Department of Reproductive Medicine and Gynecology, University Medical Center, Utrecht, the Netherlands.
Fertil Steril. 2011 Dec;96(6):1451-6. doi: 10.1016/j.fertnstert.2011.09.039. Epub 2011 Oct 22.
To assess the prevalence of chronic endometritis and the impact on the fertility of asymptomatic patients indicated for in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment.
In the context of a randomized controlled trial, a hysteroscopy-guided endometrial biopsy was obtained and histologically examined. The live birth rate (including spontaneous pregnancies) after initiation of IVF/ICSI treatment of patients diagnosed with chronic endometritis was compared with the live birth rate of a randomly selected matched control group of patients without endometritis.
Two tertiary infertility care units.
PATIENT(S): A total of 678 asymptomatic infertile women with a normal transvaginal ultrasound (TVS) who underwent diagnostic hysteroscopy before a first IVF/ICSI treatment cycle.
INTERVENTION(S): Hysteroscopy guided endometrial biopsy.
MAIN OUTCOME MEASURE(S): The prevalence of chronic endometritis and the live birth rate (including spontaneous pregnancies) within 3 years after initiation of the randomized controlled trial.
RESULT(S): The prevalence of chronic endometritis in the 606 patients with an adequate biopsy was 2.8%. The cumulative live birth rate (including spontaneous pregnancies) did not significantly differ between patients with or without endometritis: 76% versus 54%. Also, the clinical pregnancy rate per embryo transfer was not significantly different (hazard ratio 1.456, 95% confidence interval 0.770-2.750).
CONCLUSION(S): Chronic endometritis can be rarely diagnosed in a population of asymptomatic infertile patients with a normal TVS before a first IVF/ICSI treatment. Moreover, the reproductive outcome after initiation of IVF/ICSI was not found to be negatively affected by chronic endometritis. In conclusion, the clinical implication of chronic endometritis seems minimal.
评估无症状拟行体外受精（IVF）/卵胞浆内单精子注射（ICSI）治疗患者中慢性子宫内膜炎的患病率及其对生育能力的影响。
在一项随机对照试验的背景下，进行宫腔镜引导下子宫内膜活检并进行组织学检查。比较诊断为慢性子宫内膜炎的患者在开始 IVF/ICSI 治疗后的活产率（包括自然妊娠）与随机选择的无子宫内膜炎的匹配对照组患者的活产率。
两个三级不孕不育治疗中心。
共 678 例无症状不孕且经阴道超声（TVS）正常的妇女，在首次 IVF/ICSI 治疗周期前进行诊断性宫腔镜检查。
宫腔镜引导下子宫内膜活检。
慢性子宫内膜炎的患病率和随机对照试验开始后 3 年内的活产率（包括自然妊娠）。
在 606 例有足够活检的患者中，慢性子宫内膜炎的患病率为 2.8%。有或没有子宫内膜炎的患者的累积活产率（包括自然妊娠）无显著差异：76%比 54%。此外，胚胎移植的临床妊娠率也无显著差异（危险比 1.456，95%置信区间 0.770-2.750）。
在首次 IVF/ICSI 治疗前 TVS 正常的无症状不孕患者中，很少能诊断出慢性子宫内膜炎。此外，IVF/ICSI 启动后，慢性子宫内膜炎并未对生育结局产生负面影响。总之，慢性子宫内膜炎的临床意义似乎很小。
