Czernobilsky B
Fertil Steril. 1978 Aug;30(2):119-30. doi: 10.1016/s0015-0282(16)43448-5.
Endometrial biopsy is an essential tool in the evaluation of the infertile couple. Among the various causes of infertility which may be elucidated by such a biopsy, endometritis plays a significant role. In this review endometritis has been subdivided into three distinct pathologic entities: acute, chronic, and fibrotic. Detailed histologic features are discussed separately for each of these varieties. Most of the acute inflammations of the endometrium are cauased by bacteria. They are usually of short duration, respond well to treatment, and only rarely are associated with long-standing infertility. Chronic endometritis, on the other hand, can be caused by a variety of agents such as bacteria, viruses, and parasites. However, in the majority of cases with chronic endometritis the etiology cannot be determined and these are then considered nonspecific. Tuberculous endometritis, which is discussed under the heading of chronic endometritis, constitutes a common cause of infertility in certain countries but much less so in the United States. Other less common conditions such as mycoplasma infection and cytomegalic virus infection, have also been associated with reproductive failure. However, chronic endometritis, especially the most common so-called nonspecific type, is a relatively uncommon cause of infertility. The syndrome of intrauterine adhesions or synechiae has been classified here as fibrotic endometritis because of the pathogenesis and histopathology of this lesion. This entity is commonly associated with infertility and may constitute the end result of a long-standing inflammatory process in the endometrium. The diagnosis of endometritis is not a simple one and necessitates close cooperation between the clinician and pathologist. Pertinent clinical and detailed histopathologic data have to be exchanged between the treating physician and pathologist, especially in cases of infertility, in order for the patient to have benefit from the examination of endometrial tissue obtained.
子宫内膜活检是评估不孕夫妇的一项重要手段。在通过这种活检可能阐明的各种不孕原因中，子宫内膜炎起着重要作用。在本综述中，子宫内膜炎被细分为三种不同的病理实体：急性、慢性和纤维化。分别讨论了这些类型各自详细的组织学特征。子宫内膜的大多数急性炎症是由细菌引起的。它们通常病程较短，对治疗反应良好，并且很少与长期不孕相关。另一方面，慢性子宫内膜炎可由多种病原体引起，如细菌、病毒和寄生虫。然而，在大多数慢性子宫内膜炎病例中，病因无法确定，这些病例随后被认为是非特异性的。在慢性子宫内膜炎标题下讨论的结核性子宫内膜炎，在某些国家是不孕的常见原因，但在美国则少得多。其他不太常见的情况，如支原体感染和巨细胞病毒感染，也与生殖失败有关。然而，慢性子宫内膜炎，尤其是最常见的所谓非特异性类型，是一种相对不常见的不孕原因。宫腔粘连或粘连综合征在此被归类为纤维化子宫内膜炎，因为该病变的发病机制和组织病理学特征如此。这一实体通常与不孕有关，可能是子宫内膜长期炎症过程的最终结果。子宫内膜炎的诊断并非易事，需要临床医生和病理学家密切合作。治疗医生和病理学家之间必须交流相关的临床和详细的组织病理学数据，尤其是在不孕病例中，以便患者能从对所获取的子宫内膜组织的检查中受益。
