Unit of Gynecology and Obstetrics, Department of Women and Children's Health, University of Padua, Padua, Italy.
Unit of Gynecology and Obstetrics, Department of Women and Children's Health, University of Padua, Padua, Italy.
Fertil Steril. 2018 Jul 1;110(1):103-112.e1. doi: 10.1016/j.fertnstert.2018.03.017. Epub 2018 Jun 13.
To evaluate the impact of antibiotic therapy for chronic endometritis (CE) on IVF outcome.
Systematic review and meta-analysis.
Not applicable.
PATIENT(S): Infertile women with history of recurrent implantation failure, defined as two or more failed ETs, undergoing one or more IVF cycle(s).
INTERVENTION(S): The review was registered in PROSPERO (CRD42017062494) before the start of the literature search. Observational studies were identified by searching electronic databases. The following comparators were included: women with CE receiving antibiotics vs. untreated controls; women with cured CE vs. women with persistent CE; and women with cured CE vs. women with normal endometrial histology (negative for CE). The summary measures were reported as odds ratio (OR) with 95% confidence interval (CI).
MAIN OUTCOME MEASURE(S): Clinical pregnancy rate (CPR), ongoing pregnancy rate/live birth rate (OPR/LBR), implantation rate (IR), miscarriage rate.
RESULT(S): A total of 796 patients (from five studies) were included. Women receiving antibiotic therapy (without the histologic confirmation of CE cure) did not show any advantage in comparison with untreated controls (OPR/LBR, CPR, and IR). Patients with cured CE showed higher OPR/LBR (OR 6.81), CPR (OR 4.02), and IR (OR 3.24) in comparison with patients with persistent CE. In vitro fertilization outcome was comparable between women with cured CE and those without CE (OPR/LBR, CPR, and IR). Miscarriage rate was not significantly different between groups.
CONCLUSION(S): Chronic endometritis therapy may improve IVF outcome in patients suffering from recurrent implantation failure. A control biopsy should always confirm CE resolution before proceeding with IVF.
评估慢性子宫内膜炎（CE）的抗生素治疗对体外受精（IVF）结局的影响。
系统评价和荟萃分析。
不适用。
有反复着床失败史的不孕妇女，定义为两次或两次以上胚胎移植失败，接受一次或多次 IVF 周期。
该综述在文献检索开始前已在 PROSPERO（CRD42017062494）中注册。通过搜索电子数据库来确定观察性研究。包括以下比较组：患有 CE 并接受抗生素治疗的女性与未治疗的对照组；CE 治愈的女性与持续存在 CE 的女性；CE 治愈的女性与子宫内膜组织学正常（CE 阴性）的女性。汇总指标以比值比（OR）及其 95%置信区间（CI）报告。
临床妊娠率（CPR）、持续妊娠率/活产率（OPR/LBR）、着床率（IR）、流产率。
共有 796 名患者（来自五项研究）纳入研究。接受抗生素治疗（未经 CE 治愈的组织学确认）的女性与未治疗的对照组相比，并未显示出任何优势（OPR/LBR、CPR 和 IR）。与持续存在 CE 的患者相比，CE 治愈的患者具有更高的 OPR/LBR（OR 6.81）、CPR（OR 4.02）和 IR（OR 3.24）。CE 治愈的患者与无 CE 的患者相比，IVF 结局无显著差异（OPR/LBR、CPR 和 IR）。流产率在各组之间无显著差异。
慢性子宫内膜炎的治疗可能改善反复着床失败患者的 IVF 结局。在进行 IVF 之前，应始终通过控制活检来确认 CE 的缓解。
