Efficacy of endometrial microbiota testing-guided personalized therapy in infertile women stratified by CD138 status: a retrospective cohort study

Vollständiger Abstract

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Background Chronic endometritis (CE) is a persistent inflammatory condition of the endometrium associated with infertility. Current diagnosis relies on histopathological markers like CD138, which may not fully assess the functional state of the endometrial microenvironment. This study aimed to investigate whether the endometrial microbiome test (EMT) combined with personalized therapy could improve pregnancy outcomes in infertile women undergoing IVF, compared with standard management based on CD138 results. Methods This retrospective cohort study included 336 infertile women (aged 22–37 years) who underwent the CD138 test in Xiangtan Central Hospital between January 2020 and December 2022. Among them, 162 patients opted to undergo concurrent EMT using 16S rRNA sequencing and received EMT-guided personalized treatment. After excluding patients with missing CD138 results, those who underwent sequential embryo transfer, and those with endometrial thickness