Correlation between hysteroscopy finding and chronic Endometritis in Unexplained Primary Infertility

Introduction: One of the most common conditions in a fertility clinic is unexplained infertility. Only recently, chronic endometritis (CE) has been linked to embryonic transplantation failure and infertility. Aim of the study: To evaluate the role of hysteroscopy in the diagnosis of chronic endometritis (CE) and to determine the correlation between hysteroscopic and histologic findings of CE in patients with unexplained primary infertility. Subjects and methods: The present study was conducted on 25 female patients under the age of 40 years attending the infertility clinic at Mataria teaching hospital complaining of unexplained primary infertility during the period from May 2018 to April 2019. Patients underwent office hysteroscopy (for evaluation of CE by visualized hysteroscopic features of CE as endometrial hyperemia), endometrial interstitial edema, micro-polyps, and visualized endometrial biopsies were obtained. Results: We found that 21 patients (84 %) had chronic endometritis by endometrial biopsies taken after being stained with CD138. The diagnostic accuracy of hysteroscopy in the diagnosis of CE in our study was 52%. The hysteroscopy sensitivity was 48%, the specificity was 75%, the positive predictive was 91%, and the negative predictive was 21%. Conclusion: Chronic endometritis should be considered in the workup of unexplained primary infertility. Hysteroscopy is a useful procedure with high diagnostic accuracy in chronic endometritis screening in asymptomatic infertile women however, endometrial biopsy should be complemented for the CE diagnosis.