Journal of Shandong University (Health Sciences) ›› 2021, Vol. 59 ›› Issue (3): 55-59.doi: 10.6040/j.issn.1671-7554.0.2020.1614

Previous Articles     Next Articles

Effects of chronic endometritis on the pregnancy outcomes of patients with endometriosis-associated infertility

LIANG Yanchun1, YE Haihua2, LU Limei2, DAI Yujing3, CHENG Qianyi3, CHOI Unleng3, ZENG Hanqiu3, CHEN Xinghuan3, WANG Xing3, WEI Yajing1, YANG Ruyu1   

  1. 1. Department of Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong, China;
    2. Department of Gynecology, Wuming Maternal and Child Health Hospital of Nanning, Nanning 530100, Guangxi, China;
    3. Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
  • Published:2021-04-06

PDF (PC)

310

Abstract: Objective To investigate the risk factors of chronic endometritis(CE)in patients with endometriosis-associated infertility(EAI), and to explore the effects of CE on the pregnancy outcomes of such patients. Methods Patients undergoing laparoscopic and hysteroscopic surgery for infertility during June 1, 2018 and June 1, 2019 were collected. All cases were laparoscopically diagnosed and pathologically confirmed as endometriosis. According to the two different diagnostic criteria of CE, patients were divided into CE group and non-CE group. Risk factors of CE were analyzed. The cumulative pregnancy rates of the two groups at different time periods after surgery were compared. Results When ≥1 CD138 positively stained plasma cells observed in endometrial stroma under one high power field was used as the diagnostic criterion, the prevalence of CE in patients with EAI was 82.79%(101/122); fallopian tube adhesion(P=0.008)was the risk factor. When ≥5 CD138 positively stained plasma cells observed was used as the diagnostic criterion, the prevalence of CE was 54.1%(66/122); other gynecologic diseases(myoma, polycystic ovarian syndrome, etc.)(P=0.002)were the risk factor. Whatever the criterion was, after standardized antibiotic treatment, 6, 9 and 12 months after surgery, the differences in the cumulative pregnancy rates in patients with CE and without CE were not statistically significant(P>0.05). Conclusion The prevalence of CE in patients with EAI is high; fallopian tube adhesion and complicated gynecologic diseases are the risk factors of CE in such patients. Standardized antibiotic treatment can improve the pregnancy outcomes.

Key words: Chronic endometritis, Endometriosis, Infertility, CD138

CLC Number: 

  • R711.71
[1] 叶海花, 陆丽美, 戴郁菁, 等. 慢性子宫内膜炎的诊治进展[J]. 国际生殖健康/计划生育杂志, 2019, 38(6): 514-518. YE Haihua, LU Limei, DAI Yujing, et al. Advances in the diagnosis and treatment of chronic endometritis[J]. Journal of International Reproductive Health/Family Planning, 2019, 38(6): 514-518.
[2] Puente E, Alonso L, Lagana AS, et al. Chronic endometritis: old problem, novel insights and future challenges [J]. Int J Fertil Steril, 2020, 13(4): 250-256.
[3] Song D, Feng X, Zhang Q, et al. Prevalence and confounders of chronic endometritis in premenopausal women with abnormal bleeding or reproductive failure [J]. Reprod Biomed Online, 2018, 36(1): 78-83.
[4] Park HJ, Kim YS, Yoon TK, et al. Chronic endometritis and infertility [J]. Clin Exp Reprod Med, 2016, 43(4): 185-192.
[5] Lee D, Kim SK, Lee JR, et al. Management of endometriosis-related infertility: considerations and treatment options [J]. Clin Exp Reprod Med, 2020, 47(1): 1-11.
[6] Ettore C, Giuseppe T, Marcella M, et al. Higher prevalence of chronic endometritis in women with endometriosis: a possible etiopathogenetic link [J]. Fertil Steril, 2017, 108(2): 289-295.
[7] Kimura F, Takebayashi A, Ishida M, et al. Review: chronic endometritis and its effect on reproduction [J]. J Obstet Gynaecol Res, 2019, 45(5): 951-960.
[8] Ticconi C, Pietropolli A, Di Simone N, et al. Endometrial immune dysfunction in recurrent pregnancy loss [J]. Int J Mol Sci, 2019, 20(21): 5332. doi: 10.3390/ijms20215332.
[9] Zondervan KT, Becker CM, Missmer SA. Endometriosis [J]. N Engl J Med, 2020, 382(13): 1244-1256.
[10] Vallve-Juanico J, Houshdaran S, Giudice LC. The endometrial immune environment of women with endometriosis [J]. Hum Reprod Update, 2019, 25(5): 564-591.
[11] de Rivero VJ. The inflammasome in reproductive biology: a promising target for novel therapies [J]. Front Endocrinol(Lausanne), 2020, 11: 8. doi: 10.3389/fendo.2020.00008.
[12] Garcia-Gomez E, Vazquez-Martinez ER, Reyes-Mayoral C, et al. Regulation of inflammation pathways and inflammasome by sex steroid hormones in endometriosis [J]. Front Endocrinol(Lausanne), 2019, 10: 935. doi: 10.3389/fendo.2019.00935.
[13] Le NXH, Loret de Mola JR, Bremer P, et al. Alteration of systemic and uterine endometrial immune populations in patients with endometriosis [J]. Am J Reprod Immunol, 2021, 85(3): e13362. doi: 10.1111/aji.13362.
[14] Khan KN, Yamamoto K, Fujishita A, et al. Differential levels of regulatory T cells and T-Helper-17 cells in women with early and advanced endometriosis [J]. J Clin Endocrinol Metab, 2019, 104(10): 4715-4729.
[15] Pedro-Antonio R, Anna M, Manuela S, et al. Chronic inflammation in PCOS: the potential benefits of specialized pro-resolving lipid mediators(SPMs)in the improvement of the resolutive response [J]. Int J Mol Sci, 2020, 22(1): 384. doi: 10.3390/ijms22010384.
[16] Kitaya K, Matsubayashi H, Takaya Y, et al. Live birth rate following oral antibiotic treatment for chronic endometritis in infertile women with repeated implantation failure [J]. Am J Reprod Immunol, 2017, 78(5): e12719. doi: 10.1111/aji.12719.
[17] Khan KN, Fujishita A, Kitajima M, et al. Intra-uterine microbial colonization and occurrence of endometritis in women with endometriosis [J]. Hum Reprod, 2014, 29(11): 2446-2456.
[18] Wang XM, Ma ZY, Song N. Inflammatory cytokines IL-6, IL-10, IL-13, TNF-alpha and peritoneal fluid flora were associated with infertility in patients with endometriosis [J]. Eur Rev Med Pharmacol Sci, 2018, 22(9): 2513-2518.
[19] Akiyama K, Nishioka K, Khan KN, et al. Molecular detection of microbial colonization in cervical mucus of women with and without endometriosis [J]. Am J Reprod Immunol, 2019, 82(2): e13147. doi: 10.1111/aji.13147.
[20] 陈思凯, 谷智越, 郑萍, 等. 并发不孕的子宫内膜异位症患者阴道菌群的微生物组学研究[J]. 国际妇产科学杂志, 2020, 47(2): 227-231. CHEN Sikai, GU Zhiyue, ZHENG Ping, et al. The microbiome study of vaginal bacteria in endometriosis patients with infertility [J]. Journal of International Obstetrics and Gynecology, 2020, 47(2): 227-231.
[21] Wee BA, Thomas M, Sweeney EL, et al. A retrospective pilot study to determine whether the reproductive tract microbiota differs between women with a history of infertility and fertile women [J]. Aust N Z J Obstet Gynaecol, 2018, 58(3): 341-348.
[22] Kyono K, Hashimoto T, Nagai Y, et al. Analysis of endometrial microbiota by 16S ribosomal RNA gene sequencing among infertile patients: a single-center pilot study [J]. Reprod Med Biol, 2018, 17(3): 297-306.
[23] Chen C, Song X, Wei W, et al. The microbiota continuum along the female reproductive tract and its relation to uterine-related diseases [J]. Nat Commun, 2017, 8(1): 875. doi: 10.1038/s41467-017-00901-0.
[24] Koninckx PR, Ussia A, Tahlak M, et al. Infection as a potential cofactor in the genetic-epigenetic pathophysiology of endometriosis: a systematic review [J]. Facts Views Vis Obgyn, 2019, 11(3): 209-216.
[25] Lin KY, Chang CY, Lin WC, et al. Increased risk of endometriosis in patients with endometritis- a nationwide cohort study involving 84,150 individuals [J]. Ginekol Pol, 2020, 91(4): 193-200.
[1] Lei YAN,Caixin YUE,Yichun LIU. Fertility preservation in patients with endometriosis [J]. Journal of Shandong University (Health Sciences), 2022, 60(9): 31-34.
[2] Lei YAN,Zijiang CHEN. Treatment of adenomyosis complicated with infertility [J]. Journal of Shandong University (Health Sciences), 2022, 60(7): 43-47.
[3] Jinhua LENG,Jinghua SHI. Clinical manifestations of adenomyosis [J]. Journal of Shandong University (Health Sciences), 2022, 60(7): 1-5.
[4] CHEN Zhongshao, CHU Ran, LI Mingbao, ZHANG Xiangning. MRKH syndrome-related abdominal scar endometriosis after inguinal uterine hernia repair: a case report and literature review [J]. Journal of Shandong University (Health Sciences), 2022, 60(5): 114-117.
[5] LIN Xueyan, ZHANG Cancan, TIAN Minle, TIAN Yongjie. Expression and significance of poly(ADP-ribose) polymerase-1 in endometriosis [J]. Journal of Shandong University (Health Sciences), 2022, 60(2): 27-31.
[6] Jing SHAN,Xiaoqiu WANG,Dajin LI. Molecular mechanisms of NK cells involved in endometriosis and its associated infertility [J]. Journal of Shandong University (Health Sciences), 2021, 59(8): 8-13.
[7] BAI Lu, ZHANG Yuqing, FANG Yuying. Infertility stress and posttraumatic stress disorder in infertile women: mindfulness as a mediator and moderator [J]. Journal of Shandong University (Health Sciences), 2021, 59(2): 83-87.
[8] XUE Yuan, LIN Xueyan, XU Ge, TIAN Yongjie. Expression of hypoxia-inducible factor-1α in the serum of patients with endometriosis and its effect on epithelial mesenchymal transition of eutopic endometrial stromal cells [J]. Journal of Shandong University (Health Sciences), 2021, 59(2): 41-47.
[9] Guoyun WANG,Kai WANG,Ming YUAN,Zijiang CHEN. Multidimensional management system for endometriosis (The Program for Shandong Province) [J]. Journal of Shandong University (Health Sciences), 2021, 59(10): 1-16.
[10] FAN Antong, TIAN Qing, LI Xinyang, ZHAO Xinping, LIU Hongqing. Analysis of mental health status and influencing factors of female infertility patients [J]. Journal of Shandong University (Health Sciences), 2020, 58(1): 106-111.
[11] PENG Chao, ZHOU Yingfang. Medical treatment of endometriosis: an update [J]. Journal of Shandong University (Health Sciences), 2019, 57(6): 46-50.
[12] WANG Guoyun, YUAN Ming, JI Miaomiao. Research advances in the pathogenesis of endometriosis [J]. Journal of Shandong University (Health Sciences), 2019, 57(6): 33-39.
[13] LENG Jinhua, SHI Jinghua. Long-term management strategy of endometriosis [J]. Journal of Shandong University (Health Sciences), 2019, 57(6): 1-5.
[14] LU Jingjing, XIA Yu. Imaging diagnosis of endometriosis [J]. Journal of Shandong University (Health Sciences), 2019, 57(6): 40-45.
[15] LIU Chongdong, LOU Tong, DONG Jing. Malignant transformation of endometriosis [J]. Journal of Shandong University (Health Sciences), 2019, 57(6): 27-32.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] WANG Huan-liang,SUN Bao-zhu,DU Hong-mei,ZHOU Chang-qing,ZHANG Li. Controlling the depth of propofol anesthesia using the bispectral indexand the systolic blood pressure[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2006, 44(5): 471 -474 .
[2] ZENG Ji-ping,WANG Li-na,WANG Li-xiang,REN Xiao-hui,ZHANG Meng-ye,XIA Wen,CUI Xing. [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2006, 44(5): 467 -470 .
[3] SHU Ya,QI Feng. Jaw thrust device (JTD) on obesity patients for maintaining the airway patency during general anesthesia induction[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2007, 45(10): 1072 -1074 .
[4] SONG Yong-hong,MA Chun-hong,LV Hong-juan,ZHU Chuan-fu,NIE Xiang-min,WANG Mei,LIU Yan,ZHANG Ping. HLA allele polymorphism in northern Hans of China[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2007, 45(6): 546 -553 .
[5] HUANGQing,TIAN Hui,LI Lin,LIANG Fei,LIU Xi-xian. [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2006, 44(6): 556 -559 .
[6] ZHU Mei-jia,HAN Ju,WANG Xin-yi,LU Wei,WANG Ai-hua,GUAN Xin-hua,CAO Xia,CAO Bing-zhen. [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2006, 44(8): 834 -839 .
[7] HOU Xiao-yang,BU Pei-li,ZHANG Yun,FENG Jin-bo,LIU Chun-xi,LI Chuan-bao,HAO Ming-xiu. Peroxisome proliferatorsactivated receptor α play a critical role in the inhibition of myocardial fibrosis induced by AngⅡ in vitro[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2007, 45(7): 665 -668 .
[8] ZHENG Jin-Xu, GU Yan-Lan, WAN Bing. Effect of chymase inhibitor on bleomycininduced pulmonary fibrosis and its mechanism in rats[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2008, 46(12): 1132 -1135 .
[9] . 31phosphorus magnetic resonance spectroscopy in  diagnosis of the benign and malignant masses in liver[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2009, 47(11): 118 -120 .
[10] YU Hui1,2, CHEN Shaohua1, ZHAO Jiajun2, GAO Ling3
. Effects of ethanol on glycogen content, GSK3β，
and PAMPK of L02 cells[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2009, 47(04): 75 -78 .
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd