{"paper_id":"c3534c30-f3ce-46ac-8c4e-a2e095383488","body_text":"Regular Contribution\nDecreased Fertility in Women with Cesarean Scar Syndrome Is Associated with Chronic Inflammation in the Uterine Cavity\n2022 Volume 258 Issue 3 Pages 237-242\nDetails\nAbstract\nChronic inflammation in cesarean scar defect contributes to secondary infertility in women with cesarean scar syndrom; however, it remains unclear about the situation of inflammation in uterine cavity in women with cesarean scar syndrome. This ambidirectional cohort study aimed to explore the effect of inflammation in the uterine cavities of women with cesarean scar syndrome on infertility at a single university hospital. The frequency of chronic endometritis in infertile patients was retrospectively compared between the cesarean scar syndrome group and non-cesarean scar syndrome group. The frequency of endometriosis was also investigated in patients with cesarean scar syndrome who underwent laparoscopy. The level of tumor necrosis factor-α and interleukin-1β in the uterine cavity was prospectively evaluated in the cesarean scar syndrome group and in women with a history of cesarean section (control group) using an enzyme-linked immunosorbent assay. There was a significant difference in the incidence of chronic endometritis between the cesarean scar syndrome and non-cesarean scar syndrome groups (65.8% and 46.0%, respectively, p = 0.0315). Endometriosis was detected in 51 (70%) patients with laparoscopy. Tumor necrosis factor-α and interleukin-1β levels in the cesarean scar syndrome group were significantly higher than those in the control group (p = 0.0002 and p = 0.0217, respectively). Our findings suggest that one cause of secondary infertility in women with cesarean scar syndrome is embryo implantation failure-associated chronic endometritis, endometriosis, and chronic inflammation in the uterine cavity.\n© 2022 Tohoku University Medical Press\nThis article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.\nThis is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC-BY-NC-ND 4.0). Anyone may download, reuse, copy, reprint, or distribute the article without modifications or adaptations for non-profit purposes if they cite the original authors and source properly.\nhttps://creativecommons.org/licenses/by-nc-nd/4.0/\nFavorites & Alerts\nRecently viewed articles\n- About this Journal\nThe Tohoku Journal of Experimental Medicine (TJEM) was founded in 1920 by professors of Tohoku Imperial University, Medical School. The TJEM has been published continuously, except for the year of 1946 just after the World War II. The TJEM is open to original articles in all branches of medical sciences. The TJEM also covers the fields of disaster-prevention science, including earthquake archeology. - Submitted manuscripts will be screened for\nplagiarism with Similarity Check (https://www.crossref.org/services/similarity-check/).\nAnnouncements from publisher\n- Subscriptions\nInland subscriptions should be sent to Tohoku University Medical Press, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, JAPAN.\nSubscriptions from abroad should be addressed to MARUZEN CO., LTD., EXPORT DEPARTMENT, Postal address: P.O.Box 75, Shinagawa, Tokyo 140-8799, JAPAN.\ne-mail: export@maruzen.co.jp","source_license":"CC0","license_restricted":false}