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Moreno I, Cicinelli E, Garcia-Grau I et al. The diagnosis of chronic endometritis in infertile asymptomatic women: a comparative study of histology, microbial cultures, hysteroscopy, and molecular microbiology. Am J Obstet Gynecol 2018;
ENDOMETRITIS AND HYSTEROSCOPY IN ART • Estimation of 40% in repeated IVF failures and spontaneous abortion
• Diagnostic:
• Hysteroscopy with typical strawberry/whittish aspect
• Biopsy with plasma cells infiltration of the endometrium
• Microbiologically- enterobacteriaceae, streptococcus, staphilococcus, Mycoplasma and Ureaplasma
• The best tool? According to Moreno et al, AJOG 2018:
• Hysteroscopy and hystology have 58% nonconcordant results
• the molecular microbiology diagnosis demonstrates 75% sensitivity, 100% specicity, 100% positive and 25% negative predictive values, and 0% false-positive and 25% false-negative rates.
Pierre-Emmanuel Bouet et al. Chronic endometritis in women with recurrent pregnancy loss and recurrent implantation failure: prevalence and role of office hysteroscopy and immunohistochemistry in diagnosis Fertility and Sterility, 105, 2016, 106-110
ENDOMETRITIS AND HYSTEROSCOPY IN ART
• Objective: to determine the prevalence of chronic endometritis (CE) in patients with recurrent implantation failure (RIF) after IVF and unexplained recurrent pregnancy loss (RPL).
• The prevalence of ce was 14% (6/43) in group 1 and 27% (14/51) in group 2.
• The sensitivity and specificity of office hysteroscopy in the diagnosis of CE were 40% (8/20) and
80% (59/74), respectively.
• We found a high prevalence of immunohistochemically confirmed ce in women with RIF and RPL. Office hysteroscopy is a useful diagnostic tool but should be complemented by an endometrial biopsy for the diagnosis of CE.
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