Espinós Juan J, Fabregues Francisco, Fontes Juan, García-Velasco Juan A, Llácer Joaquín, Requena Antonio, Checa Miguel Á, Bellver José
Fertty, Barcelona, Spain, Universidad Autónoma de Barcelona, Bellaterra Barcelona, Spain.
Institut Clinic Gynecology, Obstetrics and Neonatology (ICGON), Hospital Clinic Barcelona, Spain.
Reprod Biomed Online. 2021 May;42(5):939-951. doi: 10.1016/j.rbmo.2021.02.003. Epub 2021 Feb 11.
Chronic endometritis is a pathology often associated with reproductive failure, but there are still no clear recommendations on whether its inclusion in the initial study of infertile couples is necessary. In this discussion paper, based on a SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis, the different aspects of the repercussions of chronic endometritis in fertility are evaluated. To avoid possible subjectivity in the analysis and results of this study, the researchers followed the Oxford criteria for the evaluation of evidence. The results from the evaluation of the reviewed literature seem to indicate that, pending new evidence, it would be advisable not to include chronic endometritis in the initial baseline study before assisted reproduction in order not to delay other assisted reproduction treatments. However, it would be advisable in cases of repetitive implantation failure and pregnancy loss after having undergone IVF with viable embryos and before continuing with costly reproductive processes, since results could be improved. The development of randomized studies assessing the impact of antibiotic treatment as a possible therapeutic option in infertile women with chronic endometritis, as well as the possible impact on endometrial microbiota and receptivity/implantation, would allow for the establishment of more precise clinical guidelines in this regard.
慢性子宫内膜炎是一种常与生殖失败相关的病理状况，但对于是否有必要在不育夫妇的初始检查中纳入该病症，目前仍没有明确的建议。在这篇讨论文章中，基于SWOT（优势、劣势、机会、威胁）分析，对慢性子宫内膜炎在生育方面的影响的不同方面进行了评估。为避免本研究的分析和结果中可能出现的主观性，研究人员遵循牛津证据评估标准。对所审查文献的评估结果似乎表明，在没有新证据的情况下，在辅助生殖前的初始基线检查中不纳入慢性子宫内膜炎是可取的，以免延误其他辅助生殖治疗。然而，对于在移植有活力胚胎的体外受精后出现反复种植失败和妊娠丢失的情况，在继续进行昂贵的生殖过程之前，纳入慢性子宫内膜炎检查是可取的，因为这样可能会改善结果。开展随机研究，评估抗生素治疗作为慢性子宫内膜炎不育女性的一种可能治疗选择的影响，以及对子宫内膜微生物群和接受性/着床的可能影响，将有助于在这方面建立更精确的临床指南。
