The Association between Endometriosis and Chronic Endometritis

Takebayashi, Akie; Kimura, Fuminori; Kishi, Yohei; Ishida, Mitsuaki; Takahashi, Akimasa; Yamanaka, Akiyoshi; Takahashi, Kentaro; Suginami, Hiroshi; Murakami, Takashi

doi:10.1371/journal.pone.0088354

Cited by 112 publications

(102 citation statements)

References 33 publications

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“…From these recent findings, it is presumed that a worsening of IUMC and a higher occurrence of endometritis could occur in women with endometriosis after GnRHa treatment. These findings of the association between endometriosis and chronic endometriosis were supported by two recently published reports …”

Section: Intrauterine Microbial Colonization After Treatment With An supporting

confidence: 85%

Bacterial contamination hypothesis: a new concept in endometriosis

Khan

Fujishita

Hiraki

et al. 2018

Reprod Medicine & Biology

100

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BackgroundEndometriosis is a multifactorial disease that mainly affects women of reproductive age. The exact pathogenesis of this disease is still debatable. The role of bacterial endotoxin (lipopolysaccharide, LPS) and Toll‐like receptor 4 (TLR4) in endometriosis were investigated and the possible source of endotoxin in the pelvic environment was examined.MethodsThe limulus amoebocyte lysate test was used to measure the endotoxin levels in the menstrual fluid and peritoneal fluid and their potential role in the growth of endometriosis was investigated. Menstrual blood and endometrial samples were cultured for the presence of microbes. The effect of gonadotrophin‐releasing hormone agonist (GnRHa) treatment on intrauterine microbial colonization (IUMC) and the occurrence of endometritis was investigated.Main findings (Results)Lipopolysaccharide regulates the pro‐inflammatory response in the pelvis and growth of endometriosis via the LPS/TLR4 cascade. The menstrual blood was highly contaminated with Escherichea coli and the endometrial samples were colonized with other microbes. A cross‐talk between inflammation and ovarian steroids or the stress reaction also was observed in the pelvis. Treatment with GnRHa further worsens intrauterine microbial colonization, with the consequent occurrence of endometritis in women with endometriosis.ConclusionFor the first time, a new concept called the “bacterial contamination hypothesis” is proposed in endometriosis. This study's findings of IUMC in women with endometriosis could hold new therapeutic potential in addition to the conventional estrogen‐suppressing agent.

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Section: Intrauterine Microbial Colonization After Treatment With An supporting

confidence: 85%

Bacterial contamination hypothesis: a new concept in endometriosis

Khan

Fujishita

Hiraki

et al. 2018

Reprod Medicine & Biology

100

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“…CE also has been associated with endometriosis (27). Based on our results, it could be hypothesized that altered uterine contractility may induce retrograde menstruation and ectopic implantation of endometrial epithelium.…”

Section: Discussionsupporting

confidence: 58%

Altered uterine contractility in women with chronic endometritis

Pinto

Matteo

Tinelli

et al. 2015

Fertility and Sterility

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“…Endometritis, an inflammation of the endometrium, is also associated with infertility and obstetrical complications (49). Endometritis is associated with aberrant inflammatory cytokine expression and has been associated with endometriosis (50). Polycystic ovary syndrome, a common cause of infertility and the most common endocrinopathy affecting reproductive-aged women, is associated with reduced endometrial receptivity (51, 52).…”

Section: Impaired Expression Of Endometrial Factors Correlates With Rmentioning

confidence: 99%

Local and systemic factors and implantation: what is the evidence?

Fox

Morin

Jeong

et al. 2016

Fertility and Sterility

139

124

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Significant progress has been made in the understanding of embryonic competence and endometrial receptivity since the inception of Assisted Reproductive Technologies (ART). The endometrium is a highly dynamic tissue that plays a crucial role in the establishment and maintenance of normal pregnancy. In response to steroid sex hormones, the endometrium undergoes marked changes during the menstrual cycle that are critical for acceptance of the nascent embryo. There is also a wide body of literature on systemic factors that impact ART outcomes. Patient prognosis is impacted by an array of factors that tip the scales in her favor or against success. Recognizing the local and systemic factors will allow clinicians to better understand and optimize the maternal environment at the time of implantation. This review will address the current literature on endometrial and systemic factors related to impaired implantation and highlight recent advances in this area of reproductive medicine.

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The Association between Endometriosis and Chronic Endometritis

Cited by 112 publications

References 33 publications

Bacterial contamination hypothesis: a new concept in endometriosis

Bacterial contamination hypothesis: a new concept in endometriosis

Altered uterine contractility in women with chronic endometritis

Local and systemic factors and implantation: what is the evidence?

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