CE is reversible with antibiotic treatment that resulted in improvements in implantation genes and clinical results. A high proportion of patients required broader spectrum antibiotic treatment.

The study was conducted from 2021 to 2022. Ten assisted reproductive technology patients who underwent an endometrial biopsy before antibiotic treatment, confirming the diagnosis of CE, and a second biopsy after completing a course of 100 mg doxycycline twice daily for 14 days were included. Paraffin-embedded endometrial samples from these patients were obtained from the pathology department. The samples were evaluated for quantifying implantation genes HOXA10 and IGF-1 using RT-PCR, and for identification of dendritic cells using immunohistochemical staining of CD141. Conceptions and live births were also evaluated.

Endometrial expression of HOXA10 and IGF-1 genes was significantly elevated after antibiotic treatment and expression of dendritic cells CD141 was decreased. Eight of the ten patients required second-line antibiotic treatment due to persistent CE. Six patients conceived and delivered. Conclusions: CE is reversible with antibiotic treatment that resulted in improvements in implantation genes and clinical results. A high proportion of patients required broader spectrum antibiotic treatment.