In:
Gynecologic and Obstetric Investigation, S. Karger AG, Vol. 88, No. 2 ( 2023), p. 108-115
Abstract:
〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 The objective of this study was to examine the prevalence of chronic endometritis (CE) in infertile women, its impact on reproductive outcomes, and the accuracy of hysteroscopy as a screening tool for CE. 〈 b 〉 〈 i 〉 Design: 〈 /i 〉 〈 /b 〉 This was a prospective observational study. 〈 b 〉 〈 i 〉 Participants: 〈 /i 〉 〈 /b 〉 Participants involved in this study were 514 asymptomatic patients with infertility. 〈 b 〉 〈 i 〉 Setting: 〈 /i 〉 〈 /b 〉 The review was conducted in a tertiary care center. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 The participants underwent a hysteroscopy and endometrial biopsy (EMB). Antibiotics were given for cases of CE. We investigated the prevalence of CE in patients starting assisted reproductive technologies (ART) as a primary outcome. Secondary outcomes were the clinical pregnancy rate (CPR) in the ART cycle after hysteroscopy, EMB, and antibiotic treatment in cases of CE; the cumulative CPR in the subsequent 2 years after hysteroscopy and EMB; the sensitivity and specificity of hysteroscopy as a screening tool compared to EMB as the “gold standard” for diagnosing CE. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 CE was identified in 2.8% of patients starting ART (11/393). CPRs did not differ significantly between patients with CE and the entire cohort of patients without CE in the subsequent ART cycle (OR: 0.43; 95% CI: 0.09–2.02) or in the 2 years after EMB (OR: 0.56; 95% CI: 0.16–1.97). In a matched control comparison (with matching for age, basal FSH, and cause of infertility), CPR in patients with CE did not differ in the subsequent ART cycle (OR: 0.39; 95% CI: 0.09–1.61); however, their CPR in the 2 years after EMB was significantly lower (OR: 0.22; 95% CI: 0.13–0.38). The sensitivity and specificity of hysteroscopy as a screening tool for diagnosing CE were 8.3% and 90.1%, respectively. 〈 b 〉 〈 i 〉 Limitations: 〈 /i 〉 〈 /b 〉 Due to our cohort’s low CE prevalence, we could not detect significant differences in CPRs. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 CE is rare in our studied population of asymptomatic patients starting ART. Hysteroscopy cannot replace EMB for diagnosing CE.
Type of Medium:
Online Resource
ISSN:
0378-7346
,
1423-002X
Language:
English
Publisher:
S. Karger AG
Publication Date:
2023
detail.hit.zdb_id:
1482695-1
