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News
A placebo-controlled trial found that doxycycline offers no advantage over placebo for women with recurrent miscarriage and chronic endometritis. Live birth and ongoing pregnancy rates were nearly identical between the two groups (52% vs. 50%). Researchers say the findings do not support using doxycycline to treat chronic endometritis defined by CD138 staining in this population.
A large randomised, double-blind, placebo-controlled trial has found that preconceptual doxycycline does not improve outcomes for women with recurrent miscarriage and chronic endometritis (CE). The study, published in Human Reproduction, enrolled 438 women with two or more consecutive first-trimester miscarriages and CE — defined by at least five CD138-positive stromal cells per 10 mm². Participants received either doxycycline 100 mg or placebo twice daily for 14 days.
The results were clear: cumulative live birth or ongoing pregnancy rates were virtually identical between the doxycycline and placebo groups. Repeated biopsies also showed no meaningful change in CD138 status following treatment, suggesting the antibiotic isn't effectively clearing the underlying condition either.
By the Numbers:
Why it matters: Chronic endometritis has long been considered a potential contributor to recurrent miscarriage, and doxycycline has been used in clinical practice to treat it. This trial delivers a clear signal that this approach doesn't work — prompting a rethink of how CE is managed in women experiencing pregnancy loss.
