Reviewer ’s report  
 
Title: Efficient treatment of chronic endometritis through a  novel approach of intrauterine 
antibi otic infusion: A case series  
 
Version: 0 Date: 02 Nov 2018  
 
Reviewer: Margar et Cruickshank  
 
Reviewer's report:  
 
This is a novel approach and interesting exploratory study with an empirical approach to a new 
delivery method of antibiotic treatment and potentially promising results with subsequent 
spontaneous pregnancies in 3 cases.  
 
 
The paper needs more detail on the hypothesis regarding endometritis and how it prevents 
implantation, why oral antibiotics are less effective, mechanistic detail on how local infusion 
works and how dosage and timing of delivery and duration was course was  determined. It needs 
some scientific rigor to underpin why they implemented this treatment  and to reassure that 
safety issues had been considered.  There is some mention of  these issues in the discussion in 
the next steps required but the initial scienc e/rational needs to be clear.  
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specif y what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or sa lary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the public ation of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I de clare that I have  no competing interests' 
below . If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under a n Open Acc ess Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editor s, which will not be published.  
 
I agree to the open peer review policy of the journal