Challenges in Clinical Diagnosis and Management of Chronic Endometritis

Abstract

Chronic endometritis (CE) is a local mucosal infectious and inflammatory disorder characterized by unusual filtration of CD138(+) endometrial stromal plasmacytes. CE is attracting attention due to its potential association with infertility of unknown etiology, repeated implantation failure, recurrent pregnancy loss, and several maternal/neonatal complications. Due to the variance in study design among researchers, universal diagnostic criteria remain to be established for the clinical diagnosis and management of CE. This review article aims to summarize current knowledge and provide insights into unsolved questions on CE to establish clinical guidelines for the disease from the viewpoint of human reproduction.

High prevalence of chronic endometritis is associated with metabolic abnormality and reduced live birth rate among IVF women with non‐uniform endometrial echogenicity

“…There is substantial evidence to support this observation in previous literature 38–40 . As reported, CE can be diagnosed using two established methods: hysteroscopic visualization and endometrial biopsy with histology 1 . Considering histologic diagnosis as the gold standard, CE is usually diagnosed based on the identification and counting of ESPCs within the endometrium 41 .…”

“…Chronic endometritis (CE) is often asymptomatic endometritis that is also associated with recognized fertility problems 1 . In recent years, the impact of CE on assisted reproductive technology (ART) has come under greater scrutiny 2 .…”

“…There is increasing evidence to suggest that CE may be a cause of recurrent implantation failure (RIF), early miscarriages, recurrent pregnancy loss, and certain obstetric complications 4 . The prevalence of CE is often underestimated because it is difficult to diagnose 1 . Despite that lack of data, there are known differences in CE prevalence between different subpopulations and even among infertile patients 5 …”

“…4 The prevalence of CE is often underestimated because it is difficult to diagnose. 1 Despite that lack of data, there are known differences in CE prevalence between different subpopulations and even among infertile patients. 5 There are still no clear recommendations on whether CE needs to be screened before ART in the initial assessment of infertile couples, especially when a transvaginal ultrasound before the first in vitro fertilization (IVF) treatment reveals no problems.…”

Discussion issues in the treatment of chronic endometritis

“…Хронический эндометрит (ХЭ) представляет собой локальное инфекционно-воспалительное заболевание слизистой оболочки матки, характеризующееся инфильтрацией плазмоцитами (CD138+) в строме эндометрия [1].…”