Chronic Endometritis (CE)

By RRM Academy Reviewed by Dr. Naomi Whittaker, MD, Board-Certified OBGYN, MIGS, NFPMC, FCI Updated May 7, 2026

A persistent, low-grade inflammatory condition of the endometrial lining caused by abnormal colonization of the endometrium by bacteria (e.g., Enterococcus, E. coli, Streptococcus). Often subclinical (no obvious symptoms). CE is significantly associated with recurrent implantation failure and recurrent pregnancy loss. Diagnosed by office hysteroscopy (strawberry-pattern micropolypoid endometrium) confirmed by CD138 immunohistochemistry on endometrial biopsy. Treated with targeted antibiotics (typically doxycycline, amoxicillin, or based on culture). A cohort study showed the biopsy/treatment group had significantly higher chances of pregnancy (HR 2.28) and live birth (HR 2.76) compared to hysteroscopy-only controls.⁵¹²⁶

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