The hysteroscopy and histological diagnosis and treatment value of chronic endometritis in recurrent implantation failure patients

Yang, Rui; Du, Xiaoguo; Wang, Ying; Song, Xueling; Yang, Yan; Qiao, Jie

doi:10.1007/s00404-013-3131-2

Cited by 125 publications

(150 citation statements)

References 25 publications

Supporting

Mentioning

131

Contrasting

Unclassified

Order By: Relevance

“…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

196

144

View full text Add to dashboard Cite

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.

show abstract

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

196

144

View full text Add to dashboard Cite

show abstract

“…During the last decade hysteroscopy has become the tool of choice for the evaluation of the endometrial cavity including assessment of abnormal uterine bleeding (AUB), infertility, and recurrent pregnancy loss (RPL) [1][2][3]. The ever increasing value of diagnostic and operative hysteroscopy for patients with AUB serves as an appropriate tribute to Pantaleoni, who in 1869 described this procedure to look inside the uterus and could visualize an endometrial polyp [4].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Intrauterine Pathology: Efficacy of Diagnostic Hysteroscopy in Comparison to Histopathological Examination

Elbareg¹

2015

Reprod Syst Sex Disord

View full text Add to dashboard Cite

The aim of this work is to evaluate the diagnostic accuracy of hysteroscopy compared to histopathological findings in cases with intrauterine pathology. This prospective clinical trial was carried out over a period of two years. 280 patients were recruited with an average of 45 years (range: 25-65 years). Two hundred and thirty patients (82.14%) with abnormal findings in ultrasound examinations, the remaining 50 (17.85%) had normal scan, referred mainly because of abnormal uterine bleeding (AUB) and infertility. Hysteroscopic findings divided into; uterine cavity lesions: endometrial or cervical polyps, myomas, cysts, placental derbis, adhesions, congenital malformations and IUCD retention, endometrial characterization including: functional, dysfunctional, atrophic endometrium, hyperplasia, polypoid and carcinoma. Biopsies or removal of pathology were performed and sent for histopathology examinations, results were compared with hysteroscopic findings. Sensitivity, Specificity and predictive value (PV) of hysteroscopy were calculated. Results: uterine cavity abnormalities were detected in (71.4%) patients, significantly more at ages of >30 years (58.3%) compared with ages of <30 years (34.6%) (P<0.05). In benign endometrial lesions, the sensitivity of hysteroscopy was (98.9%), specificity was (97.5%), positive predictive value was (98.8%), negative predictive value was (98.5%) with diagnostic accuracy of 98.3%, same parameters for endometrial characterization: (78.9%), (90.7%), (82.8%), (90.9%) with diagnostic accuracy of 87.8%. Conclusions: Hysteroscopy allows direct visualization of uterine cavity, it is a safe and reliable procedure for evaluating benign endometrial lesion, but in view of poor validity to exclude endometrial hyperplasia and cancer, it is recommended always to perform diagnostic hysteroscopy combined with biopsy procedures, giving it an irreplaceable value in diagnosis and treatment of intrauterine disease.

show abstract

“…In cases of CE, the peaceful co-existence between the host immunity and microorganisms breaks down, the distribution of lymphocytes involved in the implantation of embryos is altered, and ultimately, EM receptivity is reduced due to the inadequate secretion of various cytokines. Recent clinical studies in patients with RPL or RIF showed that antibiotic treatment for CE could produce dramatic changes in future pregnancy outcomes [14222425]. Our review article attempted to evaluate the benefits of hysteroscopic procedures in the diagnosis and treatment of latent CE as an addition to extant theories.…”

Section: Discussionmentioning

confidence: 99%

“…In a retrospective study including patients with unexplained RPL, the patients in whom hysteroscopic findings normalized after antibiotic treatment for CE, regardless of the results of endometrial cultures, showed a significantly higher incidence of successful pregnancy than the patients who did not show normalization [24]. Considering the link between hysteroscopic CE findings and poor reproductive outcomes, the difficulties involved in the pathological diagnosis of CE, and the discrepancy between pathological and hysteroscopic findings, hysteroscopic evaluation of the endometrial cavity should be considered as a regular test in clinical practice in the assessment of patients with RIF or RPL [2425]. …”

Section: Diagnosis Of Cementioning

confidence: 99%

“…According to the retrospective study of Yang et al [25], the implantation rate (18.6% [18 of 97] vs. 4.9% [3 of 61]) and the ongoing pregnancy rate (29.3% [12 of 41] vs. 7.4% [2/27]) in IVF-ET cycles significantly increased after antibiotic treatment, in comparison to pre-treatment outcomes. Cicinelli et al [22] conducted a retrospective study of RIF patients undergoing fresh IVF-ET cycles, and found that the clinical pregnancy rate and the live birth rate in the group with normal hysteroscopic findings after antibiotic treatment were significantly higher than in the group with consistent CE findings (65% vs. 33% and 60.8% vs. 13.3%, respectively).…”

Section: Treatment Of Cementioning

confidence: 99%

See 1 more Smart Citation

Chronic endometritis and infertility

Park

Kim

Yoon

et al. 2016

Clin Exp Reprod Med

140

111

View full text Add to dashboard Cite

Chronic endometritis (CE) is a condition involving the breakdown of the peaceful co-existence between microorganisms and the host immune system in the endometrium. A majority of CE cases produce no noticeable signs or mild symptoms, and the prevalence rate of CE has been found to be approximately 10%. Gynecologists and pathologists often do not focus much clinical attention on CE due to the time-consuming microscopic examinations necessary to diagnose CE, its mild clinical manifestations, and the benign nature of the disease. However, the relationship between CE and infertility-related conditions such as repeated implantation failure and recurrent miscarriage has recently emerged as an area of inquiry. In this study, we reviewed the literature on the pathophysiology of CE and how it may be associated with infertility, as well as the literature regarding the diagnosis and treatment of CE. In addition, we discuss the value of hysteroscopic procedures in the diagnosis and treatment of CE.

show abstract

The hysteroscopy and histological diagnosis and treatment value of chronic endometritis in recurrent implantation failure patients

Abstract: CE occurs frequently in RIF patients; hysteroscopy has more diagnostic and treatment value for them.

Cited by 125 publications

References 25 publications

Review: Chronic endometritis and its effect on reproduction

Review: Chronic endometritis and its effect on reproduction

Evaluation of Intrauterine Pathology: Efficacy of Diagnostic Hysteroscopy in Comparison to Histopathological Examination

Chronic endometritis and infertility

Contact Info

Product

Resources

About