Endometrial causes of recurrent pregnancy losses: endometriosis, adenomyosis, and chronic endometritis

Fertil Steril. 2021 Mar;115(3):546-560. doi: 10.1016/j.fertnstert.2020.12.010. Epub 2021 Feb 11.

Abstract

Chronic inflammatory processes affecting the endometrium, as encountered in endometriosis, adenomyosis, and chronic endometritis, alter endometrial receptivity. These disorders are associated with early pregnancy losses and possibly recurrent pregnancy losses (RPL). In the cases of endometriosis, other factors associated with the disease also are susceptible of causing miscarriages and possibly RPL, such as an impact of intrapelvic inflammatory processes affecting the oocyte and embryo in case of natural conception. Conversely these latter effects obviously are bypassed in case of assisted reproductive technology. Chronic inflammation of the endometrium in the condition known as chronic endometritis also causes early pregnancy losses and RPL with beneficial effects achieved when specific treatment is undertaken.

Keywords: Miscarriage; chronic endometritis; early pregnancy loss; endometriosis; recurrent pregnancy losses.

Publication types

  • Review

MeSH terms

  • Abortion, Habitual / diagnosis
  • Abortion, Habitual / etiology
  • Abortion, Habitual / physiopathology*
  • Adenomyosis / complications
  • Adenomyosis / diagnosis
  • Adenomyosis / physiopathology*
  • Chronic Disease
  • Embryo, Mammalian / pathology
  • Embryo, Mammalian / physiopathology
  • Endometriosis / complications
  • Endometriosis / diagnosis
  • Endometriosis / physiopathology*
  • Endometritis / complications
  • Endometritis / diagnosis
  • Endometritis / physiopathology*
  • Endometrium / pathology
  • Endometrium / physiopathology*
  • Female
  • Humans
  • Oocytes / physiology
  • Pregnancy