Abstract
Background: Chronic endometritis (CE) is a persistent inflammation of the endometrial lining. The prevalence of CE is high in infertile women. There is no accepted diagnostic standard.
Objectives: To evaluate the prevalence of CE, the characteristics of CE patients, assess the diagnostic value of CE diagnosis via hysteroscopy compared to endometrial biopsy.
Methods: A prospective study was conducted on 103 patients undergoing in vitro fertilization (IVF) at Hai Phong Obstetrics and Gynecology Hospital between August 2024 and August 2025. The diagnostic criterion of biopsy for CE: ≥ 5 CD138+ plasma cells per 10 high-power fields (HPF); hysteroscopic diagnosis was based on the Delphi 2019 consensus criteria.
Results: The prevalence of CE among IVF patients was 37.9% (39/103). The most frequent hysteroscopic lesion associated with CE is micropolyp (76.9%); micropolyp and diffuse endometrial hyperemia were significantly higher in the CE group compared with the normal group. The diagnostic performance of hysteroscopy compared with histopathology showed a Se 85%, Sp 22%, PPV 40%, NPV 70%. The predictive ability of hysteroscopy for diagnosing CE relative to histopathological confirmation is moderate. Factors associated with the risk of CE: Chronic endometritis is more frequent among patients with secondary infertility than primary infertility.
Conclusion: The prevalence of CE was 37.9%. Hysteroscopy compared with histopathology demonstrates limited diagnostic performance and poor discriminatory capacity for chronic endometritis.
| Published | 2026-06-28 | |
| Fulltext |
|
|
| Language |
|
|
| Issue | Vol. 16 No. 3 (2026) | |
| Section | Original Articles | |
| DOI | 10.34071/jmp.2026.3.930 | |
| Keywords | Keywords: Endometritis, hysteroscopy, endometrial biopsy. Từ khóa: viêm niêm mạc tử cung mạn tính, nội soi buồng tử cung, sinh thiết niêm mạc tử cung. |
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2026 Hue Journal of Medicine and Pharmacy
Song D, Feng X, Zhang Q, Xia E, Xiao Y, Xie W et al. Prevalence and confounders of chronic endometritis in premenopausal women with abnormal bleeding or reproductive failure. Reproductive biomedicine online. 2018;36(1):78-83.
Yang R, Du X, Wang Y, Song X, Yang Y, Qiao J. The hysteroscopy and histological diagnosis and treatment value of chronic endometritis in recurrent implantation failure patients. Archives of gynecology and obstetrics. 2014;289:1363-9.
Kitaya K, Yasuo T. Aberrant expression of selectin E, CXCL1, and CXCL13 in chronic endometritis. Mod Pathol. 2010;23(8):1136-46.
Cicinelli E, Matteo M, Tinelli R, Lepera A, Alfonso R, Indraccolo U, et al. Prevalence of chronic endometritis in repeated unexplained implantation failure and the IVF success rate after antibiotic therapy. Human reproduction (Oxford, England). 2015;30(2):323-30.
Santoro A, Travaglino A, Inzani F, Angelico G, Raffone A, Maruotti GM, et al. The role of plasma cells as a marker of chronic endometritis: a systematic review and meta-analysis. Biomedicines. 2023;11(6):1714.
Cicinelli E, Vitagliano A, Kumar A, Lasmar RB, Bettocchi S, Haimovich S. Unified diagnostic criteria for chronic endometritis at fluid hysteroscopy: proposal and reliability evaluation through an international randomized-controlled observer study. Fertil Steril. 2019;112(1):162-73.e2.
Bashiri A, Halper KI, Orvieto R. Recurrent Implantation Failure-update overview on etiology, diagnosis, treatment and future directions. Reproductive Biology and Endocrinology. 2018;16(1):121.
Liu Y, Chen X, Huang J, Wang CC, Yu MY, Laird S, et al. Comparison of the prevalence of chronic endometritis as determined by means of different diagnostic methods in women with and without reproductive failure. Fertil Steril. 2018;109(5):832-9.
Liu H, Song J, Zhang F, Li J, Kong W, Lv S, et al. A new hysteroscopic scoring system for diagnosing chronic endometritis. Journal of Minimally Invasive Gynecology. 2020;27(5):1127-32.