Antibiotic exposure during IVF: An overlooked variable in assisted reproduction?

To study whether the single intravenous perioperative administration of antibiotics during an oocyte retrieval procedure (OPU) has an impact on the ongoing pregnancy / live birth rate in a subsequent single euploid frozen embryo transfer.

Retrospective cohort study including women who underwent an OPU procedure with or without single intravenous perioperative administration of antibiotics, followed by a single euploid frozen embryo transfer (seFET) in the consecutive month between 07/2018 and 10/2024. The seFET was performed within 20 to 35 days after OPU.

A total of 676 women were included in the study, 359 patients receiving no antibiotics (no-AB-group) and 317 patients receiving antibiotics (AB-group) during OPU. There were no significant differences between the two groups regarding age, antral follicle count (AFC), or the interval between OPU and embryo transfer (ET). Women in the AB-group had significantly higher body mass index (BMI) (27.6 vs. 26.6, p = 0.022) and higher anti-Müllerian hormone (AMH) levels (2.2 vs. 1.8, p = 0.027). There were no significant differences between the groups for the clinical outcomes (ongoing pregnancy/livebirth). The multivariate logistic regression analysis demonstrates the significant impact of embryo quality (ICM as well as TE) on the chance of an ongoing pregnancy / live birth, but single intravenous perioperative administration of antibiotics did not reveal any impact.

Single intravenous perioperative prophylactic antibiotic medication during an OPU procedure has no effect on pregnancy, ongoing pregnancy, or live birth rates in a freeze-all approach when single euploid frozen embryo transfers are performed the month following the OPU.