Effect of chronic endometritis on pregnancy outcome in patients undergoing assisted reproductive technology

To investigate the impact of chronic endometritis (CE) on pregnancy outcome in patients with assisted reproduction and to evaluate the clinical significance of normative therapy.

A retrospective analysis was performed on infertile patients with chronic endometritis who received assisted reproductive technology during January 2019 to January 2021 in our center. According to the number of CD138-positive cells in endometrial tissues, they were divided into severe group (>10/HPF) and mild group (≤10/HPF). Then according to whether CE was clearly cured after standard treatment with antibiotics, they were divided into cured group and treated group. The differences of biochemical pregnancy rate, clinical pregnancy rate, early abortion rate, embryo implantation rate and live birth rate were compared among different groups of patients.

A total of 155 patients were enrolled, including 56 patients in the cured group and 99 patients in the treated group. And there were 91 patients with mild CE and 64 with severe CE. The number of CD138-positive cells in the cured group was significantly higher than that in the treated group (19.32±13.72 vs 11.52±10.32, P<0.05). There were no significant differences in embryo implantation rate (34.95% vs 27.42%, P=0.219) and early abortion rate (13.33% vs 25.00%, P=0.235) between the 2 groups. The biochemical pregnancy rate (64.29% vs 43.43%, P=0.013), clinical pregnancy rate (53.57% vs 36.36%, P=0.037) and live birth rate (46.43% vs 27.27%, P=0.016) were obviously higher in the cured group than the treated group. In mild CE, there were no statistical differences in biochemical pregnancy rate, clinical pregnancy rate, early abortion rate, live birth rate and embryo implantation rate the clinical outcomes between the cured group and the treated group. In severe CE, the cured group had obviously higher biochemical pregnancy rate (76.47% vs 43.33%, P=0.007), clinical pregnancy rate (64.71% vs 33.33%, P=0.012) and live birth rate (58.82% vs 20.00%, P=0.002) than the treated group.

CE has a negative impact on assisted reproductive outcomes, and standard antibiotic treatment can improve the pregnancy outcomes in the patients.