#95 : Analysis of the Incidence of and Risk Factors for Chronic Endometritis Recurrence in Infertile Women
Background and Aims: Chronic endometritis (CE) is an inflammatory condition of the endometrium which is related to repeated implantation failure. Recovery from CE can increase opportunities for successful pregnancy; however, some of them remain incapable of conceiving or have a miscarriage and conce...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
World Scientific Publishing
2023-12-01
|
| Series: | Fertility & Reproduction |
| Online Access: | https://www.worldscientific.com/doi/10.1142/S266131822374359X |
| _version_ | 1797237148344123392 |
|---|---|
| author | Keisuke Shiobara Keiji Kuroda Shunsuke Ishiyama Kazuki Nakao Azusa Moriyama Takashi Horikawa Satoru Takamizawa Koji Nakagawa Rikikazu Sugiyama |
| author_facet | Keisuke Shiobara Keiji Kuroda Shunsuke Ishiyama Kazuki Nakao Azusa Moriyama Takashi Horikawa Satoru Takamizawa Koji Nakagawa Rikikazu Sugiyama |
| author_sort | Keisuke Shiobara |
| collection | DOAJ |
| description | Background and Aims: Chronic endometritis (CE) is an inflammatory condition of the endometrium which is related to repeated implantation failure. Recovery from CE can increase opportunities for successful pregnancy; however, some of them remain incapable of conceiving or have a miscarriage and concern CE recurrence. The aim of this study is to identify the incidence rates of and risk factors for the recurrence of CE in infertile women. Method: The study population consisted of 1,897 infertile women from a hospital specializing in reproductive medicine who recovered from CE between December 2018 and August 2021. Among the 152 women (13.0%) who did not conceive or experienced pregnancy loss, 105 consecutive women who underwent repeat endometrial biopsy for CD138 immunostaining and endometrial bacterial culturing within 18 months from CE recovery were recruited. Thereafter, patients with and without CE recurrence were compared. Results: The total recurrence rate of CE was 29.5% (31 women). Multivariable logistic regression analysis to determine risk factors for CE recurrence revealed that hysteroscopic surgery (odds ratio [OR], 0.10; 95% confidence interval [CI], 0.02–0.56) and pregnancy loss (OR, 4.13; 95% CI, 1.31–13.05) were significantly associated with decreased and increased CE recurrence rates, respectively. Also, re-examination with CD138 immunostaining after 16–18 months (OR, 9.75; 95% CI, 1.47–64.64) was significantly associated with increased CE recurrence rates. Among 40 patients without a history of hysteroscopic surgery and pregnancy loss, the cumulative CE recurrence rates after 6, 12, and 18 months were 12.5%, 23.3%, and 30.0%, respectively (Graph 1). Conclusion: We recommend re-examination with endometrial CD138 immunostaining in patients with pregnancy loss or long-term infertility during fertility treatment. Hysteroscopic surgery without antibiotic therapy for CE associated with intrauterine abnormalities is also recommended. |
| first_indexed | 2024-04-24T17:15:08Z |
| format | Article |
| id | doaj.art-99be9fcb70b1421d85722d3ac520c8ce |
| institution | Directory Open Access Journal |
| issn | 2661-3182 2661-3174 |
| language | English |
| last_indexed | 2024-04-24T17:15:08Z |
| publishDate | 2023-12-01 |
| publisher | World Scientific Publishing |
| record_format | Article |
| series | Fertility & Reproduction |
| spelling | doaj.art-99be9fcb70b1421d85722d3ac520c8ce2024-03-28T07:54:16ZengWorld Scientific PublishingFertility & Reproduction2661-31822661-31742023-12-01050462662710.1142/S266131822374359X#95 : Analysis of the Incidence of and Risk Factors for Chronic Endometritis Recurrence in Infertile WomenKeisuke Shiobara0Keiji Kuroda1Shunsuke Ishiyama2Kazuki Nakao3Azusa Moriyama4Takashi Horikawa5Satoru Takamizawa6Koji Nakagawa7Rikikazu Sugiyama8Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Shinjuku ku, JapanCenter for Reproductive Medicine and Endoscopy, Sugiyama Clinic Marunouchi, Chiyoda ku, JapanCenter for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Shinjuku ku, JapanCenter for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Shinjuku ku, JapanCenter for Reproductive Medicine and Endoscopy, Sugiyama Clinic Marunouchi, Chiyoda ku, JapanCenter for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Shinjuku ku, JapanCenter for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Shinjuku ku, JapanCenter for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Shinjuku ku, JapanCenter for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Shinjuku ku, JapanBackground and Aims: Chronic endometritis (CE) is an inflammatory condition of the endometrium which is related to repeated implantation failure. Recovery from CE can increase opportunities for successful pregnancy; however, some of them remain incapable of conceiving or have a miscarriage and concern CE recurrence. The aim of this study is to identify the incidence rates of and risk factors for the recurrence of CE in infertile women. Method: The study population consisted of 1,897 infertile women from a hospital specializing in reproductive medicine who recovered from CE between December 2018 and August 2021. Among the 152 women (13.0%) who did not conceive or experienced pregnancy loss, 105 consecutive women who underwent repeat endometrial biopsy for CD138 immunostaining and endometrial bacterial culturing within 18 months from CE recovery were recruited. Thereafter, patients with and without CE recurrence were compared. Results: The total recurrence rate of CE was 29.5% (31 women). Multivariable logistic regression analysis to determine risk factors for CE recurrence revealed that hysteroscopic surgery (odds ratio [OR], 0.10; 95% confidence interval [CI], 0.02–0.56) and pregnancy loss (OR, 4.13; 95% CI, 1.31–13.05) were significantly associated with decreased and increased CE recurrence rates, respectively. Also, re-examination with CD138 immunostaining after 16–18 months (OR, 9.75; 95% CI, 1.47–64.64) was significantly associated with increased CE recurrence rates. Among 40 patients without a history of hysteroscopic surgery and pregnancy loss, the cumulative CE recurrence rates after 6, 12, and 18 months were 12.5%, 23.3%, and 30.0%, respectively (Graph 1). Conclusion: We recommend re-examination with endometrial CD138 immunostaining in patients with pregnancy loss or long-term infertility during fertility treatment. Hysteroscopic surgery without antibiotic therapy for CE associated with intrauterine abnormalities is also recommended.https://www.worldscientific.com/doi/10.1142/S266131822374359X |
| spellingShingle | Keisuke Shiobara Keiji Kuroda Shunsuke Ishiyama Kazuki Nakao Azusa Moriyama Takashi Horikawa Satoru Takamizawa Koji Nakagawa Rikikazu Sugiyama #95 : Analysis of the Incidence of and Risk Factors for Chronic Endometritis Recurrence in Infertile Women Fertility & Reproduction |
| title | #95 : Analysis of the Incidence of and Risk Factors for Chronic Endometritis Recurrence in Infertile Women |
| title_full | #95 : Analysis of the Incidence of and Risk Factors for Chronic Endometritis Recurrence in Infertile Women |
| title_fullStr | #95 : Analysis of the Incidence of and Risk Factors for Chronic Endometritis Recurrence in Infertile Women |
| title_full_unstemmed | #95 : Analysis of the Incidence of and Risk Factors for Chronic Endometritis Recurrence in Infertile Women |
| title_short | #95 : Analysis of the Incidence of and Risk Factors for Chronic Endometritis Recurrence in Infertile Women |
| title_sort | 95 analysis of the incidence of and risk factors for chronic endometritis recurrence in infertile women |
| url | https://www.worldscientific.com/doi/10.1142/S266131822374359X |
| work_keys_str_mv | AT keisukeshiobara 95analysisoftheincidenceofandriskfactorsforchronicendometritisrecurrenceininfertilewomen AT keijikuroda 95analysisoftheincidenceofandriskfactorsforchronicendometritisrecurrenceininfertilewomen AT shunsukeishiyama 95analysisoftheincidenceofandriskfactorsforchronicendometritisrecurrenceininfertilewomen AT kazukinakao 95analysisoftheincidenceofandriskfactorsforchronicendometritisrecurrenceininfertilewomen AT azusamoriyama 95analysisoftheincidenceofandriskfactorsforchronicendometritisrecurrenceininfertilewomen AT takashihorikawa 95analysisoftheincidenceofandriskfactorsforchronicendometritisrecurrenceininfertilewomen AT satorutakamizawa 95analysisoftheincidenceofandriskfactorsforchronicendometritisrecurrenceininfertilewomen AT kojinakagawa 95analysisoftheincidenceofandriskfactorsforchronicendometritisrecurrenceininfertilewomen AT rikikazusugiyama 95analysisoftheincidenceofandriskfactorsforchronicendometritisrecurrenceininfertilewomen |