The impact of chronic endometritis on reproductive outcome

Objective To assess the prevalence of chronic endometritis and the impact on the fertility of asymptomatic patients indicated for in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment. Design In the context of a randomized controlled trial, a hysteroscopy-guided endometrial...

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Bibliographic Details
Published in:Fertility and sterility 2011-12, Vol.96 (6), p.1451-1456
Main Authors: Kasius, Jenneke C., M.D, Fatemi, Human M., M.D., Ph.D, Bourgain, Claire, M.D., Ph.D, Sie-Go, Daisy M.D.S., M.D., Ph.D, Eijkemans, René J.C., Ph.D, Fauser, Bart C., M.D., Ph.D, Devroey, Paul, M.D., Ph.D, Broekmans, Frank J.M., M.D., Ph.D
Format: Article
Language:English
Subjects:
Algorithms
Ambulatory Surgical Procedures
Bacterial diseases
Bacterial diseases of the genital system
Biological and medical sciences
biopsy
Birth control
birth rate
Chronic Disease
Chronic endometritis
confidence interval
embryo transfer
endometrial pathology
endometritis
Endometritis - complications
Endometritis - physiopathology
Endometritis - surgery
endometrium
Female
Gynecology. Andrology. Obstetrics
Human bacterial diseases
Humans
Hysteroscopy
ICSI
in vitro fertilization
Infectious diseases
infertility
Infertility, Female - complications
Infertility, Female - diagnosis
Infertility, Female - physiopathology
Infertility, Female - therapy
Internal Medicine
IVF
Live Birth
Medical sciences
Obstetrics and Gynecology
patients
plasma cell
Pregnancy
Pregnancy Rate
Prognosis
randomized clinical trials
Reproduction - physiology
Reproductive Techniques, Assisted
spermatozoa
Sterility. Assisted procreation
Treatment Outcome
ultrasonics
Uterine Diseases - complications
Uterine Diseases - physiopathology
Uterine Diseases - surgery
women
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Summary:Objective To assess the prevalence of chronic endometritis and the impact on the fertility of asymptomatic patients indicated for in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment. Design In the context of a randomized controlled trial, a hysteroscopy-guided endometrial biopsy was obtained and histologically examined. The live birth rate (including spontaneous pregnancies) after initiation of IVF/ICSI treatment of patients diagnosed with chronic endometritis was compared with the live birth rate of a randomly selected matched control group of patients without endometritis. Setting Two tertiary infertility care units. Patient(s) A total of 678 asymptomatic infertile women with a normal transvaginal ultrasound (TVS) who underwent diagnostic hysteroscopy before a first IVF/ICSI treatment cycle. Intervention(s) Hysteroscopy guided endometrial biopsy. Main outcome measure(s) The prevalence of chronic endometritis and the live birth rate (including spontaneous pregnancies) within 3 years after initiation of the randomized controlled trial. Result(s) The prevalence of chronic endometritis in the 606 patients with an adequate biopsy was 2.8%. The cumulative live birth rate (including spontaneous pregnancies) did not significantly differ between patients with or without endometritis: 76% versus 54%. Also, the clinical pregnancy rate per embryo transfer was not significantly different (hazard ratio 1.456, 95% confidence interval 0.770–2.750). Conclusion(s) Chronic endometritis can be rarely diagnosed in a population of asymptomatic infertile patients with a normal TVS before a first IVF/ICSI treatment. Moreover, the reproductive outcome after initiation of IVF/ICSI was not found to be negatively affected by chronic endometritis. In conclusion, the clinical implication of chronic endometritis seems minimal.
ISSN:0015-0282
1556-5653
DOI:10.1016/j.fertnstert.2011.09.039