Live birth rate following oral antibiotic treatment for chronic endometritis in infertile women with repeated implantation failure
Live birth rate following oral antibiotic treatment for chronic endometritis in infertile women with repeated implantation failure
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DOI：
10.1111/aji.12719
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发表时间：
2017-11-01
影响因子：
3.6
通讯作者：
Ishikawa, Tomomoto
中科院分区：
文献类型：
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作者：
Kitaya, Kotaro;Matsubayashi, Hidehiko;Ishikawa, Tomomoto
这项前瞻性研究的目的是调查有重复着床失败(RIF)史的不孕妇女中慢性子宫内膜炎(CE)的患病率，并确定口服抗生素治疗是否能提高在接下来的胚胎移植(ET)周期中的活产率。方法对患有RIF的不孕妇女的子宫内膜活检标本进行免疫组织化学/组织病理学诊断。结果33.7%的RIF不孕症患者被诊断为CE。在一线多西环素治疗后，随后的子宫内膜活检的组织病理学治愈率为92.3%。甲硝唑/环丙沙星二线治疗后，总治愈率为99.1%。治愈后RIF/CE组第1个ET周期活产率(P=0.031，RR 1.48，95%CI 1.03~2.12)和累计3个ET周期活产率(P=0.037，RR 1.39，95%CI 1.02~1.90)显著高于RIF/非CE组(分别为22.1%和27.9%)。对于患有RIF的不孕妇女，口服抗生素治疗CE可能是一种有前途的治疗选择。
ProblemThe aim of this prospective study was to investigate the prevalence of chronic endometritis (CE) in infertile women with a history of repeated implantation failure (RIF) and to determine whether oral antibiotic treatment improves their live birth rate in the following embryo transfer (ET) cycles.Method of studyEndometrial biopsy samples obtained from infertile women with RIF were subjected to immunohistochemistrical/histopathologic diagnosis of CE. Following antibiotic administration to the RIF/CE group, their histopathologic cure rate, microbial detection rate, and reproductive outcome in the subsequent ET cycles were prospectively studied.Results33.7% of infertile women with RIF were diagnosed with CE. Following the first-line doxycycline treatment, the histopathologic cure rate in the subsequent endometrial biopsy was 92.3%. Following the second-line metronidazole/ciprofloxacin treatment, the overall cure rate was 99.1%. The live birth rate in the first ET cycle (P=.031, RR 1.48, 95% CI 1.03-2.12) and cumulative three ET cycles (P=.037, RR 1.39, 95% CI 1.02-1.90) following antibiotic treatment in the cured RIF/CE group (32.8% and 38.8%, respectively) was significantly higher than in the RIF/non-CE group (22.1% and 27.9%, respectively).ConclusionChronic endometritis was found in one-third of infertile women with RIF. The oral antibiotic treatment against CE might be a promising therapeutic option for infertile women with RIF.