International Journal of Infertility & Fetal Medicine

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VOLUME 14 , ISSUE 3 ( September-December, 2023 ) > List of Articles


Does Oral Antibiotic Therapy for Chronic Endometritis Improve Reproductive Outcomes in Assisted Reproductive Technology? A Prospective Cohort Study

Amulya Nagulapalli, Hiya Agrawal, Monna Pandurangi, Radha Vembu, Sanjeeva R Nellepalli

Keywords : Assisted reproductive technology, Cluster of differentiation 138 immunohistochemistry, Chronic endometritis, Oral antibiotic therapy, Reproductive outcomes

Citation Information : Nagulapalli A, Agrawal H, Pandurangi M, Vembu R, Nellepalli SR. Does Oral Antibiotic Therapy for Chronic Endometritis Improve Reproductive Outcomes in Assisted Reproductive Technology? A Prospective Cohort Study. Int J Infertil Fetal Med 2023; 14 (3):123-128.

DOI: 10.5005/jp-journals-10016-1324

License: CC BY-NC 4.0

Published Online: 28-11-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Background: Chronic endometritis (CE) is a continuous and subtle inflammation of the endometrium caused by bacterial pathogens. It is associated with infertility and poor reproductive outcomes and presents with nonspecific symptoms, making the diagnosis difficult. The gold standard diagnostic criterion is histopathological examination (HPE) and cluster of differentiation (CD) 138 immunohistochemistry (IHC) of endometrial tissue, which is a marker of plasma cells. The effect of antibiotic treatment on reproductive outcomes in Indian infertile women with CE undergoing assisted reproductive technology (ART) has not been extensively studied. Aim: To investigate the influence of oral antibiotic treatment on reproductive outcomes in women with CE undergoing ART. Settings and design: Prospective cohort study at a tertiary care teaching hospital. Materials and methods: A total of 234 infertile women planned for ART underwent endometrial biopsy in the proliferative phase. They were divided into CE-negative (group I) and CE-positive group (group II) based on endometrial biopsy HPE and CD138 IHC. Women in group II received oral antibiotic therapy, and a repeat biopsy was done to assess the cure rate. If CE persisted, they received a second course of antibiotic therapy. They had undergone intracytoplasmic sperm injection (ICSI), and embryo transfer was done where at least one good-grade embryo was transferred. The baseline characteristics and ART outcomes were compared among the two groups. Statistical analysis: Statistical Package for the Social Sciences (SPSS) 29.0 version, Chi-squared test, one-way analysis of variance (ANOVA), and independent sample t-test. Results: The baseline characteristics, controlled ovarian stimulation cycle characteristics, and cycle outcomes were comparable among the two groups. No significant difference in cumulative pregnancy rate (p = 0.95), cumulative miscarriage rate (p = 0.21), ongoing pregnancy rate (p = 0.52), and cumulative live birth rate (p = 0.69) was noted between the two groups. Conclusion: Evaluation and treatment of infertile women undergoing ART for CE is an effective option to improve reproductive outcomes. Clinical significance: To improve reproductive outcomes in ART, routine screening and timely oral antibiotic treatment for CE is a feasible choice.

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