Infections and the Reproductive Microbiome Chronic Endometritis

Chronic endometritis is a frequent finding in women with recurrent implantation failure after in vitro fertilization

Johnston-MacAnanny EB, Hartnett J, Engmann LL, Nulsen JC, Sanders MM, Benadiva CA

Published February 2010 Fertility and sterility, 93(2), 437-41
DOI 10.1016/j.fertnstert.2008.12.131 PMID 19217098

Abstract

Objective

To determine the role of endometrial sampling for identification and treatment of chronic endometritis (CE) in patients undergoing IVF-ET who repeatedly failed to conceive despite the transfer of good-quality embryos.

Design

Retrospective chart review.

Setting

University-based tertiary fertility center.

Patients

Thirty-three patients with recurrent implantation failure (RIF) who underwent endometrial sampling and subsequent ET were analyzed based on immunohistochemically confirmed CE: CE present on biopsy (group 1; n = 10) and CE absent on biopsy (group 2; n = 23). Patients with RIF undergoing IVF cycles during the same time period who did not have endometrial sampling were used as controls (group 3; n = 485).

Interventions

Endometrial sampling for CE and subsequent antibiotic treatment in affected patients followed by another IVF-ET cycle.

Results

Chronic endometritis was identified in 30.3% of patients with RIF. Group 1 had lower implantation rates (11.5%) in the IVF cycle following treatment than did group 2 and group 3 (32.7% and 20.3%, respectively). Clinical pregnancy and ongoing pregnancy rates were similar across groups.

Conclusions

Recurrent implantation failure warrants investigation of CE as a contributing factor. Women demonstrating CE on endometrial sampling have lower implantation rates in a subsequent IVF-ET cycle; however, there were no differences in subsequent clinical pregnancy or ongoing pregnancy rates after successful antibiotic treatment.

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Infections and the Reproductive Microbiome › Chronic Endometritis › Endometritis and Reproductive Outcomes · Diagnostics › Endometrial Assessment › Endometrial Infection · Infertility › Uterine Factor › Endometrial Receptivity
Erika B Johnston-MacAnanny, Janice Hartnett, Lawrence L Engmann, John C Nulsen, M Melinda Sanders, Claudio A Benadiva
E Johnston-MacAnanny, J Hartnett, Larry Engmann, L Engmann, Jack Nulsen, J Nulsen, C Benadiva
PMID 19217098 19217098 DOI 10.1016/j.fertnstert.2008.12.131 10.1016/j.fertnstert.2008.12.131 Johnston-MacAnanny et al. 2010, Johnston-MacAnanny 2010