Chronic endometritis is a frequent finding in women with recurrent implantation failure after in vitro fertilization

Fertil Steril. 2010 Feb;93(2):437-41. doi: 10.1016/j.fertnstert.2008.12.131. Epub 2009 Feb 12.


Objective: To determine the role of endometrial sampling for identification and treatment of chronic endometritis (CE) in patients undergoing IVF-ET who repeatedly failed to conceive despite the transfer of good-quality embryos.

Design: Retrospective chart review.

Setting: University-based tertiary fertility center.

Patient(s): Thirty-three patients with recurrent implantation failure (RIF) who underwent endometrial sampling and subsequent ET were analyzed based on immunohistochemically confirmed CE: CE present on biopsy (group 1; n = 10) and CE absent on biopsy (group 2; n = 23). Patients with RIF undergoing IVF cycles during the same time period who did not have endometrial sampling were used as controls (group 3; n = 485).

Intervention(s): Endometrial sampling for CE and subsequent antibiotic treatment in affected patients followed by another IVF-ET cycle.

Result(s): Chronic endometritis was identified in 30.3% of patients with RIF. Group 1 had lower implantation rates (11.5%) in the IVF cycle following treatment than did group 2 and group 3 (32.7% and 20.3%, respectively). Clinical pregnancy and ongoing pregnancy rates were similar across groups.

Conclusion(s): Recurrent implantation failure warrants investigation of CE as a contributing factor. Women demonstrating CE on endometrial sampling have lower implantation rates in a subsequent IVF-ET cycle; however, there were no differences in subsequent clinical pregnancy or ongoing pregnancy rates after successful antibiotic treatment.

MeSH terms

  • Adult
  • Biopsy
  • Chronic Disease
  • Embryo Implantation
  • Embryo Transfer
  • Endometritis / epidemiology*
  • Endometritis / pathology
  • Endometrium / pathology
  • Female
  • Fertilization
  • Fertilization in Vitro / adverse effects*
  • Humans
  • Immunohistochemistry
  • Patient Selection
  • Pregnancy
  • Recurrence
  • Retrospective Studies
  • Treatment Failure*