Zhang Qingyan, Yang Guoxia, Tan Jinfeng, Xiong Yujing, Xu Yan, Xu Yanwen, Gu Fang
Reproductive Medical Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; The Key Laboratory of Reproductive Medicine of Guangdong Province, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Clinical Research Center for Obstetrical and Gynecological Diseases, Guangzhou, China.
Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Reprod Biomed Online. 2024 Feb;48(2):103611. doi: 10.1016/j.rbmo.2023.103611. Epub 2023 Oct 13.
Do patients with antibiotic-cured chronic endometritis (CCE) have a comparable pregnancy outcome to those with non-chronic endometritis (NCE) in the subsequent frozen embryo transfer (FET) cycle?
A retrospective cohort analysis included 833 patients in their first FET cycles with single euploid embryo transfer. Chronic endometritis (≥5 CD138+ plasma cells per high-power field [CD138+/HPF]) was treated with standard antibiotic therapy. Patients were classified into two groups: the NCE group (n = 611, <5 CD138+/HPF) and the CCE group (n = 222, ≥5 CD138+/HPF and cured after antibiotic treatment). Pregnancy outcomes were compared. NCE group was divided into subgroup 1 (CD138+/HPF = 0) and subgroup 2 (CD138+/HPF = 1-4) for further analysis.
The rate of early pregnancy loss (EPL), incorporating all losses before 10 weeks' gestation, was significantly higher in the CCE group than the NCE group (21.2% versus 14.2%, P = 0.016), and the difference was statistically significant (adjusted odds ratio [AOR] 1.68, 95% confidence interval [CI] 1.11-2.55). No significant differences were observed between the two groups with regard to other pregnancy outcomes. In the subgroup analysis, the EPL rate and biochemical pregnancy rate were significantly higher in subgroup 2 than subgroup 1 (17.2% versus 9.4%, AOR 2.21, 95% CI 1.30-3.74; 12.2% versus 6.9%, AOR 2.01, 95% CI 1.09-3.68).
Chronic endometritis cured by standard antibiotic therapy remains a risk factor for EPL in FET cycles, although no differences were found in live birth rates between patients with CCE or with NCE.
抗生素治愈的慢性子宫内膜炎（CCE）患者在随后的冻融胚胎移植（FET）周期中的妊娠结局与非慢性子宫内膜炎（NCE）患者是否相当？
一项回顾性队列分析纳入了833例首次进行单倍体整倍体胚胎移植的FET周期患者。慢性子宫内膜炎（每高倍视野[CD138+/HPF]≥5个CD138+浆细胞）采用标准抗生素治疗。患者分为两组：NCE组（n = 611，<5 CD138+/HPF）和CCE组（n = 222，≥5 CD138+/HPF且抗生素治疗后治愈）。比较妊娠结局。NCE组分为亚组1（CD138+/HPF = 0）和亚组2（CD138+/HPF = 1 - 4）进行进一步分析。
CCE组妊娠10周前的早期妊娠丢失（EPL）率显著高于NCE组（21.2%对14.2%，P = 0.016），差异具有统计学意义（调整优势比[AOR] 1.68，95%置信区间[CI] 1.11 - 2.55）。两组在其他妊娠结局方面未观察到显著差异。在亚组分析中，亚组2的EPL率和生化妊娠率显著高于亚组1（17.2%对9.4%，AOR 2.21，95% CI 1.30 - 3.74；12.2%对6.9%，AOR 2.01，95% CI 1.09 - 3.68）。
尽管CCE患者和NCE患者的活产率无差异，但标准抗生素治疗治愈的慢性子宫内膜炎仍是FET周期中EPL的一个危险因素。
