The Center for Advanced Reproductive Services, Department of Obstetrics and Gynecology, University of Connecticut Health Center, Farmington, Connecticut 06030, USA.
Fertil Steril. 2010 Feb;93(2):437-41. doi: 10.1016/j.fertnstert.2008.12.131. Epub 2009 Feb 12.
To determine the role of endometrial sampling for identification and treatment of chronic endometritis (CE) in patients undergoing IVF-ET who repeatedly failed to conceive despite the transfer of good-quality embryos.
Retrospective chart review.
University-based tertiary fertility center.
PATIENT(S): Thirty-three patients with recurrent implantation failure (RIF) who underwent endometrial sampling and subsequent ET were analyzed based on immunohistochemically confirmed CE: CE present on biopsy (group 1; n = 10) and CE absent on biopsy (group 2; n = 23). Patients with RIF undergoing IVF cycles during the same time period who did not have endometrial sampling were used as controls (group 3; n = 485).
INTERVENTION(S): Endometrial sampling for CE and subsequent antibiotic treatment in affected patients followed by another IVF-ET cycle.
RESULT(S): Chronic endometritis was identified in 30.3% of patients with RIF. Group 1 had lower implantation rates (11.5%) in the IVF cycle following treatment than did group 2 and group 3 (32.7% and 20.3%, respectively). Clinical pregnancy and ongoing pregnancy rates were similar across groups.
CONCLUSION(S): Recurrent implantation failure warrants investigation of CE as a contributing factor. Women demonstrating CE on endometrial sampling have lower implantation rates in a subsequent IVF-ET cycle; however, there were no differences in subsequent clinical pregnancy or ongoing pregnancy rates after successful antibiotic treatment.
确定子宫内膜取样在体外受精-胚胎移植（IVF-ET）反复妊娠失败患者中的作用，这些患者尽管移植了优质胚胎，但仍反复着床失败。
回顾性图表分析。
大学附属的三级生育中心。
33 名反复着床失败（RIF）患者接受了子宫内膜取样和随后的胚胎移植，根据免疫组织化学证实的慢性子宫内膜炎（CE）进行分析：活检显示 CE 阳性（组 1；n = 10）和活检显示 CE 阴性（组 2；n = 23）。同时期接受 IVF 周期但未进行子宫内膜取样的 RIF 患者作为对照组（组 3；n = 485）。
CE 的子宫内膜取样和随后的抗生素治疗，然后进行另一个 IVF-ET 周期。
RIF 患者中 30.3%存在 CE。治疗后的 IVF 周期中，组 1的着床率（11.5%）低于组 2和组 3（分别为 32.7%和 20.3%）。各组的临床妊娠率和持续妊娠率相似。
反复着床失败提示 CE 是一个致病因素。子宫内膜取样显示 CE 的女性在随后的 IVF-ET 周期中的着床率较低；然而，在成功抗生素治疗后，临床妊娠和持续妊娠率没有差异。
