Performance of hysteroscopy in diagnosing chronic endometritis and the role of intra- and inter-observer variability: a prospective study of 70 cases

Ahmed Halouani; Haithem Aloui; Rim Hamdaoui; Y. Masmoudi; Amel Triki; A. Ben Amor; Lazhar Halouani

doi:10.1016/j.xagr.2025.100515

Performance of hysteroscopy in diagnosing chronic endometritis and the role of intra- and inter-observer variability: a prospective study of 70 cases

Ahmed Halouani, Haithem Aloui, Rim Hamdaoui, Y. Masmoudi, Amel Triki, A. Ben Amor, Lazhar Halouani

In: AJOG Global Reports · 2025 · vol. 5(3) , pp. 100515 · doi:10.1016/j.xagr.2025.100515 · PMID:40607240 · W4410593669

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⚙ AI-generated summary by claude@2026-06, 2026-06-13 ⓘ

This study evaluated hysteroscopy's diagnostic performance for chronic endometritis and found it less sensitive than endometrial biopsy with CD138 analysis.

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Abstract

Introduction: Chronic endometritis (CE) is a persistent inflammation of the endometrium often implicated in female infertility. Histological examination with immunohistochemical (IHC) analysis of the plasma cell marker CD138 is the gold standard for diagnosing this condition. Methods: This prospective, multicentered, observational study was conducted from June 6, 2021, to August 8, 2022. We evaluated the diagnostic sensitivity and specificity of hysteroscopy (HSC) using the standardized criteria of Cicinelli et al, which include micro polyps, focal hyperemia, diffuse hyperemia, stromal edema, strawberry aspect, and hemorrhagic spots. We also assessed intra- and inter-observer variability in the hysteroscopic diagnosis of CE. Results: =0.58). Conclusion: HSC is not the examination of choice for diagnosing CE. An endometrial biopsy using the Novak curette with IHC analysis of CD138 expression is a more sensitive and less costly diagnostic method.

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Condition tags

infertilitydisambig:endometritis

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Too few in-corpus citations on either side for a chart; here are the lists.

Cites (2)

References (16)

Construction of deep learning-based convolutional neural network model for automatic detection of fluid hysteroscopic endometrial micropolyps in infertile women with chronic endometritis via openalex
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[1] Evaluation of Endometrium for Chronic Endometritis by Using Syndecan-1 in Abnormal Uterine Bleeding 2012

[2] Construction of deep learning-based convolutional neural network model for automatic detection of fluid hysteroscopic endometrial micropolyps in infertile women with chronic endometritis 2024