Occurrence of chronic endometritis in different types of human adenomyosis

Khaleque Newaz Khan, Akira Fujishita, Kanae Ogawa, Akemi Koshiba, Taisuke Mori, Kyoko Itoh, Masahiro Nakashima, Jo Kitawaki
Reproductive medicine and biology · 2021 · vol. 21(1) , pp. e12421 · doi:10.1002/rmb2.12421 · PMID:35386364 · PMC8967303 · W3209100899
article OA: gold CC0 ⤵ 26 in-corpus citations
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This study found that focal and diffuse adenomyosis had a higher trend of chronic endometritis occurrence compared to controls, with focal adenomyosis showing more chronic endometritis on the ipsilateral side.

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Abstract

Abstract Purpose Human adenomyosis has an adverse effect on female fertility. Exact mechanistic basis is still unclear. We investigated the occurrence of chronic endometritis (CE) in different types of human adenomyosis. Methods This is a prospective non‐randomized observational study enrolling patients with focal ( n = 30), diffuse ( n = 26), intrinsic ( n = 23), and extrinsic ( n = 10) adenomyosis. Endometrial biopsy samples were collected from hysterectomy specimens. Immunohistochemical analysis was performed using antibody against CD68 (Mφ marker) with biopsy samples of intrinsic/extrinsic adenomyosis and CD138 (Syndecan‐1), a marker of plasma cells, in all biopsy samples. Results In GnRHa‐untreated groups, a higher trend in the occurrence of CE, as characterized by infiltration of ≥1 plasma cells in endometrial stroma, was found in women with focal (58.8%, p = 0.0849) and diffuse adenomyosis (60.0%, p = 0.0841) comparing to control women (10.0%). In women with focal adenomyosis, ipsilateral side showed a significantly higher occurrence of CE (58.8%) than on the contralateral side (11.7%) ( p = 0.043). Tissue infiltration of macrophages in endometria was significantly higher in intrinsic than in extrinsic adenomyosis ( p = 0.03) without showing any significant difference in the occurrence of CE between these two variants of adenomyosis. Conclusion A variable occurrence of CE in different types of adenomyosis may be involved in adverse reproductive outcome.

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adenomyosis

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