Endometritis in infertile couples: the role of hysteroscopy and bacterial endotoxin

作者：Gérsia Araújo Viana, Vito Cela, Maria Rosaria Ruggiero, Nicola Pluchino, Andrea Riccardo Genazzani, Carlo Tantini · 发表于：JBRA · 年份：2015 · DOI：10.5935/1518-0557.20150006 · 被引用次数：16 · 研究领域：Reproductive System and Pregnancy、Gynecological conditions and treatments、Reproductive tract infections research

OBJECTIVE: The role of endometritis on infertility is still controversial. The aim of our prospective controlled study was to select infertile couples and to analyze: hysteroscopic findings of endometritis, bacterial endotoxin level in the menstrual blood, histological pattern of endometrial biopsy and to determine the effect of antibiotic therapy on endometritis resolution. METHODS: 100 infertile couples of University Hospital waiting for in vitro fertilization program. We evaluated the incidence of endometritis in infertile population by hysteroscopy, endometrial biopsy and bacterial endotoxin levels in the menstrual samples. Moreover, we verified the effectiveness of antimicrobial treatment on the endometritis resolution by hysteroscopic control. RESULTS: Out of 100 women enrolled, 15 showed hysteroscopic evidence of endometritis and 12 of these patients presented higher bacterial endotoxin in the menstrual samples. The histological results were positive for endometritis in 9 cases, 1 woman had no adequate samples and 5 patients had negative result. After antibiotic therapy, 9 patients had a complete hysteroscopic endometritis resolution, 4 patients had an improvement and in 2 cases there was no endometrial change. Concerning histological findings after therapy, we had negative results in 12 patients and persistent inflammatory findings in 2 patients. CONCLUSION: Our study demonstrated a high incidence of endometritis in infertile couples (15%). The endometrial biopsy was ...