Chronic endometritis and recurrent reproductive failure: a systematic review and meta-analysis

Urology-nephrology

The endometrium plays a crucial role in reproduction by promoting blastocyst adhesion, cytotrophoblast invasion and foetal development. Among the various uterine disorders, endometritis, particularly chronic endometritis, has attracted attention due to its association with adverse reproductive outcomes (recurrent pregnancy loss, recurrent implantation failure and infertility).

The association between chronic endometritis and adverse reproductive outcomes highlights the need for comprehensive diagnostic and therapeutic strategies to optimise fertility outcomes and support individuals on their journey to parenthood.

Objective: to explore the relationship between chronic endometritis and reproductive disorders.

A systematic review and meta-analysis were carried out based on data published between 1990 and 2024, in accordance with PRISMA guidelines.

A population of 1,038 women was included. With regard to the association between chronic endometritis and infertility, a positive correlation was found, with a rate of chronic endometritis of 19.46% in infertile women compared with 7.7% in controls (OR: 2.96, 95% CI 1.53-5.72, p 0.001). No significant association was observed between recurrent implantation failure and chronic endometritis (OR: 1.10, 95% CI 0.26-4.61, p 0.90), and the rates of chronic endometritis in the two groups were relatively comparable, with 6.35% in women with recurrent implantation failure and 5.8% in controls.

In contrast, a strong association between chronic endometritis and recurrent pregnancy loss was found, reporting a chronic endometritis rate of 37.6% in cases of recurrent pregnancy loss versus 16.4% in controls (OR: 3.59, 95% CI 2.46-5.24, p < 0.00001).

Conclusions: chronic endometritis appears to be associated with infertility and recurrent pregnancy loss, whereas no significant association was noted in cases of recurrent implantation failure.

Source(s) :
Ticconi C; Inversetti A; Marraffa S; Campagnolo L; Arthur J; Zambella E; Di Simone N ;

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