Fertility and sterility · 2019
The impact of chronic endometritis on endometrial fibrosis and reproductive prognosis in patients with moderate and severe intrauterine adhesions: a prospective cohort study.
Клиническое исследованиеСтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Liu Lixiang, Yang Huan, Guo Yaling, Yang Guoxia, Chen Yuqing
Аннотация
OBJECTIVE: To study the effect of chronic endometritis (CE) diagnosed by CD138 immunohistochemical (IHC) staining on endometrial fibrosis and reproductive prognosis in patients with moderate or severe intrauterine adhesions (IUAs).
DESIGN: Prospective cohort study (Canadian Task Force classification II-2).
SETTING: University-affiliated hospital.
PATIENT(S): One hundred sixty-seven women with moderate to severe IUAs.
INTERVENTION(S): Transcervical resection of adhesions (TCRA) and endometrial biopsy were performed in all patients. According to results of IHC staining with anti-syndecan-1 antibodies to identify CD138 cells, participants were classified into two groups: 78 patients with CE (CE group) and 89 women without CE (NCE group). IHC staining for fibrosis markers transforming growth factor beta 1, anti-fibrosis markers matrix metalloproteinase 9, and endometrial receptivity marker integrin alpha v beta 3 was later applied to all tissue samples.
MAIN OUTCOME MEASURE(S): Endometrial fibrosis, endometrial receptivity, and reproductive prognosis.
RESULT(S): CE diagnosed by CD138 IHC staining has a high incidence, 46%, in moderate and severe IUAs. In the CE group, the expression of transforming growth factor beta 1 was higher than that in the NCE group, and the expression of matrix metalloproteinase 9 and alpha v beta 3 was lower than that in the NCE group. The pregnancy rate and live birth rate in the NCE group were higher than those in the CE group (42.7% vs. 31.5%, 26.9% vs. 17.9%).
CONCLUSION(S): CE may affect the endometrial fibrosis homeostasis in IUAs. Women with CE were more likely to experience recurrence of adhesions and had poorer reproductive outcomes.
CLINICAL TRIAL REGISTRATION NO: NCT02744807.
DESIGN: Prospective cohort study (Canadian Task Force classification II-2).
SETTING: University-affiliated hospital.
PATIENT(S): One hundred sixty-seven women with moderate to severe IUAs.
INTERVENTION(S): Transcervical resection of adhesions (TCRA) and endometrial biopsy were performed in all patients. According to results of IHC staining with anti-syndecan-1 antibodies to identify CD138 cells, participants were classified into two groups: 78 patients with CE (CE group) and 89 women without CE (NCE group). IHC staining for fibrosis markers transforming growth factor beta 1, anti-fibrosis markers matrix metalloproteinase 9, and endometrial receptivity marker integrin alpha v beta 3 was later applied to all tissue samples.
MAIN OUTCOME MEASURE(S): Endometrial fibrosis, endometrial receptivity, and reproductive prognosis.
RESULT(S): CE diagnosed by CD138 IHC staining has a high incidence, 46%, in moderate and severe IUAs. In the CE group, the expression of transforming growth factor beta 1 was higher than that in the NCE group, and the expression of matrix metalloproteinase 9 and alpha v beta 3 was lower than that in the NCE group. The pregnancy rate and live birth rate in the NCE group were higher than those in the CE group (42.7% vs. 31.5%, 26.9% vs. 17.9%).
CONCLUSION(S): CE may affect the endometrial fibrosis homeostasis in IUAs. Women with CE were more likely to experience recurrence of adhesions and had poorer reproductive outcomes.
CLINICAL TRIAL REGISTRATION NO: NCT02744807.