Understanding Next-Generation Sequencing (NGS) testing for the urogenital tract

Next-Generation Sequencing is a DNA test, in our case, for the vaginal microbiome (but it can be used for human or other DNA samples). DNA sequencing means matching the sequence of nucleotides to the DNA strand, or sequence, with a known microbe as a method of identification.

Meaning, we can take a sample of fluid and match whatever microbes are in there with what’s in the huge database. NGS testing creates a genetic fingerprint of everything in the sample and can identify tens of thousands of microorganisms in one test. This aspect is important in the vagina because it’ll tell you how many of each species you have, rather than if it’s present (like in PCR testing).

DNA stands for deoxyribonucleic acid.

Why use NGS for the vaginal microbiome?

NGS has advantages and disadvantages over other forms of testing. NGS testing searches a database of over 50,000 known microbes for matches, so your test result will have everything found listed. Not everything listed needs treatment, so it may be confusing.

We do not understand the microbiome very well at all, so results need to be examined by someone who knows what they’re looking for. Microbes aren’t good or bad; they’re just doing their thing without concern for our welfare.

What is NGS?

NGS is a catch-all term that describes a variety of newer DNA sequencing techniques. DNA and RNA can now be sequenced far quicker and cheaper than ever.

NGS platforms sequence millions of tiny fragments of DNA at the same time. This is why there has been a lot of new companies doing human genome testing in the last few years; it no longer takes 10 years!

Benefits of NGS vaginal microbiome testing

  • Samples tolerate temperature fluctuations and time spent in transit
  • No need to grow microbes or culture them
  • Able to identify 100 per cent of microbes in a sample with 99.9 per cent accuracy
  • Results are reasonably fast
  • Database of over 50,000 known microbes checked
  • Microbes and fungi can be tested at the same time
  • Antibiotic-resistant genes checked for 17 antibiotic classes with an antibiotic recommendation sheet

The original Sanger sequencing took over a decade to get a full read, but new techniques offer far more efficient testing.

Some sequencing techniques include:

  • Illumina (Solexa) sequencing
  • Roche 454 sequencing
  • Ion Torrent: Proton/PGM sequencing


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