The Impact of Chronic Endometritis on Infertility: Prevalence, Reproductive Outcomes, and the Role of Hysteroscopy as a Screening Tool.
Gynecol Obstet Invest
; 88(2): 108-115, 2023.
Article
en En
| MEDLINE
| ID: mdl-36739858
ABSTRACT
OBJECTIVES:
The objective of this study was to examine the prevalence of chronic endometritis (CE) in infertile women, its impact on reproductive outcomes, and the accuracy of hysteroscopy as a screening tool for CE.DESIGN:
This was a prospective observational study.PARTICIPANTS:
Participants involved in this study were 514 asymptomatic patients with infertility.SETTING:
The review was conducted in a tertiary care center.METHODS:
The participants underwent a hysteroscopy and endometrial biopsy (EMB). Antibiotics were given for cases of CE. We investigated the prevalence of CE in patients starting assisted reproductive technologies (ART) as a primary outcome. Secondary outcomes were the clinical pregnancy rate (CPR) in the ART cycle after hysteroscopy, EMB, and antibiotic treatment in cases of CE; the cumulative CPR in the subsequent 2 years after hysteroscopy and EMB; the sensitivity and specificity of hysteroscopy as a screening tool compared to EMB as the "gold standard" for diagnosing CE.RESULTS:
CE was identified in 2.8% of patients starting ART (11/393). CPRs did not differ significantly between patients with CE and the entire cohort of patients without CE in the subsequent ART cycle (OR 0.43; 95% CI 0.09-2.02) or in the 2 years after EMB (OR 0.56; 95% CI 0.16-1.97). In a matched control comparison (with matching for age, basal FSH, and cause of infertility), CPR in patients with CE did not differ in the subsequent ART cycle (OR 0.39; 95% CI 0.09-1.61); however, their CPR in the 2 years after EMB was significantly lower (OR 0.22; 95% CI 0.13-0.38). The sensitivity and specificity of hysteroscopy as a screening tool for diagnosing CE were 8.3% and 90.1%, respectively.LIMITATIONS:
Due to our cohort's low CE prevalence, we could not detect significant differences in CPRs.CONCLUSION:
CE is rare in our studied population of asymptomatic patients starting ART. Hysteroscopy cannot replace EMB for diagnosing CE.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Histeroscopía
/
Endometritis
/
Infertilidad Femenina
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Límite:
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
Gynecol Obstet Invest
Año:
2023
Tipo del documento:
Article
País de afiliación:
Bélgica