Impact of oral antibiotic treatment for chronic endometritis on pregnancy outcomes in the following frozen-thawed embryo transfer cycles of infertile women: a cohort study of 640 embryo transfer cycles

Antibiotic treatment is an effective way to improve reproductive outcomes of women with the number of CD138þ cells/high-power field >5.

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VOLUME 116, ISSUE 2, P413-421

Authors:

Yujing Xiong, M.D., Ph.D., Qi Chen, M.Sc., Chunxiao Chen, B.S., Jinfeng Tan, M.Sc., Zengyan Wang, M.D., Ph.D., Fang Gu, M.D., Ph.D., Yanwen Xu, M.D., Ph.D. 

Abstract:

Objective

To investigate the therapeutic effect of antibiotic treatment on pregnancy outcomes in the following frozen-thawed embryo transfer cycles of infertile women.


Design

Retrospective study.


Setting

University assisted reproduction unit.


Patient(s)

A total of 640 women were included. Among them, the number of CD138+ cells per high-power field (CD138+/HPF) in the endometrium at the first evaluation was 0 in 88 women; 315 women had 1–4 CD138+/HPF and the remaining 237 had ≥5 CD138+/HPF. Finally, 26 of 237 women had persistent chronic endometritis (PCE) diagnosed.


Intervention(s)

Hysteroscopy and endometrial biopsy were performed in the proliferative phase. After antibiotic treatment, endometrial biopsy samples were collected again.


Main Outcome Measure(s)

Live birth rate.


Result(s)

No significant difference in pregnancy outcomes was found between women with CD138+/HPF = 0 and those with CD138+/HPF 1–4. The cure rate was 89.0% in women with CD138+/HPF ≥5 after treatment. The implantation rate (51.6% vs. 32.3%, relative risk [RR] 2.23, 95% confidence interval [CI] 1.07–4.66), clinical pregnancy rate (65.7% vs. 42.3%, RR 2.62, 95% CI 1.17–5.86), live birth rate (52.1% vs. 30.7%, RR 2.45, 95% CI 1.04–5.76), and cumulative live birth rate (64.2% vs. 38.5%, RR 2.88, 95% CI 1.27–6.51) were all significantly higher in women with CD138+/HPF ≤4 than in women with PCE.


Conclusion(s)

CD138+/HPF ≤4 in the endometrium had no negative impact on pregnancy outcomes. Antibiotic treatment was an effective way to improve the reproductive outcomes of women with CD138+/HPF ≥5. PCE was associated with poorer pregnancy outcomes.

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.