Chronic Endometritis in Patients with Failure of IVF

Background: Chronic endometritis (CE) is highly prevalent in patients with unexplained infertility. This study aimed to determine the associations between CE and infertility. Methods and Results: We performed a prospective study of 197 women with implantation failure and pregnancy loss after undergoing in vitro fertilization (IVF). The endometrium was examined with a hysteroscope, and a sample was taken for biopsy in areas suspected of having inflammation. Immunohistochemistry was performed for CD138 antibodies. Diagnostic criterion was more than 5 plasma cells per 10 high-power fields. Patients who were positive for CE were treated with antibiotics. Among the 197 patients in our study, 115(58.4%) were positive for CE. Regarding the success of CE treatment and pregnancy after treatment, among the 115 CD138-positive patients, 32 became pregnant without IVF after treatment, while another 43 had successful pregnancies and childbirth with IVF. Thus, with treated CE, a successful pregnancy and childbirth was detected in 65.2% of cases, including spontaneous pregnancies and IVF. Conclusion: Patients with infertility and those who have pregnancies lost in IVF have a high rate of CE. Failure to treat CE results in infertility and IVF failure. An efficient diagnosis and treatment of CE are important for a successful pregnancy.