Chronic endometritis and reproductive disorders: versions and contraversions (review)

Abstract

Among married couples of childbearing age, the frequency of infertility in different regions of Russia and the world ranges from 10 to 21%. The effectiveness of the results of in vitro fertilization (IVF) and embryo transfer is determined by two factors: the functional completeness of the embryo at the blastocyst stage and the absence of intrauterine pathology. One of the main causes of imperfect or unsuccessful implantation is an impaired function and damaged endometrial structure, which is often caused by a chronic inflammatory process in the endometrium. Chronic endometritis (CE) is a condition associated with a violation of the coexistence between microorganisms and the immune system of a macroorganism in the endometrium. A majority of CE cases produce no noticeable clinical signs or mild symptoms and the CE prevalence rate is approximately 10% based on the histological findings of an endometrial biopsy. The interconnection between СE and reproductive dysfunctions, such as implant damage and repeated miscarriage, has been studied by many researchers at the present stage. Chronic endometritis is common among patients with unexplained infertility. Diagnosis and treatment of chronic endometritis increase the frequency of spontaneous pregnancies and live births in such patients. The diagnosis of chronic endometritis is not simple, often contradictory, and, thus, requires close cooperation between the fertility specialist and the pathologist. In this study, we reviewed the literature on the pathophysiology of chronic endometritis and how it may be associated with infertility, as well as the literature regarding the diagnosis and treatment of CE, published at PubMed as on May 2019 in a version and contra-version format.