title: Chronic endometritis is a frequent finding in women with recurrent implantation failure after in vitro fertilization.
abstract: OBJECTIVE
  To determine the role of endometrial sampling for identification and treatment of chronic endometritis (CE) in patients undergoing IVF-ET who repeatedly failed to conceive despite the transfer of good-quality embryos.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  University-based tertiary fertility center.
  
  
  METHODS
  Thirty-three patients with recurrent implantation failure (RIF) who underwent endometrial sampling and subsequent ET were analyzed based on immunohistochemically confirmed CE: CE present on biopsy (group 1; n = 10) and CE absent on biopsy (group 2; n = 23). Patients with RIF undergoing IVF cycles during the same time period who did not have endometrial sampling were used as controls (group 3; n = 485).
  
  
  METHODS
  Endometrial sampling for CE and subsequent antibiotic treatment in affected patients followed by another IVF-ET cycle.
  
  
  RESULTS
  Chronic endometritis was identified in 30.3% of patients with RIF. Group 1 had lower implantation rates (11.5%) in the IVF cycle following treatment than did group 2 and group 3 (32.7% and 20.3%, respectively). Clinical pregnancy and ongoing pregnancy rates were similar across groups.
  
  
  CONCLUSIONS
  Recurrent implantation failure warrants investigation of CE as a contributing factor. Women demonstrating CE on endometrial sampling have lower implantation rates in a subsequent IVF-ET cycle; however, there were no differences in subsequent clinical pregnancy or ongoing pregnancy rates after successful antibiotic treatment.
authors.affiliation: The Center for Advanced Reproductive Services, Department of Obstetrics and Gynecology, University of Connecticut Health Center, Farmington, Connecticut 06030, USA.
authors.forename: Erika B
authors.initials: EB
authors.lastname: Johnston-MacAnanny
authors.forename: Janice
authors.initials: J
authors.lastname: Hartnett
authors.forename: Lawrence L
authors.initials: LL
authors.lastname: Engmann
authors.forename: John C
authors.initials: JC
authors.lastname: Nulsen
authors.forename: M Melinda
authors.initials: MM
authors.lastname: Sanders
authors.forename: Claudio A
authors.initials: CA
authors.lastname: Benadiva
mesh_terms: D000328:Adult; D001706:Biopsy; D002908:Chronic Disease; D010064:Embryo Implantation; D004624:Embryo Transfer; D004716:Endometritis / Q000453:epidemiology* / Q000473:pathology; D004717:Endometrium / Q000473:pathology; D005260:Female; D005306:Fertilization; D005307:Fertilization in Vitro / Q000009:adverse effects*; D006801:Humans; D007150:Immunohistochemistry; D018579:Patient Selection; D011247:Pregnancy; D012008:Recurrence; D012189:Retrospective Studies; D017211:Treatment Failure