Effect of chronic endometritis on pregnancy outcome in patients undergoing assisted reproductive technology

Chaoyu ZHANG; Lin ZHU; Xiaojuan TU; Yuyan LI; Xinlin ZHOU; Wei HE

doi:10.16016/j.2097-0927.202202065

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Effect of chronic endometritis on pregnancy outcome in patients undergoing assisted reproductive technology

Clinical Medicine | 更新时间：2026-01-09

- Effect of chronic endometritis on pregnancy outcome in patients undergoing assisted reproductive technology
- Journal of Army Medical University Vol. 44, Issue 8, Pages: 829-834(2022)
- 作者机构：
  
  400038 重庆，陆军军医大学(第三军医大学)第一附属医院生殖医学中心
- 作者简介：
- 基金信息：
  
  the Special Scientific Research Project of Family Planning(17JS002);the Scientific and Technological Innovation Special Fund for Social Undertaking and People's Livelihood Security of Chongqing(cstc2017shms-zdyfX0035)
- DOI：10.16016/j.2097-0927.202202065
  CLC： R711.32;R713.7;R714.2
- Received：15 February 2022，
  
  Revised：2022-03-16，
  
  Published：30 April 2022
- 稿件说明：
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Chaoyu ZHANG, Lin ZHU, Xiaojuan TU, et al. Effect of chronic endometritis on pregnancy outcome in patients undergoing assisted reproductive technology[J]. Journal of Army Medical University, 2022, 44(8): 829-834.
DOI：

Chaoyu ZHANG, Lin ZHU, Xiaojuan TU, et al. Effect of chronic endometritis on pregnancy outcome in patients undergoing assisted reproductive technology[J]. Journal of Army Medical University, 2022, 44(8): 829-834. DOI： 10.16016/j.2097-0927.202202065.

摘要

目的

探讨慢性子宫内膜炎(chronic endometritis，CE)对辅助生殖助孕患者妊娠结局的影响，评估规范性治疗的临床意义。

方法

回顾性分析2019年1月至2021年1月在陆军军医大学第一附属医院生殖医学中心接受辅助生殖技术助孕的患有慢性子宫内膜炎的不孕症患者资料。根据患者子宫内膜组织中CD138阳性细胞数目，将患者分为重度(>10个/HPF)及轻度(≤10个/HPF)组；再根据抗生素规范治疗后CE是否明确痊愈分为治愈组与治疗组。比较不同分组的患者间生化妊娠率、临床妊娠率、早期流产率、胚胎着床率及活产率的差异。

结果

纳入研究的155例患者中轻度CE 91例，重度CE 64例；治愈组56例，治疗组99例。治愈组子宫内膜中的CD138阳性细胞数目显著高于治疗组(19.32±13.72

11.52±10.32，

＜0.05)。两组间的胚胎着床率(34.95%

27.42%，

=0.219)及早期流产率(13.33%

25.00%，

=0.235)差异无统计学意义；但治愈组的生化妊娠率(64.29%

43.43%，

=0.013)、临床妊娠率(53.57%

36.36%，

=0.037)、活产率(46.43%

27.27%，

=0.016)

均明显高于治疗组。在轻度CE中，治愈组与治疗组患者的生化妊娠率、临床妊娠率、早期流产率、活产率及胚胎着床率差异均无统计学意义。在重度CE中，除胚胎着床率和早期流产率外，治愈组的生化妊娠率(76.47%

43.33%，

=0.007)、临床妊娠率(64.71%

33.33%，

=0.012)、活产率(58.82%

20.00%，

=0.002)均明显高于治疗组。

结论

慢性子宫内膜炎对辅助生殖结局有不利影响，规范的抗生素治疗可改善CE患者的妊娠结局。

Abstract

Objective

To investigate the impact of chronic endometritis (CE) on pregnancy outcome in patients with assisted reproduction and to evaluate the clinical significance of normative therapy.

Methods

A retrospective analysis was performed on infertile patients with chronic endometritis who received assisted reproductive technology during January 2019 to January 2021 in our center. According to the number of CD138-positive cells in endometrial tissues

they were divided into severe group (>10 /HPF) and mild group (≤10 /HPF). Then according to whether CE was clearly cured after standard treatment with antibiotics

they were divided into cured group and treated group. The differences of biochemical pregnancy rate

clinical pregnancy rate

early abortion rate

embryo implantation rate and live birth rate were compared among different groups of patients.

Results

A total of 155 patients were enrolled

including 56 patients in the cured group and 99 patients in the treated group. And there were 91 patients with mild CE and 64 with severe CE. The number of CD138-positive cells in the cured group was significantly higher than that in the treated group (19.32±13.72

11.52±10.32

0.05). There were no significant differences in embryo implantation rate (34.95%

27.42%

=0.219) and early abortion rate (13.33%

25.00%

=0.235) between the 2 groups. The biochemical pregnancy rate

(64.29%

43.43%

=0.013)

clinical pregnancy rate (53.57%

36.36%

=0.037) and live birth rate (46.43%

27.27%

=0.016) were obviously higher in the cured group than the treated group. In mild CE

there were no statistical differences in biochemical pregnancy rate

clinical pregnancy rate

early abortion rate

live birth rate and embryo implantation rate the clinical outcomes between the cured group and the treated group. In severe CE

the cured group had obviously higher biochemical pregnancy rate (76.47%

43.33%

=0.007)

clinical pregnancy rate (64.71%

33.33%

=0.012) and live birth rate (58.82%

20.00%

=0.002) than the treated group.

Conclusion

CE has a negative impact on assisted reproductive outcomes

and standard antibiotic treatment can improve the pregnancy outcomes in the patients.

关键词

Keywords

references

PUENTE E, ALONSO L, LAGANÀ A S, et al . Chronic endometritis: old problem, novel insights and future challenges[J ] . Int J Fertil Steril, 2020, 13(4): 250-256. DOI: 10.22074/ijfs.2020.5779.

MORIMUNE A, KIMURA F, NAKAMURA A, et al . The effects of chronic endometritis on the pregnancy outcomes[J ] . Am J Reprod Immunol, 2021, 85(3): e13357. DOI: 10.1111/aji.13357.

BUZZACCARINI G, VITAGLIANO A, ANDRISANI A, et al . Chronic endometritis and altered embryo implantation: a unified pathophysiological theory from a literature systematic review[J ] . J Assist Reprod Genet, 2020, 37(12): 2897-2911. DOI: 10.1007/s10815-020-01955-8.

GAY C, HAMDAOUI N, PAULY V, et al . Impact of antibiotic treatment for chronic endometritis on unexplained recurrent pregnancy loss[J ] . J Gynecol Obstet Hum Reprod, 2021, 50(5): 102034. DOI: 10.1016/j.jogoh.2020.102034.

XIONG Y J, CHEN Q, CHEN C X, et al . Impact of oral antibiotic treatment for chronic endometritis on pregnancy outcomes in the following frozen-thawed embryo transfer cycles of infertile women: a cohort study of 640 embryo transfer cycles[J ] . Fertil Steril, 2021, 116(2): 413-421. DOI: 10.1016/j.fertnstert.2021.03.036.

KURODA K, HORIKAWA T, MORIYAMA A, et al . Impact of chronic endometritis on endometrial receptivity analysis results and pregnancy outcomes[J ] . Immun Inflamm Dis, 2020, 8(4): 650-658. DOI: 10.1002/iid3.354.

SONG D M, HE Y F, WANGY X, et al . Impact of antibiotic therapy on the rate of negative test results for chronic endometritis: a prospective randomized control trial[J ] . Fertil Steril, 2021, 115(6): 1549-1556. DOI: 10.1016/j.fertnstert.2020.12.019.

TERSOGLIO A E, SALATINO D R, REINCHISI G, et al . Repeated implantation failure in oocyte donation. What to do to improve the endometrial receptivity?[J ] . JBRA Assist Reprod, 2015, 19(2): 44-52. DOI: 10.5935/1518-0557.20150012.

JOHNSTON-MACANANNY E B, HARTNETT J, ENGMANN L L, et al . Chronic endometritis is a frequent finding in women with recurrent implantation failure after in vitro fertilization[J ] . Fertil Steril, 2010, 93(2): 437-441. DOI: 10.1016/j.fertnstert.2008.12.131..

乔杰, 马彩虹, 刘嘉茵, 等. 辅助生殖促排卵药物治疗专家共识[J]. 生殖与避孕, 2015, 35(4): 211-223. DOI: 10.7669/j.issn.0253-357X.2015.04.0211.

QIAO J, MA C H, LIU J Y, et al . A consensus of poor ovarian response[J ] . Chin J Reprod Contracept, 2015, 35(4): 211-223. DOI: 10.7669/j.issn.0253-357X.2015.04.0211.

COOMARASAMY A, WILLIAMS H, TRUCHANOWICZ E, et al . A randomized trial of progesterone in women with recurrent miscarriages[J ] . N Engl J Med, 2015, 373(22): 2141-2148. DOI: 10.1056/NEJMoa1504927.

孙赟, 刘平, 叶虹, 等. 黄体支持与孕激素补充共识[J]. 生殖与避孕, 2015, 35(1): 1-8. DOI: 10.7669/j.issn.0253-357X.2015.01.0001.

SUN Y, LIU P, YE H, et al . Luteal phase support with progesterone supplementation consensus[J ] . Chin J Reprod Contracept, 2015, 35(1): 1-8. DOI: 10.7669/j.issn.0253-357X.2015.01.0001.

CICINELLI E, MATTEO M, TINELLI R, et al . Prevalence of chronic endometritis in repeated unexplained implantation failure and the IVF success rate after antibiotic therapy[J ] . Hum Reprod, 2015, 30(2): 323-330. DOI: 10.1093/humrep/deu292.

梁炎春, 文扬幸, 韦雅婧, 等. 慢性子宫内膜炎影响生殖预后的相关机制[J]. 中国实用妇科与产科杂志, 2020, 36(12): 1214-1218. DOI: 10.19538/j.fk20201 20121.

LIANG Y C, WEN Y X, WEI Y J, et al . Mechanism of chronic endometritis affecting reproductive prognosis[J ] . Chin J Pract Gynecol Obstet, 2020, 36(12): 1214-1218. DOI: 10.19538/j.fk2020120121.

PARK H J, KIM Y S, YOON T K, et al . Chronic endometritis and infertility[J ] . Clin Exp Reprod Med, 2016, 43(4): 185-192. DOI: 10.5653/cerm.2016.43.4.185.

WANG W J, ZHANG H, CHEN Z Q, et al . Endometrial TGF-β, IL-10, IL-17 and autophagy are dysregulated in women with recurrent implantation failure with chronic endometritis[J ] . Reprod Biol Endocrinol, 2019, 17(1): 2. DOI: 10.1186/s12958-018-0444-9.

CICINELLI E, CICINELLI R, VITAGLIANO A. Consistent evidence on the detrimental role of severe chronic endometritis on in vitro fertilization outcome and the reproductive improvement after antibiotic therapy: on the other hand, mild chronic endometritis appears a more intricate matter[J ] . Fertil Steril, 2021, 116(2): 345-346. DOI: 10.1016/j.fertnstert.2021.06.022.

LIU Y Y, CHEN X Y, HUANG J, et al . Comparison of the prevalence of chronic endometritis as determined by means of different diagnostic methods in women with and without reproductive failure[J ] . Fertil Steril, 2018, 109(5): 832-839. DOI: 10.1016/j.fertnstert.2018.01.022.

VITAGLIANO A, SACCARDI C, NOVENTA M, et al . Effects of chronic endometritis therapy on in vitro fertilization outcome in women with repeated implantation failure: a systematic review and meta-analysis[J ] . Fertil Steril, 2018, 110(1): 103-112.e1. DOI: 10.1016/j.fertnstert.2018.03.017..

YANG R, DU X G, WANG Y, et al . The hysteroscopy and histological diagnosis and treatment value of chronic endometritis in recurrent implantation failure patients[J ] . Arch Gynecol Obstet, 2014, 289(6): 1363-1369. DOI: 10.1007/s00404-013-3131-2.

SONG D M, HE Y F, WANG Y X, et al . Impact of antibiotic therapy on the rate of negative test results for chronic endometritis: a prospective randomized control trial [J ] . Fertil Steril, 2021, 115(6): 1549-1556. DOI: 10.1016/j.fertnstert.2020.12.019.

CICINELLI E, MATTEO M, TROJANO G, et al . Chronic endometritis in patients with unexplained infertility: prevalence and effects of antibiotic treatment on spontaneous conception[J ] . Am J Reprod Immunol, 2018. DOI: 10.1111/aji.12782.

HUANG W Y, LIU B, HE Y H, et al . Variation of diagnostic criteria in women with chronic endometritis and its effect on reproductive outcomes: a systematic review and meta-analysis[J ] . J Reprod Immunol, 2020, 140: 103146. DOI: 10.1016/j.jri.2020.103146.

LI Y Y, XU S R, YU S Y, et al . Diagnosis of chronic endometritis: how many CD138 + cells/HPF in endometrial stroma affect pregnancy outcome of infertile women?[J ] . AmJ Reprod Immunol, 2021, 85(5): e13369. DOI: 10.1111/aji.13369..

FAN X X, LI X F, LI Y, et al . Endometrial CD138 count appears to be a negative prognostic indicator for patients who have experienced previous embryo transfer failure[J ] . Fertil Steril, 2019, 112(6): 1103-1111. DOI: 10.1016/j.fertnstert.2019.08.006.

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