Chronic endometritis positively correlates with the aggravation of intrauterine adhesions but has limited effects on reproductive prognosis with antibiotic application

Int J Gynaecol Obstet. 2023 Mar;160(3):986-992. doi: 10.1002/ijgo.14434. Epub 2022 Sep 26.

Abstract

Objective: To assess the effect of chronic endometritis (CE) diagnosed by CD138 staining on the aggravation of intrauterine adhesions (IUAs), and the reproductive prognosis after transcervical resection of adhesions (TCRA).

Methods: Sixty-three patients with severe IUAs (group A) and 119 patients with moderate IUAs (group B) were included in this retrospective study. TCRA and endometrial biopsy with CD138 staining were performed. Participants in each group were classified into two subgroups: CE group and NCE group (without CE). Patients were treated with a course of oral antibiotics for 2 weeks after TCRA. Embryo transfer would be performed if patients had embryos after operations.

Results: Increased incidence of CE was found in group A (18/63, 28.57%) compared with group B (18/119, 15.13%) (P = 0.030). No significant differences were found in the comparisons of chemical pregnancy rate, early miscarriage rate, or full-term pregnancy rate between the CE group and NCE group (P > 0.05), in either the subgroup analysis of group A and group B, or the total analysis.

Conclusion: CE has a positive correlation with the aggravation of IUAs. CE did not have a negative impact on the reproductive prognosis of patients with moderate or severe IUAs after TCRA followed by antibiotic administration.

Keywords: CD138; chronic endometritis; intrauterine adhesions; reproductive prognosis.

MeSH terms

  • Abortion, Spontaneous*
  • Anti-Bacterial Agents / therapeutic use
  • Chronic Disease
  • Endometritis* / drug therapy
  • Endometritis* / epidemiology
  • Female
  • Humans
  • Hysteroscopy
  • Pregnancy
  • Prognosis
  • Retrospective Studies
  • Tissue Adhesions / surgery
  • Uterine Diseases* / drug therapy
  • Uterine Diseases* / surgery

Substances

  • Anti-Bacterial Agents

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