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

<b>Background/Objectives:</b> This retrospective study assessed the impact of chronic endometritis (CE) on the expression of implantation genes <i>HOXA10</i> (Homeobox A10) and <i>IGF-1</i> (insulin-like growth factor 1), and on dendritic cells before and after antibiotic treatment, as well as on clinical reproductive outcomes. <b>Methods:</b> 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 <i>HOXA10</i> and <i>IGF-1</i> using RT-PCR, and for identification of dendritic cells using immunohistochemical staining of CD141. Conceptions and live births were also evaluated. <b>Results:</b> Endometrial expression of <i>HOXA10</i> and <i>IGF-1</i> 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. <b>Conclusions:</b> 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.