Chronic endometritis: Really so relevant in repeated <scp>IVF</scp> failure?

Vitagliano, Amerigo; Saccardi, Carlo; Litta, Pietro; Noventa, Marco

doi:10.1111/aji.12758

Cited by 29 publications

(28 citation statements)

References 16 publications

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“…The prevalence of CE in the medical literature varies based on the investigated patient population and diagnostic approach. Prevalence estimates range from 13.95% to 57.55% in women with repeated in vitro fertilization failure (10,11), from 7% to 56% in women with RPL (5,9), and from 1.4% to 52% in women with AUB (1,2).…”

mentioning

confidence: 99%

Unified diagnostic criteria for chronic endometritis at fluid hysteroscopy: proposal and reliability evaluation through an international randomized-controlled observer study

Cicinelli

Vitagliano

Kumar³

et al. 2019

Fertility and Sterility

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Objective: To develop a consensus on the diagnostic criteria for chronic endometritis (CE) at hysteroscopy (HSC), and to evaluate these proposed criteria in a randomized-controlled observer study. Design: Systematic review of studies evaluating the diagnostic accuracy of HSC in CE diagnosis; Delphi consensus on hysteroscopic diagnostic criteria for CE; randomized-controlled observer study to evaluate the reproducibility of the proposed diagnostic criteria. Setting: Not applicable. Participant(s): Experts from different countries were involved in the systematic review and contributed to the Delphi consensus. Physicians from different countries were involved in the observer study. Intervention(s): After reaching consensus on the diagnostic criteria, the Delphi poll created a questionnaire including 100 hysteroscopic pictures (50 from women with CE [domain 1] and 50 from women without CE [domain 2]), with a single question per picture (Answer_A: suggestive of CE; answer B: not suggestive of CE). A total of 200 physicians were invited to take part in the observer study. Before completing the questionnaire, physicians were randomized to receive a description of the diagnostic criteria (group A) or no such information (group B). Main Outcome Measure(s): The primary outcome was to compare the questionnaire scores for the two groups of observers. The secondary outcome was to assess the interobserver agreement in the diagnosis of CE in each group. Result(s): A total of 126 physicians completed the questionnaire (62 in group A and 64 in group B). Observers in group A obtained higher total scores compared with those in group B (P< .001). Specifically, group A showed higher mean score in domain 1 (P< .001), but not in domain 2 (P¼ .975). A substantial agreement was found among observers in group A (intraclass correlation coefficient [ICC] 0.78), whereas a fair agreement was found among observers in group B (ICC 0.40). Conclusion(s):This randomized-controlled observer study found a positive impact of our criteria on physicians' ability to recognize CE. (Fertil Steril Ò 2019;112:162-73. Ó2019 by American Society for Reproductive Medicine.) El resumen está disponible en Español al final del artículo.

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confidence: 99%

Unified diagnostic criteria for chronic endometritis at fluid hysteroscopy: proposal and reliability evaluation through an international randomized-controlled observer study

Cicinelli

Vitagliano

Kumar³

et al. 2019

Fertility and Sterility

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“…Different authors have recently demonstrated that CE is highly prevalent in infertile women, especially in those with recurrent implantation failure (RIF) at IVF (5)(6)(7). Interestingly, specific antibiotics (against Gram-negative or intracellular bacteria) can cure CE in the majority of patients (cure rate up to 80% after a single antibiotic cycle) (7). Nevertheless, it is still unclear whether CE cure results in a better chance to achieve clinical pregnancy and live birth in subsequent IVF-ET attempts (7,8).…”

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confidence: 99%

“…Interestingly, specific antibiotics (against Gram-negative or intracellular bacteria) can cure CE in the majority of patients (cure rate up to 80% after a single antibiotic cycle) (7). Nevertheless, it is still unclear whether CE cure results in a better chance to achieve clinical pregnancy and live birth in subsequent IVF-ET attempts (7,8).…”

mentioning

confidence: 99%

Effects of chronic endometritis therapy on in vitro fertilization outcome in women with repeated implantation failure: a systematic review and meta-analysis

Vitagliano

Saccardi

Noventa

et al. 2018

Fertility and Sterility

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“…Основываясь на существующих данных, влияние ХЭ на бесплодие остается неясным. Тем не менее лечение хронического воспаления эндометрия может положительно повлиять на фертильность [17].…”

Section: эпидемиологияunclassified

Chronic endometritis: pathogenesis, diagnosis, management and associated infertility

Оразов¹,

Mikhaleva²,

Семенов³

2020

Clin. Exp. Morphology

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Хронический эндометрит (ХЭ) характеризуется постоянным субклиническим воспалением и инфильтрацией плазматических клеток в стромальной зоне эндометрия. Общая распространенность данного заболевания широко варьирует. Неадекватные процессы пролиферации и дифференцировки, изменение иммунного ответа на уровне эндометрия, а также аберрантная экспрессия медиаторов воспаления определяют проблемы, связанные с фертильностью женщин с ХЭ. Иммуногистохимический метод обнаружения плазматических клеток в эндометрии является золотым стандартом диагностики. Гистероскопию в сочетании с гистологическим исследованием можно считать благоприятной комбинацией для диагностики ХЭ. Антибиотикотерапия ХЭ на данный момент считается методом выбора, хотя существует множество противоречивых мнений насчет ее эффективности в преодолении бесплодия на фоне ХЭ. Цель обзора-охарактеризовать патофизиологию хронического эндометрита и его связи с инфертильностью, а также существующие методы диагностики и лечения ХЭ. Заключение. Несмотря на обилие накопленной информации, все еще требуются качественные клинико-морфологические исследования с сильной доказательной базой для преодоления неясностей этиологии, патофизиологии, диагностики и лечения сниженной фертильности женщин, страдающих ХЭ. Ключевые слова: хронический эндометрит, повторные неудачи имплантации, повторные потери беременности.

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Chronic endometritis: Really so relevant in repeated IVF failure?

Cited by 29 publications

References 16 publications

Unified diagnostic criteria for chronic endometritis at fluid hysteroscopy: proposal and reliability evaluation through an international randomized-controlled observer study

Unified diagnostic criteria for chronic endometritis at fluid hysteroscopy: proposal and reliability evaluation through an international randomized-controlled observer study

Effects of chronic endometritis therapy on in vitro fertilization outcome in women with repeated implantation failure: a systematic review and meta-analysis

Chronic endometritis: pathogenesis, diagnosis, management and associated infertility

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