Chronic endometritis diagnosis and fertility outcomes: an old unresolved question

Early human evidence such as case series or small samples is exploring possible benefits.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Abstract Chronic endometritis, defined by chronic inflammation of the endometrium, remains a clinical and biologic challenge even using hysteroscopy allowing a direct vision of the uterine cavity without anesthesia, and conventional histology using Hematoxylin and Eosin staining. Our primary objectives were to evaluate the relevance of hysteroscopy and conventional histology compared to immunohistochemical expression of syndecan-1 (CD138, a marker of plasma cells), which is a heparan sulfate proteoglycan involved in inflammation and enables diagnosis of chronic endometritis. The second objective was to evaluate the impact of antibiotics on pregnancy rate. A retrospective study was conducted involving infertile women undergoing hysteroscopy and endometrial biopsy. Chronic endometritis was assessed using hysteroscopic findings and conventional histology compared to CD138 immunostaining. Effects of antibiotic therapy on CD138 expression on a second biopsy and on pregnancy rate were evaluated. Among the 661 infertile patients, 51 underwent hysteroscopy and endometrial biopsy. Twenty-three had a normal uterine cavity (45%) and among 28 patients with abnormal uterine cavity, ten (35.7%) had hysteroscopic findings of chronic endometritis. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the hysteroscopy were 22, 100, 100, and 17%, with an

Evidence level

Early human evidence such as case series or small samples is exploring possible benefits.

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