Prevalence of Chronic Endometritis in Unexplained Implantation Failure

Abstract

Background: The actual load of chronic endometritis (CE) in the general population as well as implantation failure is still ill-defined, Aim of the study: was to assess incidence of CE at hysteroscopy and histology, in a cases with implantation failure at ICSI. Patients and methods: The International Islamic Center for Population Studies and Research at Al Azhar University performed this prospective observational cross-sectional research from 2017 to 2022.The study was conducted on 150 women with one unexplained implantation failure or more at ICSI. Results: Histopathological examination confirmed the diagnosis of CE in 55/66 cases suspected to have CE by hysteroscopy (True Positive), while 11 cases were found to be free from CE (False Positive). On the other hand, histopathological examination confirmed absence of CE in 82/84 negative cases by hysteroscopy (True Negative), while only two cases were found to have CE (False Negative). In our study, hysteroscopy is trustworthy CE diagnostic method for CE in unexplained implantation failure with sensitivity, specificity, accuracy, PPV and NPV as 96.5%, 88.17%, 91.3%, 83.3% and, 97.6% respectively. Conclusion: According to this research, hysteroscopy is a useful diagnostic tool in women with unexplained implantation failure as regard CE diagnosis. However, endometrial samples should be obtained during hysteroscopy to increase the diagnostic accuracy.