Gynecologic and Obstetric Investigation
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Article / Publication Details
Abstract
Objectives: To study the prevalence of chronic endometritis (CE) in infertile women, its impact on reproductive outcomes, and the accuracy of hysteroscopy as a screening tool for CE.
Design: Prospective observational study.
Participants: 514 asymptomatic patients with infertility.
Setting: Tertiary care center.
Methods: The participants underwent a hysteroscopy and endometrial biopsy (EMB). Antibiotics were given for cases of CE.
We investigated the prevalence of CE in patients starting assisted reproductive technologies (ART) as a primary outcome.
Secondary outcomes were the clinical pregnancy rate (CPR) in the ART cycle after hysteroscopy, EMB, and antibiotic treatment in cases of CE; the cumulative CPR in the subsequent 2 years after hysteroscopy and EMB; the sensitivity and specificity of hysteroscopy as a screening tool compared to EMB as the “gold standard” for diagnosing CE.
Results: CE was identified in 2.8% of patients starting ART (11/393). CPRs did not differ significantly between patients with CE and the entire cohort of patients without CE in the subsequent ART cycle (OR 0.43; 95% CI 0.09–2.02) or in the 2 years after EMB (OR 0.56; 95% CI 0.16-1.97). In a matched control comparison (with matching for age, basal FSH, and cause of infertility) CPR in patients with CE did not differ in the subsequent ART cycle (OR 0.39; 95% CI 0.09–1.61); however, their CPR in the 2 years after EMB was significantly lower (OR 0.22; 95% CI 0.13–0.38). The sensitivity and specificity of hysteroscopy as a screening tool for diagnosing CE were 8.3% and 90.1%, respectively.
Limitations: Due to our cohort’s low CE prevalence, we could not detect significant differences in CPRs.
Conclusion: CE is rare in our studied population of asymptomatic patients starting ART. Hysteroscopy cannot replace EMB for diagnosing CE.
S. Karger AG, Basel
Article / Publication Details
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