Prevalence of Chronic Endometritis in Recurrent Pregnancy Loss and Reproductive Outcomes after Treatment: A Prospective, Observational, Pilot Study
Leena Wadhwa, Jyoti Jaiswal, Priyanka Singh, Anand Kumar VermaIntroduction:
Chronic endometritis (CE) is persistent inflammation of uterus and is associated with a number of adverse reproductive outcomes including Recurrent pregnancy loss (RPL). Its role as a contributory factor for RPL has prevalence ranging from 7%-57%. Chronic endometritis which is emerging as a cause of unexplained RPL with very few studies in Indian population, has been evaluated through Endometrial biopsy and Hysteroscopy in our study.
Objective:
To determine prevalence of chronic endometritis in women with recurrent pregnancy loss (RPL) and to find out reproductive outcome after antibiotic therapy. Methods: Prospective observational study, 60 women with RPL were enrolled from OPD after meeting inclusion and exclusion criteria. All women underwent hysteroscopy and endometrial biopsy in postmenstrual phase. Presence of one or more plasma cell per 10 HPF was taken as diagnostic for CE in EB. The findings of CE on hysteroscopy were presence of micropolyp, hyperemia and stromal oedema. Women diagnosed with CE received Doxycycline for 14 days as first line therapy. All cases were followed for 6 months and clinical pregnancy rate was noted.
Results:
The prevalence of chronic endometritis by endometrial biopsy was 16.6% (10/60) and by hysteroscopy 10.2% (4/60). Clinical pregnancy rate (CPR) in subsequent cycle after antibiotic therapy was 66.7% (8/60) and it was 18.8% (9/48) in RPL women without CE.
Conclusion:
Unexplained RPL cases should be evaluated for Chronic endometritis as the treatment for the same improves future reproductive outcome.