title: The hysteroscopy and histological diagnosis and treatment value of chronic endometritis in recurrent implantation failure patients.
abstract: OBJECTIVE
  To study the consistency of hysteroscopy findings and histological chronic endometritis (CE) in recurrent implantation failure (RIF) cases, and to compare their values in indicating antibiotic treatment.
  
  
  METHODS
  Sixty RIF cases (January 2009-January 2010) and 202 consecutive RIF cases (May 2010-April 2012) in Peking University Third Hospital reproductive medical center were studied. 60 RIF patients' endometrial samples redid section and CD38/CD138 immunohistochemical stain for CE screening. In 202 RIF cases, the presence of hyperemia, mucosal edema, and micropolyps under hysteroscopy were considered CE diagnostic parameters. Antibiotic was offered to part of the patients. The patients' clinical outcomes were analyzed by statistical methods.
  
  
  RESULTS
  In 202 RIF cases, the hysteroscopy CE rate was 66.3 %, while histological CE rate was 43.6 %. The sensitivity and specificity of hysteroscopy were 35.2 and 67.5 %. In histological CE patients, 68 cases underwent regular antibiotic treatment and 20 did not. Two groups had similar clinical pregnancy rates (35.3 vs. 30.0 %), embryo implantation rates (18.9 vs. 20.4 %) and ongoing pregnancy rates (29.4 vs. 25.0 %). In hysteroscopy CE patients, the implantation rate (18.6 vs. 4.9 %) and ongoing pregnancy rate (29.3 vs. 7.4 %) significantly increased (P < 0.05) with antibiotic treatment, and higher intrauterine pregnancy rate in treatment group (29.3 vs. 11.1 %). In reviewing the chosen 60 RIF cases, the histological CE rates were similar in both pregnancy and non-pregnancy group after subsequent embryo transfer.
  
  
  CONCLUSIONS
  CE occurs frequently in RIF patients; hysteroscopy has more diagnostic and treatment value for them.
authors.affiliation: Department of Obstetrics and Gynecology, Reproductive Medical Center, Peking University Third Hospital, No. 49, North Huayuan Road, Haidian District, Beijing, 100191, China, yrjeff0812@gmail.com.
authors.forename: Rui
authors.initials: R
authors.lastname: Yang
authors.forename: Xiaoguo
authors.initials: X
authors.lastname: Du
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.forename: Xueling
authors.initials: X
authors.lastname: Song
authors.forename: Yan
authors.initials: Y
authors.lastname: Yang
authors.forename: Jie
authors.initials: J
authors.lastname: Qiao
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001706:Biopsy; D002908:Chronic Disease; D010064:Embryo Implantation; D004716:Endometritis / Q000150:complications / Q000188:drug therapy* / Q000473:pathology*; D004717:Endometrium / Q000473:pathology; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D011247:Pregnancy; D018873:Pregnancy Rate; D012008:Recurrence; D012680:Sensitivity and Specificity; D017211:Treatment Failure
chemical_list: D000900:Anti-Bacterial Agents