Journal of minimally invasive gynecology · 2026
Evaluating Chronic Endometritis in Unexplained Infertility Through Hysteroscopy and Immunohistochemistry.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Torres Mychelle de Medeiros Garcia, de Andrade Maíra Medeiros Pacheco, Sales Alexandre de Oliveira, Lanza Daniel Carlos Ferreira
Аннотация
OBJECTIVE: To evaluate the prevalence of chronic endometritis (CE) in women with unexplained infertility compared to healthy controls, with diagnostic assessments conducted during the embryo implantation window.
DESIGN: Prospective observational cohort study.
SETTING: University hospital.
PATIENT(S): Women with unexplained infertility and healthy controls.
INTERVENTION(S): Endometrial biopsies were obtained during the implantation window and analyzed using immunohistochemical staining for syndecan-1 (CD138) to identify plasma cell infiltration.
MAIN OUTCOME MEASURE(S): Prevalence of CE, as determined by hysteroscopic features, conventional histology, and immunohistochemical staining.
RESULTS: CE was more frequently identified in women with unexplained infertility than in healthy controls. Immunohistochemical analysis detected plasma cell infiltration in 40.63% of infertile women and 23.08% of controls. Hysteroscopic findings suggestive of CE were observed in 53.12% of infertile women, showing a sensitivity of 68.75% and a negative predictive value of 80.76%. Diagnostic concordance between hysteroscopic evaluation and immunohistochemistry was 71.1%.
CONCLUSION: CE may be more prevalent among women with unexplained infertility during the embryo implantation window. Although hysteroscopy-directed biopsy combined with immunohistochemical analysis may improve diagnostic accuracy, further studies are needed to compare different biopsy techniques and assess potential impact on fertility outcomes.
DESIGN: Prospective observational cohort study.
SETTING: University hospital.
PATIENT(S): Women with unexplained infertility and healthy controls.
INTERVENTION(S): Endometrial biopsies were obtained during the implantation window and analyzed using immunohistochemical staining for syndecan-1 (CD138) to identify plasma cell infiltration.
MAIN OUTCOME MEASURE(S): Prevalence of CE, as determined by hysteroscopic features, conventional histology, and immunohistochemical staining.
RESULTS: CE was more frequently identified in women with unexplained infertility than in healthy controls. Immunohistochemical analysis detected plasma cell infiltration in 40.63% of infertile women and 23.08% of controls. Hysteroscopic findings suggestive of CE were observed in 53.12% of infertile women, showing a sensitivity of 68.75% and a negative predictive value of 80.76%. Diagnostic concordance between hysteroscopic evaluation and immunohistochemistry was 71.1%.
CONCLUSION: CE may be more prevalent among women with unexplained infertility during the embryo implantation window. Although hysteroscopy-directed biopsy combined with immunohistochemical analysis may improve diagnostic accuracy, further studies are needed to compare different biopsy techniques and assess potential impact on fertility outcomes.