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JBRA Assisted Reproduction Aug 2022Endometritis is defined as an infection or inflammation of the endometrium. Endometritis is of two types: acute and chronic. Acute endometritis is the symptomatic acute... (Review)
Review
Endometritis is defined as an infection or inflammation of the endometrium. Endometritis is of two types: acute and chronic. Acute endometritis is the symptomatic acute inflammation of the endometrium, which upon examination with a microscope shows micro-abscess and neutrophil invasion in the superficial endometrium. One of its most common manifestations is postpartum endometritis. Chronic endometritis is a silent disease usually diagnosed on the workup of secondary amenorrhoea and infertility. An important cause of chronic endometritis is tuberculosis, especially in developing nations. Chronic and acute endometritis have been associated with poor reproductive outcomes. Worse outcomes have been reported for individuals with chronic endometritis. This is a scoping review of endometritis and its impact on fertility.
Topics: Endometritis; Endometrium; Female; Fertility; Humans; Infertility; Inflammation
PubMed: 35621273
DOI: 10.5935/1518-0557.20220015 -
American Journal of Obstetrics and... Mar 2021Bacterial vaginosis, pelvic inflammatory disease, and endometritis are infections of the genital tract that can lead to many adverse health outcomes, including... (Review)
Review
Bacterial vaginosis, pelvic inflammatory disease, and endometritis are infections of the genital tract that can lead to many adverse health outcomes, including infertility. Bacterial vaginosis is characterized by a lower prevalence of lactobacilli and a higher prevalence of anaerobic bacteria, including Gardnerella vaginalis, Megasphaera spp., and Atopobium vaginae. Endometritis and pelvic inflammatory disease are caused by the ascension of pathogenic bacteria to the uterus, although the mechanisms by which they do so are unclear. Bacterial vaginosis, chronic endometritis, and pelvic inflammatory disease have been linked to infertility in retrospective and prospective trials. Similarly, the causes of bacterial vaginosis and endometritis-related infertility are likely multifactorial and stem from inflammation, immune targeting of sperm antigens, the presence of bacterial toxins, and increased risk of sexually transmitted infections. Diagnosis and treatment of bacterial vaginosis, chronic endometritis, and pelvic inflammatory disease before attempting conception may be important components of preconceptional care for symptomatic women to improve outcomes of natural and assisted reproduction.
Topics: Endometritis; Female; Humans; Infertility, Female; Pelvic Inflammatory Disease; Vaginosis, Bacterial
PubMed: 33091407
DOI: 10.1016/j.ajog.2020.10.019 -
Fertility and Sterility Mar 2021Chronic inflammatory processes affecting the endometrium, as encountered in endometriosis, adenomyosis, and chronic endometritis, alter endometrial receptivity. These... (Review)
Review
Chronic inflammatory processes affecting the endometrium, as encountered in endometriosis, adenomyosis, and chronic endometritis, alter endometrial receptivity. These disorders are associated with early pregnancy losses and possibly recurrent pregnancy losses (RPL). In the cases of endometriosis, other factors associated with the disease also are susceptible of causing miscarriages and possibly RPL, such as an impact of intrapelvic inflammatory processes affecting the oocyte and embryo in case of natural conception. Conversely these latter effects obviously are bypassed in case of assisted reproductive technology. Chronic inflammation of the endometrium in the condition known as chronic endometritis also causes early pregnancy losses and RPL with beneficial effects achieved when specific treatment is undertaken.
Topics: Abortion, Habitual; Adenomyosis; Chronic Disease; Embryo, Mammalian; Endometriosis; Endometritis; Endometrium; Female; Humans; Oocytes; Pregnancy
PubMed: 33581856
DOI: 10.1016/j.fertnstert.2020.12.010 -
Fertility and Sterility Aug 2018Endometritis is subdivided into two categories. Acute endometritis is symptomatic and characterized by microabscess formation and neutrophil invasion in the endometrial... (Review)
Review
Endometritis is subdivided into two categories. Acute endometritis is symptomatic and characterized by microabscess formation and neutrophil invasion in the endometrial superficial epithelium, gland lumina, and uterine cavity. Chronic endometritis is rather silent and recognized as unusual plasmacyte infiltration in the endometrial stromal areas. Over the last decade, studies have disclosed the potential association between poor reproductive outcomes and endometritis, particularly chronic endometritis. The aim of this review is to address the current literature surrounding chronic endometritis and highlight recent advances in the research of this long-neglected gynecologic disease.
Topics: Anti-Bacterial Agents; Chronic Disease; Endometritis; Endometrium; Female; Humans; Infertility, Female; Microbiota; Pregnancy
PubMed: 29960704
DOI: 10.1016/j.fertnstert.2018.04.012 -
Reproductive Biology and Endocrinology... Dec 2018Recurrent implantation failure (RIF) refers to cases in which women have had three failed in vitro fertilization (IVF) attempts with good quality embryos. The definition... (Review)
Review
Recurrent implantation failure (RIF) refers to cases in which women have had three failed in vitro fertilization (IVF) attempts with good quality embryos. The definition should also take advanced maternal age and embryo stage into consideration. The failure of embryo implantation can be a consequence of uterine, male, or embryo factors, or the specific type of IVF protocol. These cases should be investigated to determine the most likely etiologies of the condition, as this is a complex problem with several variables. There are multiple risk factors for recurrent implantation failure including advanced maternal age, smoking status of both parents, elevated body mass index, and stress levels. Immunological factors such as cytokine levels and presence of specific autoantibodies should be examined, as well as any infectious organisms in the uterus leading to chronic endometritis. Uterine pathologies such as polyps and myomas as well as congenital anatomical anomalies should be ruled out. Sperm analysis, pre-implantation genetic screening and endometrial receptivity should be considered and evaluated, and IVF protocols should be tailored to specific patients or patient populations. Treatment approaches should be directed toward individual patient cases. In addition, we suggest considering a new initial step in approach to patients with RIF, individualized planned activities to activate the brain's reward system in attempt to improve immunological balance in the body.
Topics: Embryo Implantation; Embryo Transfer; Endometritis; Female; Fertilization in Vitro; Humans; Infertility, Female; Preimplantation Diagnosis; Recurrence; Risk Factors; Treatment Failure
PubMed: 30518389
DOI: 10.1186/s12958-018-0414-2 -
Ginekologia Polska 2023Chronic endometritis is a persistent, low-intensity inflammation of endometrial mucosa, characterized by the infiltration of plasma cells into the endometrial stroma... (Review)
Review
Chronic endometritis is a persistent, low-intensity inflammation of endometrial mucosa, characterized by the infiltration of plasma cells into the endometrial stroma This immunological alteration is thought to be a consequence of a bacterial infection. For a long time, chronic endometritis was poorly investigated and rarely considered in clinical practice because it is either asymptomatic or presents with no specific symptoms. Its association with adverse effects on fertility and retrospectively reported effectiveness of antibiotic treatment were the main reasons for a growing interest in this endometrial pathology. Chronic endometritis is now a hot topic in recurrent pregnancy loss and recurrent implantation failure research. Nevertheless, there are still no recommendations to include chronic endometritis investigation in a clinical evaluation of infertile patients. The uncertain role of this condition is an effect of significant differences in study results presented by different research groups. One important reason for these inconsistent findings is a lack of standardised chronic endometritis diagnostic methods. We present a review of the literature, focusing on the currently available chronic endometritis diagnostic techniques. The review is subdivided into three parts concerning the diagnostic accuracy of three main diagnostic modalities. Histopathological examination of endometrial tissue, hysteroscopic evaluation of uterine cavity and identification of the bacterial factor. In conclusion, it is of great importance to establish a consensus on the diagnostic criteria for chronic endometritis. This is the only way to enhance international cooperation and create well-design multicenter studies to evidence the role of this endometrial pathology in infertility.
Topics: Female; Pregnancy; Humans; Endometritis; Retrospective Studies; Hysteroscopy; Endometrium; Chronic Disease; Infertility, Female
PubMed: 36511457
DOI: 10.5603/GP.a2022.0147 -
Nature Communications Jul 2021The vaginal and uterine microbiota play important roles in the health of the female reproductive system. However, the interactions among the microbes in these two niches... (Observational Study)
Observational Study
The vaginal and uterine microbiota play important roles in the health of the female reproductive system. However, the interactions among the microbes in these two niches and their effects on uterine health remain unclear. Here we profile the vaginal and uterine microbial samples of 145 women, and combine with deep mining of public data and animal experiments to characterize the microbial translocation in the female reproductive tract and its role in modulating uterine health. Synchronous variation and increasing convergence of the uterine and vaginal microbiome with advancing age are shown. We also find that transplanting certain strains of vaginal bacteria into the vagina of rats induces or reduces endometritis-like symptoms, and verify the damaging or protective effects of certain vaginal bacteria on endometrium. This study clarifies the interdependent relationship of vaginal bacterial translocation with uterine microecology and endometrial health, which will undoubtedly increase our understanding of female reproductive health.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Animals; Bacterial Translocation; Chronic Disease; Cohort Studies; DNA, Bacterial; Disease Models, Animal; Endometritis; Endometrium; Female; Humans; Microbiota; Middle Aged; Protective Factors; RNA, Ribosomal, 16S; Rats; Reproductive Health; Risk Factors; Vagina; Women's Health; Young Adult
PubMed: 34234149
DOI: 10.1038/s41467-021-24516-8 -
Open Veterinary Journal Apr 2019Fungus is well capable of producing reproductive failures in bovines. As fungus is an opportunistic pathogen, there are more chances for fungus to cause infection in the... (Review)
Review
Fungus is well capable of producing reproductive failures in bovines. As fungus is an opportunistic pathogen, there are more chances for fungus to cause infection in the uterus when certain predisposing factors like prolonged intra-uterine antibiotic therapy, persistent endometritis, presence of necrotic foci, immunosuppression, and pneumovagina are available. Various authors have reported the incidence of fungal endometritis in repeat breeder endometritic cows and buffaloes. Uterine culture along with the cytological examination of the uterine secretions considered being best way to diagnose this condition; however, endometrial biopsy can be used to access the efficacy of treatment to invasive yeast. Intra-uterine treatment with antiseptic solutions and Lugol's iodine had been found effective in bovines..
Topics: Animals; Buffaloes; Cattle; Cattle Diseases; Endometritis; Female; Mycoses
PubMed: 31086773
DOI: 10.4314/ovj.v9i1.16 -
Fertility and Sterility Aug 1978Endometrial biopsy is an essential tool in the evaluation of the infertile couple. Among the various causes of infertility which may be elucidated by such a biopsy,... (Review)
Review
Endometrial biopsy is an essential tool in the evaluation of the infertile couple. Among the various causes of infertility which may be elucidated by such a biopsy, endometritis plays a significant role. In this review endometritis has been subdivided into three distinct pathologic entities: acute, chronic, and fibrotic. Detailed histologic features are discussed separately for each of these varieties. Most of the acute inflammations of the endometrium are cauased by bacteria. They are usually of short duration, respond well to treatment, and only rarely are associated with long-standing infertility. Chronic endometritis, on the other hand, can be caused by a variety of agents such as bacteria, viruses, and parasites. However, in the majority of cases with chronic endometritis the etiology cannot be determined and these are then considered nonspecific. Tuberculous endometritis, which is discussed under the heading of chronic endometritis, constitutes a common cause of infertility in certain countries but much less so in the United States. Other less common conditions such as mycoplasma infection and cytomegalic virus infection, have also been associated with reproductive failure. However, chronic endometritis, especially the most common so-called nonspecific type, is a relatively uncommon cause of infertility. The syndrome of intrauterine adhesions or synechiae has been classified here as fibrotic endometritis because of the pathogenesis and histopathology of this lesion. This entity is commonly associated with infertility and may constitute the end result of a long-standing inflammatory process in the endometrium. The diagnosis of endometritis is not a simple one and necessitates close cooperation between the clinician and pathologist. Pertinent clinical and detailed histopathologic data have to be exchanged between the treating physician and pathologist, especially in cases of infertility, in order for the patient to have benefit from the examination of endometrial tissue obtained.
Topics: Acute Disease; Bacterial Infections; Biopsy; Chronic Disease; Endometritis; Endometrium; Female; Humans; Infertility, Female; Mycoplasma Infections; Tissue Adhesions; Tuberculosis, Female Genital
PubMed: 354978
DOI: 10.1016/s0015-0282(16)43448-5 -
JBRA Assisted Reproduction Jun 2023Endometriosis is a chronic inflammatory condition affecting up to 10% of women of reproductive age and this, depending on its severity, very often leads to infertility....
Endometriosis is a chronic inflammatory condition affecting up to 10% of women of reproductive age and this, depending on its severity, very often leads to infertility. New research has shed light on the role of underlying endometritis due to the presence of inflammatory, non-oestrogen metabolising microbiome at the mucosal interface and this in turn leads to the activation of aggressive, non-tolerant immune cells in the endometrium. These immune cells require the presence of tolerance-inducing commensals such as Lactobacilli so as to allow the implantation of the fertilised egg. New therapies should be holistic and address both the dysbiosis as well as immune abnormalities. Routine immune monitoring of the immune cells derived from the endometrium and/or microbial profiling should recommended to better predict assisted reproduction outcomes in these couples.
Topics: Female; Humans; Endometriosis; Endometritis; Infertility; Embryo Implantation; Endometrium; Infertility, Female
PubMed: 37348006
DOI: 10.5935/1518-0557.20230015