Fig 1.
N = number of participants, * 1 discontinued after one cycle of vaginal ring use.
Table 1.
Baseline characteristics, reproductive tract and sexually transmitted infections of all randomised participants who used at least one contraceptive vaginal ring.
Table 2.
Longitudinal analysis of species presence in the vagina and in contraceptive vaginal ring biomasses in both study groups.
Table 3.
Longitudinal analysis of qPCR concentrations (log10 (geq)/mL of vaginal swab eluate) and Nugent scores in the Vagina and of qPCR concentrations (log10 geq/mL of vaginal ring eluate) and density of contraceptive vaginal ring biomasses in both study groups.
Fig 2.
Evolution over time of the mean vaginal Nugent score, the mean composite qPCR vaginal health score of vaginal specimens, and the mean composite qPCR vaginal health score of contraceptive vaginal ring biomass.
The Y axis is a score from 0 to 10 for both the Nugent and the composite qPCR vaginal health score. RSV1: first ring removal visit; RSV2: second ring removal visit; LRV: last ring removal visit ____: mean Nugent score _ _ _: mean composite qPCR vaginal health score of the vaginal specimens ……: mean composite qPCR vaginal health score of the contraceptive vaginal rings The composite qPCR vaginal health score is calculated as log10 (Lactobacillus spp.)-log10 (G. vaginalis+ A. vaginae).
Fig 3.
Scanning electron microscope observation of the biomass accumulated on contraceptive vaginal rings used for three weeks.
Pictures 1a-3a: The contraceptive vaginal ring was used by a woman with a Nugent score of 10 and with presence of Lactobacillus iners, Gardnerella vaginalis and Atopobium vaginae as measured by qPCR. A vaginal biofilm consisting of Gardnerella vaginalis and Atopobium vaginae was identified using fluorescence in situ hybridization. On the ring Lactobacillus species, Gardnerella vaginalis and Atopobium vaginae were detected using qPCR, the crystal violet optical density was 3.7555 Pictures 1b-3b: Biomass on a contraceptive vaginal ring after use by a woman with a Nugent score of 0 and presence of Lactobacillus iners only. No biofilm was visualized using fluorescence in situ hybridization. On the ring Lactobacillus species was detected using qPCR, the crystal violet optical density was 3.7225.
Fig 4.
Evolution over time of the density of contraceptive vaginal ring biomass according to the normal, intermediate and BV vaginal microbiome as determined by Nugent scoring.
The Y axis is the optical density of the crystal violet measurements of the contraceptive vaginal rings. RSV1: first ring removal visit; RSV2: second ring removal visit; LRV: last ring removal visit ____: mean optical densities of ring’s biomass collected from women with a normal vaginal microbiota according to the Nugent score (0–3) _ _ _: mean optical densities of ring’s biomass collected from women with an intermediate vaginal microbiota according to the Nugent score (4–6) ……: mean optical densities of ring’s biomass collected from women with bacterial vaginosis according to the Nugent score (7–10).