Decreased Fertility in Women with Cesarean Scar Syndrome Is Associated with Chronic Inflammation in the Uterine Cavity

Nobuta Y, Yuri Nobuta, Shunichiro Tsuji, Jun Kitazawa, Kitazawa J, Tetsuro Hanada, Hanada T, Akiko Nakamura, Nakamura A, Rika Zen, Zen R, Tsukuru Amano, Amano T, Takashi Murakami, Murakami T
The Tohoku Journal of Experimental Medicine · 2022 · vol. 258(3) , pp. 237–242 · doi:10.1620/tjem.2022.j082 · PMID:36244756 · W4306667499
article OA: diamond CC0 ⤵ 6 in-corpus citations
🔓 Open OA copy Full text JSON View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

This study found that women with cesarean scar syndrome have a higher incidence of chronic endometritis and elevated inflammatory markers in their uterine cavities, contributing to infertility.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This ambidirectional cohort study at a single university hospital examined whether chronic inflammation within the uterine cavity is associated with infertility in women with cesarean scar syndrome. It retrospectively compared the frequency of chronic endometritis between cesarean scar syndrome and non-cesarean scar syndrome groups and prospectively measured tumor necrosis factor-α and interleukin-1β in the uterine cavity in cesarean scar syndrome patients versus women with a history of cesarean section. Chronic endometritis was more frequent in the cesarean scar syndrome group (65.8% vs 46.0%), and TNF-α and IL-1β levels were higher in this group; endometriosis was detected in 70% of cesarean scar syndrome patients who underwent laparoscopy. A key limitation is that infertility outcomes beyond these inflammatory measures were not directly modeled in the summary, and endometriosis assessment applied only to a subset undergoing laparoscopy. This paper is centrally about endometriosis and chronic uterine inflammation in the context of cesarean scar syndrome, and it relates to endometriosis through its laparoscopy detection rate and to adenomyosis only indirectly by focusing on uterine inflammatory mechanisms tied to fertility impairment.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

Chronic 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.
Full text 3,339 characters · extracted from oa-doi-fallback · click to expand
Regular Contribution Decreased Fertility in Women with Cesarean Scar Syndrome Is Associated with Chronic Inflammation in the Uterine Cavity 2022 Volume 258 Issue 3 Pages 237-242 Details Abstract Chronic 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. © 2022 Tohoku University Medical Press This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license. This 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. https://creativecommons.org/licenses/by-nc-nd/4.0/ Favorites & Alerts Recently viewed articles - About this Journal The 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 plagiarism with Similarity Check (https://www.crossref.org/services/similarity-check/). Announcements from publisher - Subscriptions Inland subscriptions should be sent to Tohoku University Medical Press, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, JAPAN. Subscriptions from abroad should be addressed to MARUZEN CO., LTD., EXPORT DEPARTMENT, Postal address: P.O.Box 75, Shinagawa, Tokyo 140-8799, JAPAN. e-mail: [email protected]

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

mesh:D004716endometriosisinfertility

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (26)

Cited by (6)

Source provenance

europepmc
last seen: 2026-09-10T06:15:44.054944+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-09-10T06:15:39.278259+00:00
License: CC0 · commercial use OK