Chronic endometritis: a common finding in good prognosis patients with failed implantation following in-vitro fertilization

Conway, D.; Ketefian, A.; Shamonki, M.

doi:10.1016/j.fertnstert.2010.07.695

Cited by 5 publications

(12 citation statements)

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“…The prevalence of CE was found in 55.6% of RIF patients in our study that was comparable with the rates of 57% 7 and 60% 20 as reported in histological analyses of previous studies. However, the others reported 30.3% 11 and 33.7% 3 of the prevalence of CE diagnosed by histological examination in RIF patients.…”

Section: Discussionsupporting

confidence: 92%

Subsequent IVF outcomes following antibiotic therapy for chronic endometritis in patients with recurrent implantation failure

Demirdağ

Güler

Akdulum

et al. 2021

J of Obstet and Gynaecol

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Aim: The aim is to identify the chronic endometritis (CE) incidence in recurrent implantation failure (RIF) patients undergoing in vitro fertilization (IVF) treatment and compare the IVF outcomes of RIF patients with CE following antibiotic therapy with RIF patients without CE. Another purpose is to compare the IVF outcomes of described RIF patients with patients undergoing the first cycle of IVF. Methods: In this retrospective cohort study, CE was diagnosed with CD-138 immunohistochemical staining. Among RIF patients, two groups were formed as group 1, including patients diagnosed with CE and treated by antibiotics (n = 129), and group 2, including patients without CE (n = 103). Patients with the first IVF cycle having similar infertility etiologies with RIF patients were reviewed as group 3 (n = 932). Results: CE was diagnosed in 55.6% of RIF patients. The number of oocytes retrieved was not different between groups. Implantation rates (IR) were similar after antibiotic treatment in RIF patients with or without CE. However, Group 3 had a higher IR (41.1%) than group 1 and 2 (23.1% and 30.1%, respectively) (p < 0.001). Clinical pregnancy (CPR) and live birth rates (LBR) were comparable between RIF groups. However, CPR and LBR were significantly higher in group 3 (48.6% and 40.5%) than group 1 (36.4% and 27.9%), and group 2 (37.9% and 30.1%) (p = 0.007 and p = 0.005, respectively). Conclusion: Unidentified endometrial factors except CE may also affect the implantation process, although CE is a frequent finding in patients with RIF. Reproductive outcomes may not be improved only with antibiotics in RIF patients with CE.

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Section: Discussionsupporting

confidence: 92%

Subsequent IVF outcomes following antibiotic therapy for chronic endometritis in patients with recurrent implantation failure

Demirdağ

Güler

Akdulum

et al. 2021

J of Obstet and Gynaecol

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“…Use of additional IHC techniques decrease the false-positive rate, which leads to less overtreatment in women [5]. All published studies show that immunohistochemistry for CD138 positive cells is a golden standard in CE [19]. Although there is no consensus on the IHC assessment of plasma cells, the vast majority of authors believe that the presence of a single cell is su cient for the diagnosis of CE.…”

Section: Resultsmentioning

confidence: 99%

“…Most likely due to these differences in de nition and positive diagnosis, the prevalence of this chronic illness in women that struggle with infertility is variable: from 0.2-46% [5][14] [15][16]. In studies that were evaluating patients with repeated failure of implantation the percentage was between 14 to 60% [17][18] [19].…”

Section: Introductionmentioning

confidence: 99%

“…After the administration of antibiotics we expect an improvement of the in ammatory changes and endometrial receptivity [19] [20][21] [22][23]. The immune response against bacterial invasion of the uterine cavity during chronic endometritis rarely progresses to a systemic in ammatory response [20], therefore the necessity of systemic antibiotic therapy could be considered but may not be crucial.…”

Section: Introductionmentioning

confidence: 99%

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The effectiveness of intrauterine antibiotic infusion vs oral antibiotic therapy in the treatment of Chronic Endometritis in patients during IVF (in vitro fertilization) procedures

Luncan

Huniadi

Bimbo-Szuhai

et al. 2022

Preprint

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Background: Chronic Endometritis (CE) is a subtle pathology, likely infectious in most cases, with a negative impact on the female fertility, but often overlooked even among fertility specialists. The purpose of the study is to demonstrate the predominant infectious nature of CE and to find the best therapeutic option by comparing the results of oral antibiotic therapy versus intrauterine antibiotic infusion in patients with CE undergoing IVF procedures. The objective was to compare the cure rate of CE – defined as the percentage of patients without CE at the test of cure, between the two groups and, the hysteroscopic aspect with the positive CD 138 staining. Methods: This was a prospective, case – control study that took place in a single university fertility clinic, in Oradea, Romania and included 57 patients with CE divided into 2 groups: orally administered antibiotics group who received a combination of antibiotics compared to intrauterine infusion group who received intrauterine infusion of antibiotic. Chronic Endometritis was diagnosed through hysteroscopy and immunohistochemistry for CD 138. Patients in both groups were tested for CE twice to evaluate the cure rate after oral combination antibiotic therapy versus intrauterine infusion of antibiotic. Results: Out of 115 patients with endometrial biopsies 57 tested positive for CE, with a 49.6% chronic endometritis prevalence. Among the group that was administered oral antibiotics, 11 patients (45.83%) experienced CE resolution after triple antibiotic therapy. Of the intrauterine infusion group, 25 patients (89.29%) presented negative results (p 0,0020). The normal hysteroscopic aspect had a similar prevalence in the patients with immunohistochemical positive and negative CD 138. Conclusions: Our study demonstrated the effectiveness and superiority of intrauterine antibiotic infusion over the use of oral combination antibiotic therapy for CE cure. Trial Registration: ISRCTN17542620 / 14.09.2022

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“…Most likely due to these differences in definition and positive diagnosis, the prevalence of this chronic illness in women that struggle with infertility is variable: from 0.2 to 46% [ 6 , 15 – 17 ]. In studies that were evaluating patients with repeated failure of implantation the percentage was between 14 and 60% [ 18 – 20 ].…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of intrauterine antibiotic infusion versus oral antibiotic therapy in the treatment of chronic endometritis in patients during IVF (in vitro fertilization) procedures

et al. 2022

View full text Add to dashboard Cite

Background Chronic Endometritis (CE) is a subtle pathology, likely infectious in most cases, with a negative impact on the female fertility, but often overlooked even among fertility specialists. The purpose of the study is to demonstrate the predominant infectious nature of CE and to find the best therapeutic option by comparing the results of oral antibiotic therapy versus intrauterine antibiotic infusion in patients with CE undergoing IVF procedures. The objective was to compare the cure rate of CE—defined as the percentage of patients without CE at the test of cure, between the two groups and, the hysteroscopic aspect with the positive CD 138 staining. Methods This was a prospective, case—control study that took place in a single university fertility clinic, in Oradea, Romania and included 57 patients with CE divided into 2 groups: orally administered antibiotics group who received a combination of antibiotics compared to intrauterine infusion group who received intrauterine infusion of antibiotic. Chronic Endometritis was diagnosed through hysteroscopy and immunohistochemistry for CD 138. Patients in both groups were tested for CE twice to evaluate the cure rate after oral combination antibiotic therapy versus intrauterine infusion of antibiotic. Results Out of 115 patients with endometrial biopsies 57 tested positive for CE, with a 49.6% chronic endometritis prevalence. Among the group that was administered oral antibiotics, 11 patients (45.83%) experienced CE resolution after triple antibiotic therapy. Of the intrauterine infusion group, 25 patients (89.29%) presented negative results (p 0.0020). The normal hysteroscopic aspect had a similar prevalence in the patients with immunohistochemical positive and negative CD 138. Conclusions Our study demonstrated the effectiveness and superiority of intrauterine antibiotic infusion over the use of oral combination antibiotic therapy for CE cure. Trial Registration: ISRCTN17542620/14.09.2022.

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Chronic endometritis: a common finding in good prognosis patients with failed implantation following in-vitro fertilization

Cited by 5 publications

References 0 publications

Subsequent IVF outcomes following antibiotic therapy for chronic endometritis in patients with recurrent implantation failure

Subsequent IVF outcomes following antibiotic therapy for chronic endometritis in patients with recurrent implantation failure

The effectiveness of intrauterine antibiotic infusion vs oral antibiotic therapy in the treatment of Chronic Endometritis in patients during IVF (in vitro fertilization) procedures

The effectiveness of intrauterine antibiotic infusion versus oral antibiotic therapy in the treatment of chronic endometritis in patients during IVF (in vitro fertilization) procedures

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