Figure 1.

Pathways of infection of M. genitalium in the female reproductive system. M. genitalium is carried by sperm and other risk factors into the female vagina and colonizes there to cause vaginitis. M. genitalium travels up the reproductive tract to the cervix, endometrium, and fallopian tube epithelium, causing cell swelling and shedding, releasing inflammatory factors, and triggering acute inflammatory reactions such as pelvic inflammatory disease and endometritis, inducing adverse pregnancy outcomes such as infertility, preterm delivery, and ectopic pregnancy. Long-term infection with M. genitalium transforms into a chronic inflammatory response that may be associated with tumor outcomes such as ovarian cancer.