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慢性子宫内膜炎与复发性生殖失败：系统评价与荟萃分析。

Chronic endometritis and recurrent reproductive failure: a systematic review and meta-analysis.

机构信息

Department of Surgical Sciences, Section of Gynecology and Obstetrics, University of Rome Tor Vergata, Rome, Italy.

Department of Biomedical Sciences, Humanitas University, Milan, Italy.

出版信息

Front Immunol. 2024 Aug 16;15:1427454. doi: 10.3389/fimmu.2024.1427454. eCollection 2024.

DOI:10.3389/fimmu.2024.1427454
PMID:39286255
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11403846/
Abstract

BACKGROUND

The endometrium holds a crucial role in reproduction by supporting blastocyst adhesion, cytotrophoblast invasion and fetal development. Among the various uterine disorders, endometritis, particularly chronic endometritis (CE), has gained attention due to its association with adverse reproductive outcomes (recurrent pregnancy loss (RPL), recurrent implantation failure (RIF), and infertility). The association between CE and adverse reproductive outcomes stresses the necessity for comprehensive diagnostic and therapeutic strategies to optimize fertility outcomes and support individuals in their journey towards parenthood.

AIM

To explore the relationship between CE and reproductive disorders.

METHODS

Following PRISMA guidelines, a systematic review and meta-analysis using published data from 1990 to 2024 were carried out.

RESULTS

A population of 1,038 women was included. Regarding CE-infertility association, a positive correlation was found, with 19.46% CE rate in infertile women compared to 7.7% in controls (OR: 2.96, 95% CI 1.53-5.72, p 0.001). No significant association was observed between RIF and CE (OR: 1.10, 95% CI 0.26-4.61, p 0.90), CE rates in both groups were relatively comparable, with 6.35% in women with RIF and 5.8% in controls. On the opposite, a strong association between CE and RPL was found, reporting a CE rate of 37.6% in RPL cases compared to 16.4% in controls (OR: 3.59, 95% CI 2.46-5.24, p < 0.00001).

CONCLUSIONS

CE appears to be associated to infertility and RPL, while no significant association was noted in cases of RIF.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/#recordDetails PROSPERO, identifier CRD42024541879.

摘要

背景

子宫内膜在支持胚泡附着、滋养细胞侵袭和胎儿发育方面起着至关重要的作用。在各种子宫疾病中，子宫内膜炎，特别是慢性子宫内膜炎（CE），由于与不良生殖结局（复发性妊娠丢失（RPL）、复发性着床失败（RIF）和不孕）有关而受到关注。CE 与不良生殖结局之间的关联强调了需要综合诊断和治疗策略，以优化生育结局，支持人们实现生育愿望。

目的

探讨 CE 与生殖障碍之间的关系。

方法

根据 PRISMA 指南，对 1990 年至 2024 年发表的数据进行了系统评价和荟萃分析。

结果

共纳入 1038 名妇女。关于 CE-不孕的相关性，发现存在正相关，不孕妇女的 CE 发生率为 19.46%，而对照组为 7.7%（OR：2.96，95%CI 1.53-5.72，p<0.001）。RIF 与 CE 之间未见显著相关性（OR：1.10，95%CI 0.26-4.61，p=0.90），两组的 CE 发生率相当，RIF 妇女为 6.35%，对照组为 5.8%。相反，CE 与 RPL 之间存在强烈的相关性，RPL 病例的 CE 发生率为 37.6%，而对照组为 16.4%（OR：3.59，95%CI 2.46-5.24，p<0.00001）。

结论

CE 似乎与不孕和 RPL 相关，而在 RIF 病例中则无显著相关性。

系统评价注册

https://www.crd.york.ac.uk/prospero/#recordDetails PROSPERO，标识符 CRD42024541879。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14e3/11403846/a2ccde202c1d/fimmu-15-1427454-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14e3/11403846/42b4cda1976c/fimmu-15-1427454-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14e3/11403846/f35eaa1a7bc3/fimmu-15-1427454-g002.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14e3/11403846/bd3fe5b483ff/fimmu-15-1427454-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14e3/11403846/cc8ae62699b7/fimmu-15-1427454-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14e3/11403846/41055880f9ac/fimmu-15-1427454-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14e3/11403846/0dec15690642/fimmu-15-1427454-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14e3/11403846/6cffb7daf5a6/fimmu-15-1427454-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14e3/11403846/a2ccde202c1d/fimmu-15-1427454-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14e3/11403846/42b4cda1976c/fimmu-15-1427454-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14e3/11403846/f35eaa1a7bc3/fimmu-15-1427454-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14e3/11403846/32b3a372c2fd/fimmu-15-1427454-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14e3/11403846/bd3fe5b483ff/fimmu-15-1427454-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14e3/11403846/cc8ae62699b7/fimmu-15-1427454-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14e3/11403846/41055880f9ac/fimmu-15-1427454-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14e3/11403846/0dec15690642/fimmu-15-1427454-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14e3/11403846/6cffb7daf5a6/fimmu-15-1427454-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14e3/11403846/a2ccde202c1d/fimmu-15-1427454-g009.jpg

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