Unexplained infertility is associated with chronic endometritis in women with endometrial polyps
CANSAGE ePoster Library. Badeghiesh A. 09/27/19; 275249; eP-116
Dr. Ahmad Badeghiesh
Dr. Ahmad Badeghiesh
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OBJECTIVE: To assess the prevalence of chronic endometritis (CE) in patients with endometrial polyps and unexplained infertility compared to patients without history of infertility.DESIGN: Retrospective cohort study.MATERIALS AND METHODS: We evaluated patients underwent hysteroscopic polypectomy (2015 to 2018). The inclusion criteria were age 25-42 and histologically confirmed endometrial polyps. Patients with cycle day 3-5 FSH > 10 mIU/mL, with intrauterine devices, history of repeated implantation failure and recurrent pregnancy loss, autoimmune diseases, suspected placental residua, endometrial cancer, atypical hyperplasia, previous diagnosis of CE, and received any antibiotic treatment in the period of 3 months before hysteroscopy were excluded. Study group included patients with unexplained infertility. The control group included those with no previous history of infertility, not taking hormone treatment in the past 3 months before hysteroscopy or having spontaneous pregnancy in the previous 3 years before the procedure. The primary outcome was the prevalence of CE compared between infertile and fertile patients. The secondary outcomes included clinical pregnancy rate (CPR), live birth rate (LBR) and miscarriage rate (MR) of infertile patients after CE treatment compared to infertile patients without CE. RESULTS: A total of 237 patients were included in the analysis. The prevalence of CE in group of patients with unexplained infertility (n=137) was significantly higher compared to the control group (n=140) [22.6% vs. 8.6%; P = 0.001]. The prevalence of CE between patients with primary and secondary infertility was similar (25.0% vs. 19.3%; P = 0.43). CPR, LBR and MR similar between women with treated CE (n=31) and patients without CE (n=106). Multivariate logistical model showed that infertility diagnosis was significantly associated with the diagnosis of CE (OR 3.16; 95% CI 1.53 – 6.49). CONCLUSIONS: In women with endometrial polyps the prevalence of CE is higher in patients with unexplained infertility compared to patients without infertility history. The pregnancy outcome of infertile patients with treated CE was similar to those without CE.
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