A double-blind multi-centre randomised placebo-controlled trial of doxycycline in women with recurrent miscarriage and chronic endometritis defined by CD138 positive stromal cells.
Hum ReprodOct 1, 2026
J Odendaal, N Black, K Fishwick et al.
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In 30 seconds
This multicenter, double-blind, randomized controlled trial evaluated the effect of preconceptual doxycycline on live birth rates in women with recurrent miscarriage and chronic endometritis defined by CD138 positive stromal cells. Among 438 randomized women, the doxycycline group had a cumulative live birth rate of 52%, compared to 50% in the placebo group, with an adjusted relative risk of 1.02 (Credible Interval 0.85-1.21), indicating no significant benefit from doxycycline.
Key findings
- Cumulative live birth rates were 52% in the doxycycline group vs 50% in the placebo group.
- In the chronic endometritis negative group, live birth rates were 30% compared to 41% in the placebo group.
- The trial was stopped at interim analyses due to lack of efficacy.
- No significant changes in CD138 staining patterns were observed after treatment.
Why it matters
The findings challenge the current guidelines recommending doxycycline for chronic endometritis in women with recurrent miscarriage, suggesting that this treatment may not improve live birth outcomes.