Existence of chronic endometritis and its influence on pregnancy outcomes in infertile women with minimal/mild endometriosis

Abstract

Objective This study aimed to evaluate the prevalence of chronic endometritis (CE) in women with minimal/mild endometriosis and to analyze whether CE affects their pregnancy outcomes. Methods This retrospective study included 201 infertile women who were diagnosed with minimal/mild endometriosis after undergoing hysteroscopy combined with laparoscopy from January 2016 to December 2018. Immunohistochemistry was used to detect CD138 and CD38, which are specific markers of plasma cells in the endometrial stroma to diagnose CE. Subsequently, we investigated the prevalence of CE and the effects of CE on spontaneous cumulative pregnancy rate, live birth rate, and miscarriage rate within 24 months after surgery. Results The prevalence of CE in infertile women with minimal/mild endometriosis was 24.38%. Patients diagnosed with CE showed a significantly lower cumulative pregnancy rate and live birth rate compared with women without CE (46.51% vs. 71.13% [P = 0.004]; 44.19% vs. 63.38% [P = 0.025]). However, the rate of miscarriage in women with CE was also lower than in women without CE (0 vs. 7.04%, P = 0.074). Conclusion Since CE had an adverse effect on cumulative pregnancy rate and live birth rate in infertile women with minimal/mild endometriosis, we suggested that diagnosis and treatment of CE may improve their pregnancy outcomes.

Does chronic endometritis affect pregnancy outcomes in patients with endometriosis associated infertility? A retrospective cohort study

“…Both EMS and CE are prevalent gynecological conditions. Moreover, CE, which is characterized by chronic in ammation of the endometrium due to pathogenic microorganisms, is a common cause of female infertility [ 14 ] . Evidence supports this claim.…”

“…Thus far, it is not entirely clear whether CE is a risk factor or an etiologic factor of EAI. Previous studies have revealed a higher CE frequency in patients with EMS compared to those without the disease [13][14][15] . These studies collectively indicate that the presence of EMS may be signi cantly associated with CE.…”

Seleno-Metabolites and Their Precursors: A New Dawn for Several Illnesses?

“…At present, antibiotic therapy is not enough to treat endometritis. This is a reproductive endocrine disorder and a chronic inflammatory disease that can lead to a decrease in fertility and productivity due to a disruption of the hormonal balance [46,168,169]. S. aureus is the main causative agent of this disease as well as other invasive infections.…”

Discussion issues in the treatment of chronic endometritis

“…Пациентки с бесплодием и диагнозом «ХЭ», по сравнению с женщинами без ХЭ, демонстрируют значительно более низкую кумулятивную частоту наступления беременности (46,5 против 71,1%) и живорождения (44,2 против 63,4%) соответственно при минимальной степени инфильтрации плазматическими клетками (ПК) [7]. Вне зависимости от тяжести ХЭ наблюдается еще более высокая разница, которую приводят K. Hirata et al: наступление беременности у 30,8 против 63,0%, живорождений -у 7,7 против 51,9% соответственно [8].…”