Diagnostic significance of chronic endometritis macrotypes differentiation among women with reproductive losses

Abstract

To evaluate the prognostic value of a comprehensive endometrial study after early reproductive losses (RL). A group of 306 women with early RL (missed abortion (n = 120), spontaneous miscarriage (n = 120), and ineffective in vitro fertilization attempts (n =66) were prospectively examined up to 6 months after the discharge of the uterus at the hospital bases of the Department of Obstetrics and Gynecology with the Сourse of perinatology at the PFUR Medical Faculty. Hysteroscopic macrotypes differentiation - hyperplastic (n = 89), hypoplastic (n = 94) and mixed (n = 87) - was carried out on the basis of features grouping characterizing the thickness, color and structure of the mucosa, the intensity of a vascular pattern in the presence of a chronic endometritis (CE). Evaluation of sonographic accuracy after hysteroscopic CE macrotypes differentiation showed the presence of false-negative conclusions: about unchanged mucosa (6.9%); endometrium polyps (3.5%); intrauterine synechiae (4.2%). Immunohistochemical staining with CD138 isolation showed higher diagnostic accuracy in CE detecting in comparison with the morphological method: in a hyperplastic macrotype (90.5% and 84.1%, respectively), hypo- (93.7% and 89.8%) and mixed (81.6% and 79.4%). Great diagnostic value is shown in identifying histopathic CE features in the context of hysteroscopic macrotypes differentiation in groups of women with RL.

Differences in microbial profile of endometrial fluid and tissue samples in women with in vitro fertilization failure are driven by Lactobacillus abundance

“…The resulting material from the two samples was stored at −80 ° C. The sample collection was performed between September 2016 and November 2018. We also performed analysis on CE, as described previously 18 19 .…”

“…We also performed analysis on CE, as described previously. 18 There is no consensus on the diagnostic criteria to define what accounts for CE and there are seven or more different criteria previously reported. 19 In our study CE was diagnosed based on the presence of one or more plasma cells with positive CD138 immunohistochemistry, as these cells are typically absent in the endometrium.…”

“…We also performed analysis on CE, as described previously. 18 There is no consensus on the diagnostic criteria to define what accounts for CE and there are seven or more different abundance of genus Lactobacillus. The microbiome of CE and without CE (ie non-CE) women in our sample set of IVF patients was similar.…”

Associations of hysteroscopic features of chronic endometritis with pregnancy outcomes of in vitro fertilization: A retrospective study

“…One study reported that the concordance rate of hysteroscopy-diagnosed CE and clinico-histopathologic CE was approximately 57.5%-66% 21 , and another investigation determined that the diagnostic accuracy of hysteroscopy (93.4%) was higher than that of histopathologic methods 6 . Identifying the various hysteroscopic features of CE makes it possible to re ne the general description of CE to speci c microscopic manifestations and characteristics 27 . Cicinelli et al 28 proposed new diagnostic criteria for hysteroscopic CE (the Delphi consensus) based on international randomized controlled observations.…”

Effectiveness of in Vitro Fertilization Treatment in the Presence of Chronic Endometritis

“…Існують різноманітні методи діагностики ХЕ. Доведено можливість діагностики ХЕ за допомогою ультразвукового дослідження, виділено ультразвукові критерії діагностики ХЕ в різні фази менструального циклу [10]. Гістероскопія посідає провідне місце серед діагностичних методів ХЕ.…”