The standard treatment is a two-week course of antibiotics, typically Doxycycline. Compliance can be an issue, but second-line treatments include Metronidazole and Ciprofloxacin. I prefer to avoid unnecessary interventions unless there is clinical or ultrasound evidence suggesting incomplete resolution.
I am a strong advocate of probiotics, not just for fertility but for overall well-being. A 2024 study showed a trend towards improved pregnancy rates when antibiotics were combined with probiotics. Maintaining a healthy gut and endometrial microbiome is crucial. The molecular examination of the endometrial microbiome provides valuable information about microbial composition and may help optimize treatment.
