Decoding the multifactorial etiology of chronic endometritis.

Chronic endometritis (CE) is a persistent inflammatory disorder of the endometrium, typically marked by abnormal plasma cell infiltration. It is closely associated with adverse pregnancy outcomes. The pathogenesis of CE involves a complex interplay of both infectious and non-infectious factors. Infectious etiologies include ascending infection pathways, pelvic infection pathways, sexually transmission, hematogenous infection pathways and special infections, while non-infectious factors encompass uterine structural pathology, autoimmune disorders and iatrogenic factors. Considering the multifactorial etiology of CE, adopting a personalized management approach that integrates both microbial and immune factors may enhance pregnancy outcomes for CE women.