Role of intrauterine antibiotic infusion combined with oral antibiotic administration in improving pregnancy outcome in women with chronic endometritis diagnosed by CD138 test seeking care for failed IVF.

This study is a prospective, randomised controlled trial conducted at the Wardha Test Tube Baby Centre, AVBRH, DMIHER, India, evaluating the efficacy of oral antibiotic administration (OAA) alone versus combined intrauterine antibiotic infusion plus oral antibiotic administration (OAA+IAI) in women with CD138-confirmed chronic endometritis (CE) and at least one prior failed in-vitro fertilisation (IVF) cycle. The hypothesis is that combined intrauterine and oral antibiotic therapy will improve pregnancy outcomes compared to oral antibiotics alone. Forty women (20 per arm) were allocated to receive either OAA (doxycycline + metronidazole) for 14 days or OAA plus intrauterine ciprofloxacin infusions every 3 days for 30 days. The primary outcomes were biochemical and clinical pregnancy rates; secondary outcomes included implantation rate, miscarriage rate, and treatment tolerability. The study found no statistically significant differences in pregnancy outcomes between groups, suggesting that oral antibiotic therapy alone may be sufficient for CE management in IVF failure cases, particularly in resource-limited settings.