Alterations in Implantation Genes and Dendritic Cells in Endometrial Samples After Antibiotic Treatment

TL;DR

This study shows that antibiotic treatment for chronic endometritis improves implantation-related genes and clinical outcomes in some patients.

Contribution

The novel finding is that antibiotic treatment reverses gene expression changes linked to implantation in endometrial tissue affected by chronic endometritis.

Findings

Endometrial expression of HOXA10 and IGF-1 genes increased significantly after antibiotic treatment.

Dendritic cell marker CD141 expression decreased following treatment.

Six out of ten patients conceived and delivered after treatment.

Abstract

Background/Objectives: This retrospective study assessed the impact of chronic endometritis (CE) on the expression of implantation genes HOXA10 (Homeobox A10) and IGF-1 (insulin-like growth factor 1), and on dendritic cells before and after antibiotic treatment, as well as on clinical reproductive outcomes. Methods: 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. Results: 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.

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