The significance of chronic endometritis in fertility

The significance of chronic endometritis in fertility

Chronic endometritis is an inflammation of the lining of the uterus and is considered a risk factor for unfulfilled desire to have children. This condition occurs in women with repeated miscarriages, but may also be the reason why a pregnancy does not occur both naturally and as part of IVF or ICSI therapies.

‍ What is chronic endometritis?

Chronic endometritis is a persistent inflammation of the lining of the uterus (endometrium). This disease is not uncommon and often remains undetected, as it usually progresses without any apparent symptoms. Depending on the study, the frequency can vary significantly. In a review of 12 studies, the incidence of chronic endometritis among women with recurrent pregnancy loss was estimated at around 30%. Other studies describe a frequency of 10-15% of women with infertility.

How is the diagnosis performed?

The diagnosis is usually made through an endometrial biopsy, which involves taking a small sample of tissue from the lining of the uterus. This biopsy can be performed as part of a gynecological examination or a hysteroscopy. In the sample, special cells, the so-called plasma cells, are screened for, which are an indicator of inflammation. Modern methods, such as immunohistochemical detection with an antibody against the plasma cell-specific antigen CD138, have proven to be particularly reliable.

Treatment and therapy monitoring

If the inflammation is detected, antibiotic treatment is usually recommended. The chances of recovery with antibiotics are around 90%. After treatment, another tissue sample is often taken to ensure that the inflammation has been successfully treated.

Pregnancy after chronic endometritis

Studies show that successful treatment of chronic endometritis significantly increases the chances of a successful pregnancy. Both the likelihood of becoming pregnant and the chance of maintaining a pregnancy improve after successful treatment, particularly for women who have repeatedly experienced miscarriages.

Written by
PD Dr. Dr. Kilian Vomstein
PD Dr. Dr. Kilian Vomstein

Mein beruflicher Schwerpunkt ist der Umgang mit unerfülltem Kinderwunsch und wiederholten Fehlgeburten, in dem ich umfassende klinische und wissenschaftliche Erfahrungen gesammelt habe. Ich strebe danach, für jedes Paar individuelle Lösungen zu finden.