Value of diagnosis and treatment of chronic endometritis in patients with recurrent implantation failure
10.3760/cma.j.cn101441-20221207-00548
- VernacularTitle:反复着床失败患者慢性子宫内膜炎的诊治价值
- Author:
Mengting WANG
1
;
Jiaying YUAN
1
;
Qiang LI
1
;
Zhou LI
1
;
Guijin ZHU
1
;
Lei JIN
1
;
Bei XU
1
Author Information
1. 华中科技大学同济医学院附属同济医院生殖医学中心，武汉 430030
- Publication Type:Journal Article
- Keywords:
Hysteroscopy;
CD138;
Chronic endometritis;
Recurrent implantation failure;
Frozen-thawed embryo transfer
- From:
Chinese Journal of Reproduction and Contraception
2023;43(10):1051-1056
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the pregnancy outcomes of frozen-thawed embryo transfer (FET) after antibiotic treatment in patients with recurrent implantation failure (RIF) and chronic endometritis (CE).Methods:A retrospective cohort study was conducted to analyze 496 women with RIF undergoing hysteroscopy and endometrial biopsy before the next FET in Reproductive Medicine Center of Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology from January 2018 to December 2021. According to the pathological results of endometrial biopsy and subsequent treatment, the patients were divided into cured CE group (strong positive CD138 was converted to negative after antibiotic treatment, n=103), suspected CE group (weak positive CD138, n=76), non-CE group (negative CD138, n=230) and control group (hysteroscopy and diagnostic only, no CE-related histopathological screening, n=85). The pregnancy outcomes after FET were compared among the four groups. Results:The prevalence of CE in the patients with RIF was 25.5% (105/411), and the sensitivity of hysteroscopy for the diagnosis of CE was 55.2% and the specificity was 83.0%. The conversion rate of patients with CE was 86.7% (91/105) after 1 cycle of antibiotic treatment and 98.1% (103/105) after 2 cycles of treatment. After removing the confounding factors of age, ovarian reserve function, number of previous transfer cycles, number and type of embryos transferred in FET cycle, and number of high-quality embryos, multivariate regression analysis showed that the clinical pregnancy rate of the cured CE group improved significantly after antibiotic treatment ( OR=1.841, 95% CI: 1.123-3.020, P=0.029). Conclusion:Patients with RIF should be screened for CE, and if CE is diagnosed, pharmacological treatment is recommended prior to embryo transfer, which is beneficial to improve pregnancy outcomes in FET cycles.
