Antibiotics and Uterine Flushing versus Antibiotics Alone for Chronic Endometritis with Thin Endometrium in Assisted Reproductive Technology: A Single-Center Retrospective Cohort Study.

Background: This study aimed to investigate whether uterine cavity flushing combined with antibiotic administration, improves the outcomes of assisted reproductive technology for patients with thin endometrium (<7 mm) associated with chronic endometritis.

Materials and methods: A retrospective cohort study was conducted, including 202 patients. Subsequently, a single frozen-thawed embryo of high morphological quality (≥4AB) was transferred either in an artificial cycle or on day 7 after the luteinizing hormone (LH) peak in the natural cycle. The parameters measured included the number of CD138-positive plasma cells in the endometrial stroma, endometrial thickness on the day of embryo transfer, clinical pregnancy rate (CPR), and live birth rate (LBR).

Results: Following treatment with endometrial flushing and antibiotics (group 1), there was a significant increase in endometrial thickness compared to antibiotics alone (group 2): 9.93 ± 1.37 mm vs. 8.2 ± 0.4 mm (P<0.001). Additionally, there was a significant reduction in the number of CD138-positive plasma cells in the endometrial stroma: 0.4 ± 0.8 vs. 4.1 ± 5.2 (P<0.001). The CPR with high-quality ET was 68.6 vs. 48%, respectively (P=0.016). The take-home baby rate was 60.8 vs. 39%, respectively (P=0.002).

Conclusion: Therapy for chronic endometritis, which includes uterine flushing along with antibacterial treatment, when compared with the standard treatment method, resulted in a significant reduction in the clinical symptoms of chronic endometritis (CE) and can enhance the effectiveness of assisted reproductive technology treatments.