Treatment following hysteroscopy and endometrial diagnostic biopsy increases the chance for live birth in women with chronic endometritis.
Abortion, Habitual
/ diagnosis
Adult
Anti-Bacterial Agents
/ therapeutic use
Biopsy
Chronic Disease
Embryo Implantation
Endometriosis
/ drug therapy
Female
Humans
Hysteroscopy
Live Birth
Predictive Value of Tests
Pregnancy
Pregnancy Rate
Retrospective Studies
Risk Assessment
Risk Factors
Time-to-Pregnancy
Treatment Outcome
chronic endometritis
endometrial diagnostic biopsy
plasma cells
recurrent pregnancy loss
repeated implantation failure
time to live birth
time to pregnancy
Journal
American journal of reproductive immunology (New York, N.Y. : 1989)
ISSN: 1600-0897
Titre abrégé: Am J Reprod Immunol
Pays: Denmark
ID NLM: 8912860
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
pubmed:
5
7
2021
medline:
3
3
2022
entrez:
4
7
2021
Statut:
ppublish
Résumé
Repeated implantation failure and recurrent pregnancy loss are associated with chronic endometritis, a persistent endometrial inflammation. Its diagnosis and treatment may increase pregnancy and live birth rates. The aim of this study was to assess the effectiveness of endometrial diagnostic biopsy and subsequent antibiotic treatment in cases of chronic endometritis on reproductive outcomes over a long observation period. We conducted a historical cohort study (2014-2018) at our University-based infertility center that included women (n = 108) with repeated implantation failure or recurrent pregnancy loss without known pathologies associated with either condition. Forty-one women underwent a hysteroscopy only (reference group); the remaining 67 women underwent, in addition to the hysteroscopy, an endometrial diagnostic biopsy with immunohistochemically staining for CD138 to detect plasma cells (biopsy group). If one or more plasma cells were detected, the women were treated with doxycycline 100 mg twice a day orally for 2 weeks. We performed stratified survival analysis (Kaplan-Meier) and Cox regression. The biopsy group had higher chances of pregnancy (hazard ratio 2.28; 95% confidence interval 1.23-4.24; p = .009) and of live birth (hazard ratio 2.76; 95% confidence interval 1.30-5.87; p = .008) compared with the reference group. In the sensitivity analysis, repeated implantation failure or recurrent pregnancy loss did not affect the outcome. Endometrial diagnostic biopsy followed by antibiotic treatment in case of chronic endometritis in women with repeated implantation failure or recurrent pregnancy loss may increase the chances for live birth.
Identifiants
pubmed: 34218478
doi: 10.1111/aji.13482
pmc: PMC8596418
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13482Informations de copyright
© 2021 The Authors. American Journal of Reproductive Immunology published by John Wiley & Sons Ltd.
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