Is Chronic Endometritis Associated with Tubal Infertility? A Prospective Cohort Study

Holzer I, Iris Holzer, Johannes Ott, Kurz C, Christine Kurz, Gerda Hofstetter, Hofstetter G, Marlene Hager, Lorenz Kuessel, Parry JP, John P Parry, John Preston Parry
Journal of Minimally Invasive Gynecology · 2021 · vol. 28(11) , pp. 1876–1881 · doi:10.1016/j.jmig.2021.04.011 · PMID:33892185 · W3154234230
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This prospective cohort study investigated whether chronic endometritis is associated with tubal infertility, comparing prevalence and potential contributing factors between infertile women with and without tubal disease.

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Abstract

Study objectiveChronic endometritis (CE), which often presents asymptomatically, is associated with recurrent pregnancy loss, recurrent implantation failure after in vitro fertilization, and endometriosis. Data connecting CE with fallopian tubal occlusion are limited. The aim was to assess a potential association of CE, defined by the presence of syndecan-1 (CD138)-positive plasma cells in endometrial tissue samples, with fallopian tube patency and other factors for infertility, including endometriosis, adenomyosis, and hydrosalpinges.DesignProspective, monocentral pilot study.SettingTertiary care center.PatientsA cohort of 100 women who were infertile was enrolled from July 2019 to December 2020.InterventionsHysteroscopy with endometrial biopsy and laparoscopy with chromopertubation.Measurements and main resultsCE was found in 13 women (13.0%) and was associated with endometriosis (p = .034) and unilateral/bilateral fallopian tube blockage (p = .013). In women with endometriosis, the mean number of CD138-positive cells was positively correlated with the revised American Society for Reproductive Medicine score (r = .302, p = .028). In a binary regression model, the presence of a hydrosalpinx on one or both sides (odds ratio 15.308; 95% confidence interval, 1.637-143.189; p = .017) and the finding of CE in the endometrial tissue sample (odds ratio 5.273; 95% confidence interval, 1.257-22.116; p = .023) were significantly associated with fallopian tubal occlusion.ConclusionCE was significantly associated with blockage of the fallopian tubes and endometriosis. Endometriosis stage was associated with the number of CD138-positive cells in endometrial biopsies.

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Condition tags

mesh:D004716infertilitydisambig:endometritis

MeSH descriptors

Endometritis Endometritis Endometritis Fallopian Tube Diseases Fallopian Tube Diseases Fallopian Tube Diseases Infertility, Female Infertility, Female Cohort Studies Female Humans Pilot Projects Pregnancy Prospective Studies

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