Analysis of the Predictive Factors for Chronic Endometritis Recurrence in Infertile Women

IF 2.5 3区医学 Q3 IMMUNOLOGY

American Journal of Reproductive Immunology Pub Date : 2024-10-18 DOI:10.1111/aji.70002

Keisuke Shiobara, Keiji Kuroda, Shunsuke Ishiyama, Kazuki Nakao, Azusa Moriyama, Takashi Horikawa, Satoru Takamizawa, Shuko Nojiri, Koji Nakagawa, Rikikazu Sugiyama

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引用次数: 0

Abstract

Problem

To identify the predictive factors for the recurrence of chronic endometritis (CE) in infertile women.

Method of study

In this case-control study, 1170 infertile women recovered from CE and underwent fertility treatment between December 2018 and August 2021. Among the 146 women (12.5%) who did not conceive or experienced pregnancy loss in 18 months after CE recovery, 105 consecutive women who underwent repeat endometrial biopsy for CD138 immunostaining and endometrial bacterial culturing were recruited. Thereafter, patients with and without CE recurrence were compared.

Results

The total recurrence rate of CE was 29.5% (31 women). Multivariable logistic regression analysis to determine predictive factors for CE recurrence revealed that hysteroscopic surgery (odds ratio [OR], 0.10; 95% confidence interval [CI], 0.02–0.56; p = 0.0009) and pregnancy loss (OR, 4.13; 95% CI, 1.31–13.05; p = 0.016) were significantly associated with decreased and increased CE recurrence rates, respectively. Also, reexamination with CD138 immunostaining after 16–18 months (OR, 9.75; 95% CI, 1.47–64.64; p = 0.024) was significantly associated with increased CE recurrence rates. Among 49 patients without a history of pregnancy loss, the cumulative CE recurrence rates after 6, 12, and 18 months were 5.6%, 13.5%, and 20.4%, respectively.

Conclusions

We recommend reexamination with endometrial CD138 immunostaining in patients with pregnancy loss or long-term infertility during fertility treatment. Hysteroscopic surgery without antibiotic therapy for CE associated with intrauterine abnormalities is also recommended.

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不孕妇女慢性子宫内膜炎复发的预测因素分析

问题找出不孕妇女慢性子宫内膜炎（CE）复发的预测因素。研究方法在这项病例对照研究中，1170名不孕妇女在2018年12月至2021年8月期间从CE中康复并接受了生育治疗。在146名（12.5%）CE康复后18个月内未怀孕或出现妊娠失败的女性中，招募了105名连续接受重复子宫内膜活检以进行CD138免疫染色和子宫内膜细菌培养的女性。之后，对 CE 复发和未复发的患者进行比较。结果 CE总复发率为29.5%（31名女性）。为确定 CE 复发的预测因素而进行的多变量逻辑回归分析表明，宫腔镜手术（几率比 [OR]，0.10；95% 置信区间 [CI]，0.02-0.56；P = 0.0009）和妊娠失败（OR，4.13；95% CI，1.31-13.05；P = 0.016）分别与 CE 复发率的降低和升高显著相关。此外，16-18 个月后再次进行 CD138 免疫染色检查（OR，9.75；95% CI，1.47-64.64；p = 0.024）与 CE 复发率的增加有明显相关性。在 49 名无妊娠失败史的患者中，6、12 和 18 个月后的 CE 复发率分别为 5.6%、13.5% 和 20.4%。结论我们建议在不孕治疗期间对妊娠失败或长期不孕患者进行子宫内膜 CD138 免疫染色复查。对于与宫内畸形相关的 CE，我们还建议进行宫腔镜手术，但无需抗生素治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Reproductive Immunology 医学-免疫学

CiteScore

6.20

自引率

5.60%

发文量

314

审稿时长

2 months

期刊介绍： The American Journal of Reproductive Immunology is an international journal devoted to the presentation of current information in all areas relating to Reproductive Immunology. The journal is directed toward both the basic scientist and the clinician, covering the whole process of reproduction as affected by immunological processes. The journal covers a variety of subspecialty topics, including fertility immunology, pregnancy immunology, immunogenetics, mucosal immunology, immunocontraception, endometriosis, abortion, tumor immunology of the reproductive tract, autoantibodies, infectious disease of the reproductive tract, and technical news.