiotics use in clinical practice must be supported by robust data to guide personalized, preventive, and long-term strategies in areas like recurrent bacterial vaginosis, candidiasis, urinary tract infections, and fertility support.

What are the most common misconceptions around probiotics you encounter, and how do you educate both healthcare professionals and patients?

Several persistent misconceptions continue to surround the field of probiotics, even among health professionals. One of the most widespread is the idea that “all probiotics are alike” — as though any Lactobacillus species will suffice in any context. This is fundamentally incorrect. The clinical efficacy of a probiotic is strain-dependent, and each strain must be characterised genetically, mechanistically and clinically. 

Another myth is that probiotics are only effective when administered in very high CFU counts — however, a high dose is not a substitute for targeted action. Likewise, the belief that probiotics only benefit gut health is outdated. Scientific literature now supports their role in vaginal and urinary tract health, fertility, immunomodulation, skin disorders, and even mental health via the gut–organ axis.

Another common misconception is that “probiotics have no real clinical evidence”. This stems from the fact that many products on the market rely on bibliographic data, or generic claims, without supporting trials on the final formulation. We also encounter false assumptions around timing and usage — such as the belief that probiotics must be taken indefinitely, or that they are ineffective during antibiotic treatment. In fact, certain strains can support mucosal recovery post-antibiotics, and short, targeted interventions can yield lasting benefits, particularly in reproductive or vaginal health.

To counter these misconceptions, we focus on targeted education: scientific webinars, medical training, and clinician-led content creation. For patients, we translate evidence into understandable language. Our goal is to empower both professionals and individuals with clear, honest, and reliable information — because science without education risks becoming science without impact.

Giniwa has become a flagship brand in women’s health. What was the original vision behind it, and how has the brand evolved since its creation?

Giniwa was born from a powerful metaphor: the female intimate microbiota as a garden — living, evolving, and requiring thoughtful care. Just like a well-tended garden (eubiosis) flourishes with vibrant flora, a balanced vaginal ecosystem supports health and resilience. But when neglected (dysbiosis), imbalances allow opportunistic pathogens to thrive.

The name Giniwa fuses “gynaecology” with niwa — the Japanese word for “garden” — reflecting our commitment to preserving microbial harmony through evidence-based, preventive care.

Rather than waiting for imbalance to manifest as infection or discomfort, we offer scientifically formulated probiotic solutions that work with the body to maintain microbial equilibrium

Giniwa’s formulations are built on the latest understanding of the gut–vagina and gut–urinary tract axes. Disruptions caused by antibiotics, hormonal shifts, stress, or hygiene habits can diminish protective Lactobacillus species, enabling pathogens like Gardnerella, Candida, or E. coli to dominate. Each Giniwa product is tailored to address these vulnerabilities.

For example, Giniwa V combines strains such as L. crispatus, L. acidophilus and L. plantarum with antimicrobial actions of propolis, hibiscus extract, and vitamin A to prevent the recurrency of fungal and bacterial vaginal infections,  regenerating mucosa and support immune resilience — a synergistic formula designed not just to relieve symptoms but to reestablish ecological balance.

Zinereo has expanded globally, especially across Latin America, MENA, and Asia. How do you manage such diverse markets, and what role do local partners play?

Zinereo’s global footprint has grown significantly, with a strong presence across Latin America, the MENA region, and Asia. Managing such diverse markets requires a tailored, partnership-driven approach. Our expansion model is anchored in strategic collaborations with local distributors who actively promote our portfolio within their national medical communities and are deeply integrated into their healthcare systems.

In Latin America, we’ve prioritized women’s health and gastroenterology, two therapeutic areas where unmet needs are substantial and demand for natural, evidence-based solutions is rising. In the MENA region, our efforts are centered on female fertility and intimate health, in alignment with shifting demographics and regional healthcare priorities. In Southeast Asia, where interest in microbiome science is rapidly growing, we’re preparing to launch Fertibiome® in the Philippines. We’re also honored to participate in the country’s first Probiotics & Nutraceuticals Congress—an important milestone for the region.

By building long-term relationships based on education, trust and shared scientific vision, we’re able to expand globally without diluting our values. Our presence in each new market is a reflection of our commitment to evidence, safety and patient impact — not just commercial growth. It is through this model that we translate microbiome innovation into meaningful clinical solutions across borders.

We support our partners them with regulatory documentation, and customized scientific marketing materials, enabling them to engage effectively with healthcare professionals, fertility experts, and regulatory authorities. 

In addition, we provide full launch toolkits, continuous technical training, and opportunities to co-present at global symposia and congresses. This knowledge-based, collaborative model ensures consistent scientific rigor and brand integrity across all markets. By fostering long-term relationships grounded in education, trust, and a shared commitment to science, we’re able to scale globally without compromising our values. 

Finally, what is your personal vision as the leader of this project, and where do you see Zinereo Pharma heading in the years to come?

Leading this project is, above all, a human responsibility. At Zinereo Pharma, we are working at the intersection of science and life — and that comes with the obligation to ensure that our innovation translates into real-world impact. 

My personal vision is to bring microbiome science closer to people — to transform what is often invisible, technical and complex into something deeply human: better health increasing wellbeing by means of a preventive complementary approach. Our future lies in being a scientific reference in the development of microbiome-based solutions backed by science, clinical proven and to target specific needs.

Equally, our mission is to communicate this science in a way that educates consumers and provides confidence in healthcare professionals. For me, leadership at Zinereo means ensuring that every decision is anchored in purpose: that our solutions are more than commercial innovations — they are tools for life. 

This is reflected in our signature: “life for LIFE”. A probiotic is a microscopic form of life, but it can improve human life, that’s what drives us every day. And that is where we see Zinereo going: from scientific excellence to meaningful, measurable, human outcomes — across the world.