Chronic endometritis and endometrial dysfunction - is there a causal relationship?

• Mekan R. Orazov
• Liliya R. Toktar
• Lyudmila M. Mikhaleva
• Elena S. Silant’eva
• Pavel A. Semenov
• Elena V. Lagutina
• Roman E. Orekhov

Abstract

Background. Today, chronic endometritis is understood as persistent, Low-symptom inflammation in the endometrium, which is characterized by infiltration of plasma cells into the stromal region, where their presence is not normally observed. «Thin» endometrium is defined as the thickness of the endometrium less than 7-8 mm. Mandatory endometrial biopsy to verify the diagnosis, the absence of a specific clinical picture of the disease, as well as universal international criteria for the diagnosis of ChE creates barriers to understanding the real prevalence of this condition. Nevertheless, the high incidence rates of chronic endometritis in women with infertility dictate the need to take into account the possibility of this condition when assessing female infertility and forming a strategy for overcoming it.

Aim. To present an analysis of modern ideas about the etiology and pathogenesis, diagnosis, as well as the tactics of managing patients with chronic endometritis and thin endometrium syndrome.

Material and methods. To form the review, an analysis of the PubMed, EMBASE, Medline, Cochrane databases was undertaken, and international reviews of the authors for 2015-2020 were selected with the largest randomized controlled trials in this area.

Results. Despite the abundance of literature and the high interest of researchers around the world in chronic endometritis, "thin" endometrium and their association with infertility, to date, there is no convincing data that would give a comprehensive answer to questions related to the prevalence, etiology, pathogenesis, diagnostics, as well as tactics of treatment of infertility in this cohort of patients.

Conclusion. Chronic endometritis and "thin" endometrial syndrome are apparently associated with infertility, repeated implantation failures and pregnancy loss. Despite this, the pathogenetic links of this relationship, as well as the methods for diagnosing and overcoming these reproductive problems, today cause a lot of discussion and require serious qualitative clinical and morphological studies with a strong evidence base.

Keywords:chronic endometritis, "thin" endometrium, infertility

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