Treatment following hysteroscopy and endometrial diagnostic biopsy increases chance for live birth in women with chronic endometritis
| Autor: | Michael D. Mueller, Tessa Gillon, Alexandra S. Kohl Schwartz, Sheila Meier, Michael von Wolff, V Mitter, Tilman T. Rau, Marcel Zwahlen |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Pregnancy Rate
Biopsy time to live birth chronic endometritis Pregnancy Risk Factors Immunology and Allergy 610 Medicine & health recurrent pregnancy loss medicine.diagnostic_test Obstetrics Hazard ratio Obstetrics and Gynecology Clinical Reproductive Immunology Anti-Bacterial Agents Treatment Outcome Hysteroscopy Original Article Female Live birth Live Birth 360 Social problems & social services Adult Infertility Abortion Habitual medicine.medical_specialty Immunology Endometriosis Risk Assessment plasma cells Predictive Value of Tests medicine Humans Embryo Implantation Retrospective Studies endometrial diagnostic biopsy business.industry Proportional hazards model repeated implantation failure medicine.disease Time-to-Pregnancy Reproductive Medicine Chronic Disease time to pregnancy business Chronic Endometritis |
| Zdroj: | Mitter, Vera R.; Meier, Sheila; Rau, Tilman T.; Gillon, Tessa; Mueller, Michael D.; Zwahlen, Marcel; von Wolff, Michael; Kohl Schwartz, Alexandra S. (2021). Treatment following hysteroscopy and endometrial diagnostic biopsy increases chance for live birth in women with chronic endometritis. American journal of reproductive immunology, 86(5), e13482. Blackwell Publishing 10.1111/aji.13482 American Journal of Reproductive Immunology |
| DOI: | 10.1111/aji.13482 |
| Popis: | Problem Repeated implantation failure and recurrent pregnancy loss are associated with chronic endometritis, a persistent endometrial inflammation. Its diagnosis and treatment may increase pregnancy and live birth rates. The aim of this study was to assess the effectiveness of endometrial diagnostic biopsy and subsequent antibiotic treatment in cases of chronic endometritis on reproductive outcomes over a long observation period. Method of Study We conducted a historical cohort study (2014–2018) at our University‐based infertility center that included women (n = 108) with repeated implantation failure or recurrent pregnancy loss without known pathologies associated with either condition. Forty‐one women underwent a hysteroscopy only (reference group); the remaining 67 women underwent, in addition to the hysteroscopy, an endometrial diagnostic biopsy with immunohistochemically staining for CD138 to detect plasma cells (biopsy group). If one or more plasma cells were detected, the women were treated with doxycycline 100 mg twice a day orally for 2 weeks. We performed stratified survival analysis (Kaplan‐Meier) and Cox regression. Results The biopsy group had higher chances of pregnancy (hazard ratio 2.28; 95% confidence interval 1.23–4.24; p = .009) and of live birth (hazard ratio 2.76; 95% confidence interval 1.30–5.87; p = .008) compared with the reference group. In the sensitivity analysis, repeated implantation failure or recurrent pregnancy loss did not affect the outcome. Conclusion Endometrial diagnostic biopsy followed by antibiotic treatment in case of chronic endometritis in women with repeated implantation failure or recurrent pregnancy loss may increase the chances for live birth. |
| Databáze: | OpenAIRE |
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