Endometrial polyps with increased plasma cells are associated with chronic endometritis in infertility patients: Hysteroscopic findings and post‐polypectomy pregnancy rates

Nomiyama, Mari; Yamasaki, Fumio; Tokunaga, Mariko; Ohbuchi, Yukari; Sago, Naka; Arima, Kaoru; Nishiyama, Wakako; Hashiguchi, Mariko; Kojima, Kayoko

doi:10.1002/rmb2.12394

Cited by 10 publications

(15 citation statements)

References 37 publications

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“…Finally, a total of eight studies were included in this present review [ 29 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. The study flow diagram is displayed in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Meta-analysis on the prevalence of CE in women with EPs was conducted based on data from seven studies [ 29 , 35 , 37 , 38 , 39 , 40 , 41 ]. A total number of 1248 patients with EPs were included.…”

Section: Resultsmentioning

confidence: 99%

“…Meta-analysis included data from three studies. A total number of 349 EPs were analysed [ 36 , 38 , 40 ]. The prevalence of CD-138-positive EPs among EPs ranged from 55.07% in the study by Nomiyama et al [ 38 ] to 80.00% in the study by Inaba et al [ 36 ].…”

Section: Resultsmentioning

confidence: 99%

“…A total number of 349 EPs were analysed [ 36 , 38 , 40 ]. The prevalence of CD-138-positive EPs among EPs ranged from 55.07% in the study by Nomiyama et al [ 38 ] to 80.00% in the study by Inaba et al [ 36 ]. The pooled proportion was 70.73% (95% CI, 55.73–83.68%; I 2 = 84.00%) ( Figure 3 ).…”

Section: Resultsmentioning

confidence: 99%

“…Prevalence of CE in women with EPs compared to women with a non-polypoid endometrium Data on 872 women (n = 483 with EPs and n = 389 with a non-polypoid endometrium) from three studies [38][39][40] showed a significantly higher prevalence of CE in women with EPs as compared to women with a non-polypoid endometrium (OR 3.07, 95% CI 1.59-5.95, I 2 = 77%, p = 0.0008; Figure 4). Prevalence of CE in women with EPs compared to women with a non-polypoid endometrium Data on 872 women (n = 483 with EPs and n = 389 with a non-polypoid endometrium) from three studies [38][39][40] showed a significantly higher prevalence of CE in women with EPs as compared to women with a non-polypoid endometrium 3.07, 95% CI 1.59-5.95, I 2 = 77%, p = 0.0008; Figure 4).…”

Section: Tertiary Outcomesmentioning

confidence: 99%

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Association between Endometrial Polyps and Chronic Endometritis: Is It Time for a Paradigm Shift in the Pathophysiology of Endometrial Polyps in Pre-Menopausal Women? Results of a Systematic Review and Meta-Analysis

et al. 2021

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Background: Chronic endometritis (CE) and endometrial polyps (EPs) are common conditions in reproductive age women. CE is an infectious disorder of the endometrium characterized by signs of chronic inflammation at hysteroscopic and histological analyses. EPs are abnormal endometrial growths containing glands, stroma and blood vessels projecting from the lining of the uterus. During the last years, different authors have investigated the correlation between CE and EPs, with controversial results. The aim of this study was to summarize available evidence on the potential correlation between CE and EPs. Design: Systematic literature review and meta-analysis. Methods: Observational-studies were identified by searching electronic databases from their inception to September 2021. Only studies on pre-menopausal women were included. Statistical analysis was performed using MedCalc 16.4.3 (Ostend, Belgium) and Review Manager version 5.3 (Nordic Cochrane Centre, Cochrane Collaboration). The summary measures were reported as pooled proportion or odds ratio (OR) with 95% confidence interval (CI). The primary outcome was to evaluate the prevalence of CE in women with EPs. The secondary outcome was to determine the prevalence of CD-138-positive EPs among EPs. Tertiary outcomes were to compare the prevalence of CE in women with EPs versus women with a non-polypoid endometrium and to compare the prevalence of CE in women with a single EP versus women with multiple EPs. Results: Eight observational studies (n = 3225 patients) were included in quantitative synthesis. Pooled prevalence of CE among women with EPs was 51.35% (95% CI, 27.24–75.13%). Pooled proportion of CD-138-positive EPs among EPs was 70.73% (95% CI, 55.73–83.68%). Women with EPs showed higher prevalence of CE compared to women without EPs (OR 3.07, 95% CI 1.59–5.95). Women with ≥3 EPs had higher prevalence of CE then women with a single EP (OR 3.43, 95% CI 1.83–6.46). Conclusions: In pre-menopausal women, CE and EPs may have a dependent relationship and may represent two consequent steps of a common pathological process.

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“…Finally, a total of eight studies were included in this present review [ 29 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. The study flow diagram is displayed in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Tertiary Outcomesmentioning

confidence: 99%

See 3 more Smart Citations

Association between Endometrial Polyps and Chronic Endometritis: Is It Time for a Paradigm Shift in the Pathophysiology of Endometrial Polyps in Pre-Menopausal Women? Results of a Systematic Review and Meta-Analysis

et al. 2021

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The risk factors and prognostic impact of different benign pathologic types of background endometrium surrounding endometrial polyps

Huang,

Li,

Chen

et al. 2024

Intl J Gynecology & Obste

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ObjectiveThis retrospective study investigated the prognostic significance and risk factors of benign pathologic types of background endometrium surrounding endometrial polyps (EPs).MethodsWe assessed 206 patients who underwent hysteroscopic polypectomy and background endometrium biopsy. Patients were categorized into four groups based on the pathologic types of background endometrium: normal proliferative endometrium (NPE), polypoid hyperplastic endometrium (PHE), chronic endometritis (CE), and non‐atypical endometrial hyperplasia (NEH). We employed univariable comparisons and multivariable logistic regression analysis to identify risk factors of PHE, CE, and NEH compared to NPE. Abnormal uterine bleeding (AUB) and recurrence of EPs were monitored over a 12‐month postoperative follow‐up period.ResultsIndependent risk factors for EPs with a background of CE included a history of genital tract infection (OR = 8.88, 95% CI: 2.95–26.70, P = 0.000), adenomyosis (OR = 13.70, 95% CI: 3.38–55.52, P = 0.000), and hydrosalpinx (OR = 2.23, 95% CI: 1.59–54.09, P = 0.013). Age (OR = 1.18, 95% CI: 1.07–1.30, P = 0.001) and BMI (OR = 1.33, 95% CI: 1.11–1.61, P = 0.003) were significant risk factors for EPs with a background of NEH. Patients with PHE had higher recurrence rates of EPs following 12 months of follow‐up. Moreover, background endometrium types PHE, CE, and NEH were associated with poorer control of AUB.ConclusionOur study underscores the importance of examining the histopathologic characteristics of the background endometrium surrounding EPs, as these benign lesions significantly influence the recurrence and symptomatology of EPs.

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Hysteroscopic versus histopathological agreement in the diagnosis of chronic endometritis: results from a retrospective observational study

Pérez-Cejuela,

Vitale,

Pérez-Medina

et al. 2023

Arch Gynecol Obstet

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Purpose To evaluate the agreement rate between hysteroscopy and pathological examination in case of chronic endometritis. Methods A retrospective observational study carried out at Gynecology and Obstetrics Department, Puerta de Hierro Hospital, Autónoma University of Madrid, Spain, from January 2021 to June 2022 was performed by obtaining data from 115 medical records of women who underwent office hysteroscopies that was compared with the findings of final histological examination of endometrial biopsy. Cohen's kappa index was used to evaluate this agreement rate. In addition, sensitivity, specificity, positive and negative predictive value and diagnostic accuracy were obtained. Results The agreement between hysteroscopic findings and histological examination showed a modest result with a Cohen’s kappa index of 34%. In addition, we obtained a specificity of 70% and a sensitivity of 64%. The positive and negative predictive value were 60.8% and 73.4%, respectively. An excellent agreement rate (100%) between histological and hysteroscopic results was observed in presence of hyperemia and micropolyps. Conclusion Although the sample size is not as large as that of other studies published so far, the first glance of our experience is that hysteroscopic signs are not yet sufficient to make an accurate diagnosis of chronic endometritis, thus requiring a histopathological confirmation to make it.

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Endometrial polyps with increased plasma cells are associated with chronic endometritis in infertility patients: Hysteroscopic findings and post‐polypectomy pregnancy rates

Cited by 10 publications

References 37 publications

Association between Endometrial Polyps and Chronic Endometritis: Is It Time for a Paradigm Shift in the Pathophysiology of Endometrial Polyps in Pre-Menopausal Women? Results of a Systematic Review and Meta-Analysis

Association between Endometrial Polyps and Chronic Endometritis: Is It Time for a Paradigm Shift in the Pathophysiology of Endometrial Polyps in Pre-Menopausal Women? Results of a Systematic Review and Meta-Analysis

The risk factors and prognostic impact of different benign pathologic types of background endometrium surrounding endometrial polyps

Hysteroscopic versus histopathological agreement in the diagnosis of chronic endometritis: results from a retrospective observational study

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