Endometrial preparation protocols did not impact pregnancy outcomes of patients with cured chronic endometritis

Hongzhan Zhang, Han Qiu, Qiu Han, Zhiqiang Liu, Shuyi Yu, Cong Chen, Yong Zeng, Yuye Li
In: Reproductive BioMedicine Online · 2023 · vol. 48(6) , pp. 103753 · doi:10.1016/j.rbmo.2023.103753 · PMID:38520803 · W4389060441
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This study investigated whether endometrial preparation protocols influence pregnancy outcomes in patients previously treated for chronic endometritis.

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Abstract

Research questionDo endometrial preparation protocols have an effect on pregnancy outcomes in patients with cured chronic endometritis?DesignA retrospective study was conducted on 3721 infertile patients from December 2018 to August 2020. Endometrial tissues obtained during the proliferative phase were immunostained for CD138. The presence of CD138-positive cells within the stromal cells indicated chronic endometritis. All patients diagnosed with chronic endometritis received oral antibiotics. Patients underwent endometrial preparation and frozen embryo transfer once chronic endometritis was cured. This study compared various endometrial preparation protocols to assess their effects on pregnancy outcomes. Additionally, it aimed to investigate differences in pregnancy outcomes between patients without chronic endometritis and patients with cured chronic endometritis while following the same endometrial preparation protocol.ResultsAlmost no differences in pregnancy outcomes were observed between natural cycle, hormone replacement therapy (HRT) and gonadotrophin-releasing hormone agonist-HRT (GnRH agonist-HRT) protocols in patients without chronic endometritis and patients with cured chronic endometritis. The only notable difference was that, among women without chronic endometritis, the early miscarriage rate was higher for the GnRH agonist-HRT protocol (25.8%) compared with the natural cycle (17.4%) and HRT (17.7%) protocols (P = 0.025). However, this difference was not significant after adjusting for confounders (adjusted OR 1.383, 95% CI 0.931-2.055). The live birth rate, clinical pregnancy rate, early miscarriage rate, ectopic pregnancy rate and ongoing pregnancy rate did not differ significantly (P > 0.05) between patients without chronic endometritis and patients with cured chronic endometritis who underwent natural cycle, HRT and GnRH agonist-HRT protocols.ConclusionEndometrial preparation protocols had no impact on pregnancy outcomes in patients with cured chronic endometritis.

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