抗生素治疗慢性子宫内膜炎对反复移植失败妊娠结局的影响

Effect of antibiotic therapy for chronic endometritis on pregnancy outcome after recurrent implantation failure

目的 探讨抗生素治疗对反复移植失败合并慢性子宫内膜炎患者妊娠结局的影响。方法 选取2020年8月至2022年3月于中国人民解放军总医院第七医学中心186例反复移植失败的慢性子宫内膜炎患者为研究对象,根据再次行冻融胚胎移植前是否行抗生素治疗及使用的抗生素种类,将其分为多西环素组(n=84)、联合用药(左氧氟沙星+甲硝唑)组(n=57)、未治疗组(n=45)。比较各组患者的临床基本资料和行冻融胚胎移植后的妊娠结局。结果 各组患者的年龄、BMI、不孕年限、基础窦卵泡数、基础卵泡生成素水平、既往移植周期数、既往移植优质胚胎数相比,差异无统计学意义(P>0.05)。各组患者子宫内膜准备方案、转化日的内膜厚度、移植胚胎数和类型比较差异均无统计学意义(P>0.05)。各组患者着床率、临床妊娠率、流产率比较,差异无统计学意义(P>0.05)。多西环素组和联合用药组患者活产率高于未治疗组,差异具有统计学意义(P<0.05);多西环素组和联合用药组患者活产率比较,差异无统计学意义(P>0.05)。结论 应用抗生素治疗可以提高反复移植失败合并慢性子宫内膜炎患者的活产率。

Objective To investigate the effect of antibiotic therapy on pregnancy outcome of patients undergoing recurrent implantation failure combined with chronic endometritis.Methods A total of 168 patients with chronic endometritis who underwent recurrent transplant failure in the Seventh Medical Center of General Hospital of PLA from August 2020 to March 2022 were selected as the study subjects,and they were divided into the doxycycline group(n=84),the combined medication(levofloxacin and metronidazole)group(n=57),and the untreated group(n=45)according to whether treated with antibiotics before frozen-thawed embryo transfer and the kinds of antibiotics.The basic clinical data and the pregnancy outcome after frozen-thawed embryo transfer in the three groups were compared.Results There was no statistically significant difference in the age,BMI,infertility years,basal antral follicle count,basal follicle-stimulating hormone level,number of previous transfer cycles,or number of previous good-quality embryos transferred among the groups(P>0.05).There was no statistically significant difference in the endometrial preparation schemes,endometrial thickness on the conversion day,or number and type of transferred embryos among the groups(P>0.05).There was no statistically significant difference in the implantation rate,clinical pregnancy rate,or abortion rate among the groups(P>0.05).The live birth rates in the doxycycline group and the combined medication group were higher than that in the untreated group,with statistically significant differences(P<0.05);there was no statistically significant difference in the live birth rates between the doxycycline group and the combined medication group(P>0.05).Conclusion Antibiotic therapy can improve the live birth rates of patients undergoing recurrent implantation failure combined with chronic endometritis.