Influence of chronic endometritis on women`s reproductive health: current view

2020 ◽  
pp. 57-63
Author(s):  
T.G. Romanenko ◽  
◽  
A.D. Haiduk ◽  
N.V. Yesyp ◽  
◽  
...  

Chronic inflammatory process in endometrium is an obvious factor of infertility and recurrent pregnancy loss. But uncertainty of its etiology in most of the clinical cases results in complications of diagnostic process of the disease despite the broad spectrum of diagnostic techniques. Shift of the focus from specific infectious agents towards opportunistic pathogens also leads to several complications in interpretation of bacteriological examination results. Moreover, the role of viruses as ethiological factor of chronic endometritis is still not well established. At the same time the capability of invasive diagnostic techniques is always discussed by the clinicians because of additional risks from intervention into uterine cavity. From this point of view treatment of chronic endometritis (CE) and pregravid preparation of women involved in in vitro fertilization algorithm with such pathology requires comprehensive analysis. Routine antibiotic administration, principles of choice of these medications and effectiveness of other therapeutical approaches, for example, physiotherapy techniques, are still controversial. This article highlights modern ideas about chronic endometritis: ethiological factors of the disorder, coincidence with infertility and reproductive failure, diagnostic methods, treatment and pregravid preparation of women with the disease and ways of optimization of patient management for preserving their reproductive potential. Key words: chronic endometritis, infertility, in vitro fertilization, antibiotic therapy.

2021 ◽  
pp. 22-27
Author(s):  
Ihor I. Chermak ◽  
Volodymyr I. Chermak ◽  
Mariia A. Matvian ◽  
Mansi Singh

Chronic endometritis (CE) is a persistent inflammation of the inner lining of the uterine cavity caused by bacteria such as Enterococcus, Streptococcus, Staphylococcus, Enterobacteriaceae. A majority of CE produces no signs or sometimes mild symptoms, and the prevalence rate of CE is 10-15%. Several studies have shown that it is a condition frequently associated with repeated unexplained implantation failure at in vitro fertilization, recurrent miscarriage, as well as preterm labor. In this study, we reviewed how chronic endometritis plays an important role in the development of infertility. Also, we discuss the importance of hysteroscopic procedures in the diagnosis of chronic endometritis.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Konstantinos Pantos ◽  
Mara Simopoulou ◽  
Evangelos Maziotis ◽  
Anna Rapani ◽  
Sokratis Grigoriadis ◽  
...  

AbstractThe chronic nature of Chronic Endometritis (CE) along with the challenging management and infertility entailed, call for cutting-edge therapeutic approaches. This study introduces the novel treatment of intrauterine antibiotic infusion (IAI) combined with oral antibiotic administration (OAA), and it assesses respective performance against the gold standard treatment of OAA. Data sourced herein reports on treatment efficiency and fertility restoration for both patients aiming to conceive naturally or via In Vitro fertilization. Eighty CE patients, 40 presenting with recurrent implantation failure, and 40 with recurrent pregnancy loss, were enrolled in the IVF and the natural conception arm respectively. Treatment was subjected to randomization. Effectively treated patients proceeded with either a single IVF cycle or were invited to conceive naturally over a 6-month period. Combination of IAI and OAA provided a statistically significant enhanced effectiveness treatment rate (RR 1.40; 95%CI 1.07–1.82; p = 0.01). No statistically significant difference was observed regarding the side-effects rate (RR 1.33; 95%CI 0.80–2.22; p = 0.52). No statistically significant difference was observed for either arm regarding live-birth rate. Following an intention-to-treat analysis, employment of IAI corresponds to improved clinical pregnancy rate-albeit not reaching statistical significance. In conclusion, complimentary implementation of IAI could provide a statistically significant enhanced clinical treatment outcome.


GYNECOLOGY ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 93-100
Author(s):  
Victor E. Radzinsky ◽  
Mekan R. Orazov ◽  
Liliia R. Toktar ◽  
Liudmila M. Mihaleva ◽  
Pavel A. Semenov ◽  
...  

Chronic endometritis (CE) is defined as a state of inflammation localized in the endometrium, accompanied by edema, dissociated maturation of epithelial cells and fibroblasts, increased stromal density and the presence of plasma cell infiltrate in it. The connection between chronic inflammation in the endometrium and infertility deserves special attention. Inadequate response of immunocompetent endometrial cells, including impaired synthesis of proinflammatory cytokines, dysreceptiveness, disorders of proliferation and differentiation processes are the main links in the formation of infertility in patients with CE. Despite the fact that the presence of a normocenosis of the uterine cavity today is not in doubt this is a physiological norm, persistent bacterial infection of the endometrium is still called the main etiopathogenetic factor of CE and, therefore, the main point of application of therapeutic agents. Nevertheless, a number of works have emphasized the special role of not bacterial, but viral etiology of endometritis, especially in the context of infertility developing against this background. It seems that the role of viral endometrial infection in adverse pregnancy outcomes and in vitro fertilization programs is underestimated. Further research is needed to clarify the relationship of viral infection as a trigger of implantation failure in infertile women with CE.


KnE Medicine ◽  
2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Hilma Putri Lubis

<p><strong>Introduction</strong><strong></strong></p><p>A trial or mock embryo transfer (ET) may influence pregnancy rates and it performed prior to ET allows the clinician to assess the uterine cavity and the utero-cervical angle. The aim of this study is to compare the consistency of the type of ET in mock ET with real ET.</p><p><strong>Material &amp; Methods</strong></p><p>A retrospective comparative analysis of  patients who underwent in vitro fertilization or ICSI cycle from January 2014 to December 2014 in Halim Fertility Center was done. The type of transfer was divided into two groups: ‘easy’ or ‘difficult’. An easy ET was defined as a transfer that occurred without the use of manipulation or other instrumentation and difficult ET was considered when additional instrumentation was required.</p><p><strong>Results</strong></p><p>From the study, 103 patients who underwent Mock-ET, we  found 58 patients (56.3%) with easy ET and 45 patients (43.7%) with difficult ET, which with hard catheter ET in 17 patients (16.5%), with osfander assistance in 20 patients (19.4%) and with stylet in 8 patients (7,8%). 58 patients with Easy Mock ET group were entirely easy real ET (100%) and 45 patients with difficult Mock ET group also entirely were difficult real ET (100%). The Statistical analysis shows no significant difference between the mock ET and real ET groups (p&gt;0,05). In easy real ET, clinical pregnancy rates were 32.8% and in difficult real ET, clinical pregnancy rates were 26.7% with no significant difference between the  groups (p&gt;0,05).</p><p><strong>Conclusion:</strong></p><p>Mock ET prior to the treatment cycle is consistent with real ET.</p>


2010 ◽  
Vol 25 (8) ◽  
pp. 1959-1965 ◽  
Author(s):  
H. M. Fatemi ◽  
J. C. Kasius ◽  
A. Timmermans ◽  
J. van Disseldorp ◽  
B. C. Fauser ◽  
...  

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