Active Antibiotic Treatment Improves ART Outcomes in TPOAb-Positive Chronic Endometritis Patients: A Retrospective Study.

Our study aimed to investigate the association between chronic endometritis (CE) and thyroid peroxidase antibody (TPOAb) positivity, and to evaluate the effect of antibiotic therapy on assisted reproductive technology (ART) outcomes in patients with TPOAb-positive CE. A total of 1,385 women undergoing ART were enrolled and categorized into TPOAb-negative (n = 1,240) and TPOAb-positive (n = 145) groups. The prevalence of CE was significantly higher in the TPOAb-positive group compared with the TPOAb-negative group (62.76% vs. 43.47%, p < 0.001). At our center, patients diagnosed with CE routinely received antibiotic therapy prior to ART. In subgroup analyses restricted to CE patients, with clinical pregnancy rate (CPR) and live birth rate (LBR) as the primary outcomes, TPOAb-positive patients with CE who received antibiotics showed significantly higher CPR (52.75% vs. 41.37%, p = 0.0426) and LBR (48.35% vs. 35.44%, p = 0.0184). These associations remained robust after adjustment for potential confounders. In conclusion, TPOAb positivity is linked to a higher prevalence of CE, and antibiotic therapy prior to ART improves reproductive outcomes in TPOAb-positive patients with CE.