EFFECT OF ANTIBIOTIC TREATMENT FOR CHRONIC ENDOMETRITIS ON ART CYCLE OUTCOME

Abstract

To determine the prevalence of chronic endometritis (CE) in infertile women undergoing ART and effect of antibiotic treatment on the pregnancy rate in the frozen embryo transfer (FET) cycles We recruited 78 infertile women undergoing ART in tertiary level fertility clinic. Endometrial samples were obtained in proliferative phase of menstrual cycle and subjected to immuno-histochemical (CD138) and histopathological diagnosis of CE. Antibiotic treatment comprising of Tab doxycycline 100 mg BD for 14 days followed by fixed dose combination of Tab ciprofloxacin 500mg and Tab tinidazole 600 mg BD for 14 days was administered to the CE diagnosed women and subsequently their histopathologic cure rate was assessed by repeat biopsy. Women with persistent chronic endometritis were treated with Tab clindamycin 300mg BD for 14 days. Frozen embryo transfer with at least one good quality embryo was done for all women and further reproductive outcomes were studied and compared In our study, mean age and BMI were 30.5 + 4.5years and 26.6 + 4.29 kg/m2. Majority of women had primary infertility (53/79, 67%). Twenty-six out of 78 infertile women were diagnosed with CE (33.3%). The cure rate after antibiotic treatment was 69.8%. Pregnancy rate and miscarriage rate in cured CE and non-CE group were 66.7% & 25% and 55.7% & 27.5% respectively (p value:- 0.41). There was lower pregnancy rate (37.5%) and higher miscarriage rate (33%) in women with persistent CE although it did not reach statistical significance. (p value: - 0.16) High prevalence of CE is noted in infertile women undergoing ART and antibiotic treatment may improve reproductive outcomes in these women