Division of Life Sciences and Medicine, Department of Reproductive Medicine Center, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China.
Department of Obstetrics and Gynecology, Anhui Women and Child Health Care Hospital, Anhui Medical University, Hefei, China.
Am J Reprod Immunol. 2019 Nov;82(5):e13177. doi: 10.1111/aji.13177. Epub 2019 Aug 20.
The aim of this prospective study was to investigate the prevalence of chronic endometritis (CE) in repeated implantation failure (RIF) patients and to determine whether intrauterine delivery of the combined administration of antibiotic and dexamethasone improves the clinical pregnancy outcome.
The combination of hysteroscopy and histology was used to diagnose CE in the patients with RIF, and the diagnosed patients were treated with the intrauterine delivery of the combined antibiotic and dexamethasone therapy. The prevalence of CE in the RIF patients was recorded, and the therapeutic effect was also evaluated in the first IVF-ET cycle.
In a total number of 298 patients with RIF, 109 cases (36.58%) were diagnosed as CE. Intrauterine infusion treatment resulted in CE resolution in 77.98% of patients. After the treatment, 85 cases with no signs of CE (Group 2) had a significantly higher implantation rate (31.33%) and clinical pregnancy rate (51.76%) as compared with both 126 cases without CE diagnosis (Group 1; 16.30% and 30.15%, respectively) and 24 cases with persistence of CE (Group 3; 14.89% and 25.00%, respectively). The live birth rate in the first IVF-ET cycle following treatment in Group 2 was significantly higher than that of both Group 1 and Group 3 (all P < .05).
Chronic endometritis is highly prevalent in patients with RIF. To the best of our knowledge, we for the first time reported that intrauterine delivery of the combined administration of antibiotic and dexamethasone as a treatment option of CE could achieve expected therapeutic effects and successful pregnancy outcomes.
本前瞻性研究旨在调查反复着床失败（RIF）患者中慢性子宫内膜炎（CE）的患病率，并确定宫内给予抗生素联合地塞米松是否能改善临床妊娠结局。
采用宫腔镜联合组织学检查诊断 RIF 患者的 CE，对确诊的患者采用宫内给予抗生素联合地塞米松治疗。记录 RIF 患者中 CE 的患病率，并评估首次 IVF-ET 周期的治疗效果。
在 298 例 RIF 患者中，109 例（36.58%）诊断为 CE。宫内输注治疗使 77.98%的患者 CE 得到缓解。治疗后，109 例 CE 消失患者（组 2）的着床率（31.33%）和临床妊娠率（51.76%）明显高于无 CE 诊断的 126 例患者（组 1；分别为 16.30%和 30.15%）和 24 例 CE 持续存在患者（组 3；分别为 14.89%和 25.00%）。治疗后组 2 的首次 IVF-ET 周期活产率明显高于组 1 和组 3（均 P<.05）。
CE 在 RIF 患者中患病率较高。据我们所知，我们首次报道了宫内给予抗生素联合地塞米松作为 CE 的治疗选择可以达到预期的治疗效果和成功的妊娠结局。
