Antibiotics improve reproductive outcomes after frozen-thaw embryo transfer for chronic endometritis treatment, especially in those with repeated implantation failure.

PURPOSE: To investigate the impact of antibiotic treatment for chronic endometritis (CE) on the pregnancy outcome of frozen-thawed embryo transfer (FET) cycles and the relevant clinical risk factors associated with CE. METHODS: A retrospective cohort analysis was conducted on 1352 patients who underwent hysteroscopy and diagnostic curettage at Nanjing Maternal and Child Health Hospital from July 2020 to December 2021. All patients underwent CD138 immunohistochemical (IHC) testing to diagnose CE, and a subset of them underwent FET after hysteroscopy. Patient histories were collected, and reproductive prognosis was followed up. RESULTS: Out of 1088 patients, 443 (40.7%) were diagnosed with CE. Univariate and multivariate binary logistic regression analyses revealed that parity ≥ 2, a history of ectopic pregnancy, moderate-to-severe dysmenorrhea, hydrosalpinx, endometrial polyps, a history of ≥ 2 uterine operations, and RIF were significantly associated with an elevated risk of CE (P < 0.05). Analysis of the effect of CE on pregnancy outcomes in FET cycles after antibiotic treatment indicated that treated CE patients exhibited a significantly lower miscarriage rate (8.7%) and early miscarriage rate (2.9%) than untreated non-CE patients (20.2%, 16.8%). Moreover, the singleton live birth rate (45.5%) was significantly higher in treated CE patients than in untreated non-CE patients (32.7%). Survival analysis revealed a statistically significant difference in the first clinical pregnancy time between treated CE and untreated non-CE patients after hysteroscopy (P = 0.0019). Stratified analysis based on the presence of recurrent implantation failure (RIF) demonstrated that in the RIF group, treated CE patients were more likely to achieve clinical pregnancy than untreated non-CE patients (P = 0.0021). Among hysteroscopy-positive patients, no significant difference was noted in pregnancy outcomes between the treatment and control groups (P > 0.05). CONCLUSION: Infertile patients with a history of parity ≥ 2, hydrosalpinx, a history of ectopic pregnancy, moderate-to-severe dysmenorrhea, endometrial polyps, a history of ≥ 2 uterine operations, and RIF are at an increased risk of CE; these patients should be recommended to undergo hysteroscopy combined with CD138 examination before embryo transfer. Antibiotic treatment can improve the reproductive outcomes of FET in patients with CE, especially those with RIF.

Self-assembly behavior and adhesive performance of imidazolium cation grafted cellulose nanocrystals in confined space.

Confined evaporation-induced self-assembly (C-EISA) is a powerful technique to guide disordered nanoparticles into long-range organized structures. Herein, we investigate the C-EISA behavior of 1-butyl-3-vinylimidazolium cation ([VBIm]+) grafted cellulose nanocrystals (CNC-C) in a parallel-plates confined geometry. Interestingly, CNC-C can spontaneously assemble into maze-like patterns with branch dimensions on the micrometer scale and uniformly distributed throughout the confined space, which is completely different from the lamellar self-assembly patterns of unmodified CNCs. Combining in situ observations and microscopic characterization, we speculate that the formation of maze-like patterns originates from the reduction of colloidal stability induced by the grafted imidazolium cations. The electrostatic attraction between CNC-C aggregated bundles and glass substrates acts as anchor points, thereby leading to the unstable motion of the liquid-air menisci during the inward intrusion of air. Due to the physicochemical properties and unique C-EISA behavior, the CNC-C based adhesive can maintain adhesion at temperatures of ca. 200 °C, while rapidly debonding when immersed in water, demonstrating the potential to be used as stimuli-responsive temporary or removable adhesives. Furthermore, the strategy proposed in this work for achieving CNCs patterning is also promising to be extended to other anisotropic rod-shaped nanoparticles.