Comparison of the prevalence of chronic endometritis as determined by means of different diagnostic methods in women with and without reproductive failure

Liu, Yingyu; Chen, Xiaoyan; Huang, Jin; Wang, Chi Chiu; Yu, Mei‐Yung; Laird, Susan; Li, Tin‐Chiu

doi:10.1016/j.fertnstert.2018.01.022

Cited by 134 publications

(143 citation statements)

References 36 publications

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“…The relationship between CE and infertility has recently emerged as an important clinical challenge. In fact, 2.8–56.8% of infertile women, 14–67.5% of women with RIF, and 9.3–67.6% of women with recurrent pregnancy loss are diagnosed with CE . Considering these high prevalence rates, CE is a condition that must not be ignored during fertility treatment.…”

Section: Epidemiology and Clinical Featuresmentioning

confidence: 99%

Review: Chronic endometritis and its effect on reproduction

Kimura

Takebayashi

Ishida

et al. 2019

J of Obstet and Gynaecol

197

144

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Aim Chronic endometritis (CE) is a disease of continuous and subtle inflammation characterized by the infiltration of plasma cells in the endometrial stromal area. Although the clinical significance of CE has been thought in clinical practice for a long time because it is either asymptomatic or presents with subtle symptoms, recent studies have shown the potential adverse effects of CE on fertility. In the present review, we focus on the concept, diagnosis, etiology, pathophysiology, diagnosis, impact on reproduction and treatment for it to understand CE. Methods The published articles were reviewed. Results The prevalence of CE has been found to be 2.8–56.8% in infertile women, 14–67.5% in women with recurrent implantation failure (RIF), and 9.3–67.6% in women with recurrent pregnancy loss. Microorganisms are thought to be a main cause of CE, since antibiotic treatment has been reported to be an effective therapy for CE. Common bacteria are frequently detected in the uterine cavity of CE patients by microbial culture. In CE endometrium, the prevalence of immune cells and decidualization has been reported to be modified, and these modifications are thought to adversely affect fertility. The gold standard for the diagnosis of CE is the histological detection of plasma cells in the stromal area of the endometrium in endometrial specimens, although universally accepted criteria for the diagnosis of CE have not been determined. The treatment currently thought to be most effective for the recovery of fertility in CE is administration of oral antibiotics. Patients whose CE has been cured have been reported to have a higher ongoing pregnancy rate, clinical pregnancy rate, and implantation rate compared with patients with persistent CE. Conclusion CE greatly affects implantation and impairs fertility. Antibiotic administration is an effective therapeutic option. Pregnancy rate in in vitro fertilization is improved when CE is cured by antibiotic.

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Section: Epidemiology and Clinical Featuresmentioning

confidence: 99%

Review: Chronic endometritis and its effect on reproduction

Kimura

Takebayashi

Ishida

et al. 2019

J of Obstet and Gynaecol

197

144

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“…A total of 135 subjects were included in this study. It represented an extension of our earlier series involving 93 subjects in the study of CE 13 and 97 subjects in the study of uNK cell 5 in women with recurrent miscarriage. The demographic details of the subjects are summarized in Table 1.…”

Section: Results Demographicsmentioning

confidence: 98%

“…In this study, CD56+ immune-staining was used to identify uNK cells. As described in previous studies, 5,13 paraffin-embedded human endometrial tissue sections were dewaxed in xylene, rehydrated through descending ethanol to Tris-buffered saline and unmasking of antigen in citrate buffer. The primary antibody was a mouse antihuman monoclonal primary anti-CD56 antibody (NCL-CD56-504; Novacastra Laboratories, Newcastle, UK) at a dilution of 1:100.…”

Section: Immunohistochemical Stainingmentioning

confidence: 99%

“…Based on our recent work, the upper limit of the reference range for plasma cell density derived from a fertile population was 5.15 cells per 10 mm 2 ; results above this reference range were considered to be diagnostic of CE. 13…”

Section: Immunohistochemical Stainingmentioning

confidence: 99%

“…10 However, the prevalence of CE depends on the methods used to quantify plasma cell count 11,12 ; ideally it should be based on references ranges derived a fertile population. 13 In this study, we wish to extend our earlier work on uNK cell density 5 and plasma cell count 13 in women with recurrent miscarriage by investigating the relationship between uNK cell density and plasma cell count in endometrial samples precisely timed on the 7th day after the luteinizing hormone (LH) surge, to determine if CE is an underlying cause of high uNK cell density.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Association between chronic endometritis and uterine natural killer cell density in women with recurrent miscarriage: clinical implications

Chen

Liu

Zhao

et al. 2020

J of Obstet and Gynaecol

Self Cite

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Aim: This aim of this study was to determine the association between uterine natural killer (uNK) cell density and chronic endometritis (CE). Methods: Endometrial biopsies from 135 women with recurrent miscarriage were obtained precisely 7 days after luteinizing hormone surge in natural cycles. Endometrial sections were immunostained for CD56 for uNK cells and CD138 for plasma cells, respectively. Uterine NK cell counting was performed according to a standardized protocol and results were expressed as percentage of CD56+ cells/ total stromal cells. High uNK cell density was defined as >4.5% and CE was diagnosed when the plasma cell density > 5.15 cells/ 10 mm 2 . Results: The uNK cells density in women with CE (median, 5.1%; range, 3.4-8.8%) was significantly (P < 0.05) higher than that of those without CE (median, 3.8%; range, 1.2%-7.3%). The prevalence of high uNK cell density in women with CE (11/29, 37.9%) was significantly (P < 0.05) higher than that of women without CE (8/106, 7.5%). Conclusion: To conclude, there was a significant association between high uNK cell density and CE. In women with high uNK cell density, plasma cell should be examined to determine if the underlying cause is associated with CE.

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Clinical utility of office hysteroscopy following failed in vitro fertilization–embryo transfer: A retrospective cohort study

Zhang,

Wu,

Liao

et al. 2024

Intl J Gynecology & Obste

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ObjectiveDespite its widespread use, in vitro fertilization (IVF) outcomes are challenged by implantation failure, largely due to factors such as embryo quality and endometrial receptivity. In this study, we investigated the clinical effect of office hysteroscopy (OH) on the subsequent frozen–thawed embryo transfer (FET) in infertile women who experienced a failed IVF–embryo transfer (IVF‐ET) cycle.MethodsWe included 577 infertile women who underwent OH because of a history of failed ET between October 2019 and September 2021. During OH, visible endometrial polyps (EPs) were diagnosed and removed by curette or biopsy forceps; chronic endometritis (CE) was diagnosed by histopathology and immunohistochemistry and treated with oral doxycycline (0.2 g/d) for 14 days. According to the hysteroscopic findings and endometrial pathology with immunohistochemistry, patients were divided into three groups: group A (n = 161) had CE with or without EPs, group B (n = 156) had EPs only, and group C (n = 260) had no CE or EPs.ResultsIn the following FET cycle, the implantation rates were 47%, 51%, and 45% (P = 0.411); the clinical pregnancy rates were 56%, 62%, and 55% (P = 0.436); the live birth rates were 45%, 51%, and 42% (P = 0.205); and the miscarriage rates were 18%, 16%, and 22% (P = 0.497) in groups A, B, and C, respectively. There were no significant differences among groups (P > 0.05).ConclusionOH is helpful for diagnosis and treatment of abnormal intrauterine environment in women with a failed IVF cycle and further improves their pregnancy outcome in the following FET.

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Comparison of the prevalence of chronic endometritis as determined by means of different diagnostic methods in women with and without reproductive failure

Abstract: ChiCTR-IOC-16007882.

Cited by 134 publications

References 36 publications

Review: Chronic endometritis and its effect on reproduction

Review: Chronic endometritis and its effect on reproduction

Association between chronic endometritis and uterine natural killer cell density in women with recurrent miscarriage: clinical implications

Clinical utility of office hysteroscopy following failed in vitro fertilization–embryo transfer: A retrospective cohort study

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