Chronic endometritis: A protracted discussion

Abstract

Introduction Chronic endometritis is one of the most important factors leading to reduced fertility in women. The protracted discussion about the presence of this nosology in clinical practice for more than 100 years does not allow to establish the true frequency of chronic endometritis in women of reproductive age. At the present stage, due to the unfavorable demographic situation both in the Russian Federation and in many countries, the study of chronic endometritis, as one of the main determinants of the lesions of the morphological and functional state of the endometrium, is relevant.The purpose of the study is to determine the current state of the problem of verification of chronic endometritis in women with infertility, reproductive losses and repeated failure of assisted reproductive technologies (ART).Materials and methods The sources of information were publications from the databases PubMed, Google Scholar, elibrary.ru and Russian medical journals in the field of obstetrics and gynecology, as well as pathological anatomy in the period from 2013 to 2022.Results and discussion An analysis of the literature showed that chronic endometritis is the cause of infertility, miscarriage and ineffective ART protocols and leads to decrease of the regenerative potential and endometrial reserve. Despite the evidence of the negative impact of chronic endometritis on the reproductive function, at the present stage, the discussion regarding diagnostic approaches to this nosology continues. The use of the histological method of research, as the main and available method for diagnosing the state of the endometrium, is not always allow to verify chronic endometritis, which dictates the need of using high technological methods to confirm and clarify the severity of the pathological process.Conclusion A unified algorithm for diagnosing chronic endometritis in patients with infertility, miscarriage, ineffective ART cycles and a qualified approach to the morphological diagnosis of the state of the endometrium, standardization of the diagnosis of chronic endometritis, and competent interpretation of immunohistochemical data make it possible to select a pathogenetically substantiated therapy aimed at the rehabilitation of reproductive function.