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Reproductive immunology has grown in importance in recent years and has even developed into a discipline of its own within the field of reproductive medicine. Many aspects of reproductive failure such as repeated implantation failure (RIF) or recurrent miscarriages (RM) are meanwhile seen as a consequence of aberrant expression of immunological factors. This is reflected by the increasing number of tests for assessing and quantifying different immune cell types as well as by a wide range of immune therapies offered to a clientele consisting of desperate patients requesting additional “IVF tools”. Firstly, what is still usually disregarded is the enormous plasticity and fluctuation of most immune cells in the genital tract. Second, their still poorly characterized functions in the endometrial cycle, further their partially unknown role in embryo implantation and in establishing a pregnancy. Third, the fact, that one of the fundamental hypotheses of reproductive immunology -of note- the Medawar concept or “Medawar's Paradox of semi-allogeneic graft embryo, is partially based on an erroneous assumption, i.e., the immunologic rejection and tolerance of an embryo. In the present opinion paper, we comment on the diagnostic procedures and therapy approaches for chronic endometritis (CE) within the scope of reproductive medicine.

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