Interaction Between Chronic Endometritis Caused Endometrial Microbiota Disorder and Endometrial Immune Environment Change in Recurrent Implantation Failure

Chen, Peigen; Chen, Panyu; Guo, Yingchun; Fang, Cong; Li, Tingting

doi:10.3389/fimmu.2021.748447

Cited by 52 publications

(64 citation statements)

References 44 publications

(48 reference statements)

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“…Common actors in the development of all these conditions may be some infectious agents. Notably, quantitative and qualitative alterations of endometrial microbiome were clearly demonstrated in CE, with a dominance of gram negative and intracellular bacteria [ 54 , 55 , 56 ]. In women with EPs, significant alterations of endometrial microbiome were also found (i.e., with increased percentages of Lactobacillus, Bifidobacterium, Gardnerella, Streptococcus, and Alteromonas and decreased expression of Pseudomonas) [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Endometrial Polyps and Chronic Endometritis: Is It Time for a Paradigm Shift in the Pathophysiology of Endometrial Polyps in Pre-Menopausal Women? Results of a Systematic Review and Meta-Analysis

et al. 2021

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Background: Chronic endometritis (CE) and endometrial polyps (EPs) are common conditions in reproductive age women. CE is an infectious disorder of the endometrium characterized by signs of chronic inflammation at hysteroscopic and histological analyses. EPs are abnormal endometrial growths containing glands, stroma and blood vessels projecting from the lining of the uterus. During the last years, different authors have investigated the correlation between CE and EPs, with controversial results. The aim of this study was to summarize available evidence on the potential correlation between CE and EPs. Design: Systematic literature review and meta-analysis. Methods: Observational-studies were identified by searching electronic databases from their inception to September 2021. Only studies on pre-menopausal women were included. Statistical analysis was performed using MedCalc 16.4.3 (Ostend, Belgium) and Review Manager version 5.3 (Nordic Cochrane Centre, Cochrane Collaboration). The summary measures were reported as pooled proportion or odds ratio (OR) with 95% confidence interval (CI). The primary outcome was to evaluate the prevalence of CE in women with EPs. The secondary outcome was to determine the prevalence of CD-138-positive EPs among EPs. Tertiary outcomes were to compare the prevalence of CE in women with EPs versus women with a non-polypoid endometrium and to compare the prevalence of CE in women with a single EP versus women with multiple EPs. Results: Eight observational studies (n = 3225 patients) were included in quantitative synthesis. Pooled prevalence of CE among women with EPs was 51.35% (95% CI, 27.24–75.13%). Pooled proportion of CD-138-positive EPs among EPs was 70.73% (95% CI, 55.73–83.68%). Women with EPs showed higher prevalence of CE compared to women without EPs (OR 3.07, 95% CI 1.59–5.95). Women with ≥3 EPs had higher prevalence of CE then women with a single EP (OR 3.43, 95% CI 1.83–6.46). Conclusions: In pre-menopausal women, CE and EPs may have a dependent relationship and may represent two consequent steps of a common pathological process.

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Section: Discussionmentioning

confidence: 99%

Association between Endometrial Polyps and Chronic Endometritis: Is It Time for a Paradigm Shift in the Pathophysiology of Endometrial Polyps in Pre-Menopausal Women? Results of a Systematic Review and Meta-Analysis

et al. 2021

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“…and Gardnerella spp. were associated with CE [ 69 ]; and higher numbers of Phyllobacterium and Sphingomonas are also reported in CE patients [ 70 ]. Comparison of the intrauterine microbiome of 20 patients with polyps and CE and 10 healthy individuals identified higher proportions of bacteria such as Bifidobacterium , Gardnerella, Lactobacillus , and Streptococcus in the patient group and higher numbers of Pseudomonas in the healthy control group [ 71 ].…”

Section: Microbiota Alterations In Infertilitymentioning

confidence: 99%

The Endometrial Microbiome and Its Impact on Human Conception

Toson¹,

Simón

Moreno-Gimeno

2022

IJMS

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Changes in the female genital tract microbiome are consistently correlated to gynecological and obstetrical pathologies, and tract dysbiosis can impact reproductive outcomes during fertility treatment. Nonetheless, a consensus regarding the physiological microbiome core inside the uterine cavity has not been reached due to a myriad of study limitations, such as sample size and experimental design variations, and the influence of endometrial bacterial communities on human reproduction remains debated. Understanding the healthy endometrial microbiota and how changes in its composition affect fertility would potentially allow personalized treatment through microbiome management during assisted reproductive therapies, ultimately leading to improvement of clinical outcomes. Here, we review current knowledge regarding the uterine microbiota and how it relates to human conception.

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“…To date, it still remains unclear whether opportunistic microorganisms detected in the endometrium have a negative impact on implantation, what composition of the uterine microbiota is considered to be normal and which one is associated with dysbiosis having an adverse effect on implantation, and where is the line between the norm and pathology in quantitative and qualitative ratio [ 10 – 13 ].…”

Section: Introductionmentioning

confidence: 99%

Does the uterine microbiota affect the reproductive outcomes in women with recurrent implantation failures?

et al. 2022

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Background Inefficiency of in vitro fertilization (IVF) programs can be caused by implantation failures. The uterine microbiota can influence the implantation process. However, it still remains unclear whether opportunistic microorganisms detected in the endometrium have a negative impact on the implantation success. The aim of our study was to evaluate the influence of the uterine microbiota on the embryo implantation success in patients undergoing assisted reproductive technologies. Methods The study included 130 women diagnosed with infertility. The patients were divided into three groups: group I included women with the first IVF attempt (n = 39); group II included patients with recurrent implantation failure following embryo transfer with ovarian stimulation (n = 27); group III consisted of women with recurrent implantation failure following frozen-thawed embryo transfer (n = 64). We performed microbiological examination of the embryo transfer catheter which was removed from the uterine cavity after embryo transfer; cervical discharge of all the patients was studied as well. Thirty patients were selected for metagenomic sequencing. Results The study showed that the uterine cavity is not free of microorganisms. A total of 44 species of microorganisms were detected: 26 species of opportunistic organisms and 18 species of commensals (14 species of lactobacilli and 4 species of bifidobacteria). Obligate anaerobic microorganisms and Gardnerella vaginalis were detected more frequently in group I compared to group III (strict anaerobes—15.4 and 1.6%; G. vaginalis—12.8 and 1.6%, respectively) (p < 0.05). However, this fact did not have a negative influence on the pregnancy rate: it was 51.3% in group I, it was 29.6% and 35.9% in women with recurrent implantation failures, respectively. Conclusion Opportunistic microorganisms which were revealed in low or moderate titers (103–105 CFU/ml) in the uterine cavity and cervical canal did not affect the pregnancy rate in the women in the study groups. The microflora of the uterine cavity and cervical canal differed in qualitative composition in 87.9% of patients, therefore, we can suggest that the uterine cavity may form its own microbiota. The microbiota of the uterine cavity is characterized by fewer species diversity compared to the microbiota of the cervical canal.

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Interaction Between Chronic Endometritis Caused Endometrial Microbiota Disorder and Endometrial Immune Environment Change in Recurrent Implantation Failure

Cited by 52 publications

References 44 publications

Association between Endometrial Polyps and Chronic Endometritis: Is It Time for a Paradigm Shift in the Pathophysiology of Endometrial Polyps in Pre-Menopausal Women? Results of a Systematic Review and Meta-Analysis

Association between Endometrial Polyps and Chronic Endometritis: Is It Time for a Paradigm Shift in the Pathophysiology of Endometrial Polyps in Pre-Menopausal Women? Results of a Systematic Review and Meta-Analysis

The Endometrial Microbiome and Its Impact on Human Conception

Does the uterine microbiota affect the reproductive outcomes in women with recurrent implantation failures?

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