title: Chronic endometritis in women with recurrent pregnancy loss and recurrent implantation failure: prevalence and role of office hysteroscopy and immunohistochemistry in diagnosis.
abstract: OBJECTIVE
  To determine the prevalence of chronic endometritis (CE) in patients with recurrent implantation failure (RIF) after IVF and unexplained recurrent pregnancy loss (RPL).
  
  
  METHODS
  Prospective observational study between November 2012 and March 2015.
  
  
  METHODS
  University-affiliated private IVF clinic.
  
  
  METHODS
  Women with RIF after IVF (group 1) and unexplained RPL (group 2).
  
  
  METHODS
  Office hysteroscopy followed by an endometrial biopsy was performed as part of the workup for RIF and RPL. The diagnosis of CE was histologically confirmed using immunohistochemistry stains for syndecan-1 (CD138).
  
  
  METHODS
  The prevalence of CE in each group and the sensitivity/specificity of office hysteroscopy in the diagnosis of CE.
  
  
  RESULTS
  Ninety-nine patients were included (46 in group 1 and 53 in group 2). The mean age was 36.3 ± 4.9 years in group 1 and 34.5 ± 4.9 years in group 2. Five biopsies were uninterpretable (three in group 1 and two in group 2) because of insufficient specimen. The prevalence of CE was 14% (6/43) in group 1 and 27% (14/51) in group 2. The sensitivity and specificity of office hysteroscopy in the diagnosis of CE were 40% (8/20) and 80% (59/74), respectively.
  
  
  CONCLUSIONS
  We found a high prevalence of immunohistochemically confirmed CE in women with RIF and RPL. Office hysteroscopy is a useful diagnostic tool but should be complemented by an endometrial biopsy for the diagnosis of CE.
  
  
  BACKGROUND
  NCT01762098.
authors.affiliation: Department of Reproductive Medicine, Ovo Clinic, Montreal, Quebec, Canada; Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada. Electronic address: pebouet@hotmail.com.
authors.forename: Pierre-Emmanuel
authors.initials: PE
authors.lastname: Bouet
authors.affiliation: Department of Reproductive Medicine, Ovo Clinic, Montreal, Quebec, Canada; Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Hady
authors.initials: H
authors.lastname: El Hachem
authors.affiliation: Department of Reproductive Medicine, Ovo Clinic, Montreal, Quebec, Canada; Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Elise
authors.initials: E
authors.lastname: Monceau
authors.affiliation: Department of Pathology, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Gilles
authors.initials: G
authors.lastname: Gariépy
authors.affiliation: Department of Reproductive Medicine, Ovo Clinic, Montreal, Quebec, Canada; Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Isaac-Jacques
authors.initials: IJ
authors.lastname: Kadoch
authors.affiliation: Department of Reproductive Medicine, Ovo Clinic, Montreal, Quebec, Canada; Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Camille
authors.initials: C
authors.lastname: Sylvestre
mesh_terms: D000026:Abortion, Habitual / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D010064:Embryo Implantation; D004715:Endometriosis / Q000175:diagnosis* / Q000453:epidemiology* / Q000378:metabolism / Q000473:pathology; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects*; D006801:Humans; D015907:Hysteroscopy; D007150:Immunohistochemistry; D009819:Office Visits; D011237:Predictive Value of Tests; D011247:Pregnancy; D015995:Prevalence; D011446:Prospective Studies; D011792:Quebec / Q000453:epidemiology; D053668:Syndecan-1 / Q000032:analysis*; D017211:Treatment Failure
chemical_list: D015415:Biomarkers; C508241:SDC1 protein, human; D053668:Syndecan-1
keywords: Chronic endometritis; implantation failure; office hysteroscopy; plasma cells; recurrent pregnancy loss