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Higher prevalence of chronic endometritis in women with endometriosis: a possible etiopathogenetic link
Open accessAbstract
Objective To evaluate the association between endometriosis end chronic endometritis (CE) diagnosed by hysteroscopy, conventional histology, and immunohistochemistry.Design Case-control study.Setting University hospital.Patient(s) Women with and without endometriosis who have undergone hysterectomy.Intervention(s) Retrospective evaluation of 78 women who have undergone hysterectomy and were affected by endometriosis and 78 women without endometriosis.Main outcome measure(s) CE diagnosed based on conventional histology and immunohistochemistry with anti-syndecan-1 antibodies to identify CD138 cells.Result(s) The prevalence of CE was statistically significantly higher in the women with endometriosis as compared with the women who did not have endometriosis (33 of 78, 42.3% vs. 12 of 78, 15.4% according to hysteroscopy; and 30 of 78, 38.5% vs. 11 of 78, 14.1% according to histology). The women were divided into two groups, 115 patients without CE and 41 patients with CE. With univariate analysis, parity was associated with a lower risk for CE, and endometriosis was associated with a statistically significantly elevated risk of CE. Using multivariate analysis, parity continued to be associated with a lower incidence of CE, whereas endometriosis was associated with a 2.7 fold higher risk.Conclusion(s) The diagnosis of CE is more frequent in women with endometriosis. Although no etiologic relationships between CE and endometriosis can be established, this study suggests that CE should be considered and if necessary ruled out in women with endometriosis, particularly if they have abnormal uterine bleeding. Identification and appropriate treatment of CE may avoid unnecessary surgery.
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“Chronic endometritis, which has an increased prevalence in endometriosis (17), does not seem to affect implantation rates after transfers of euploid blastocysts in E 2 and progesterone cycles (18).”
From Endometrial receptivity in adenomyosis and/or endometriosis (2023) · cites this paper as [17]
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“Endometriosis is associated with higher concentrations of Escherichia coli in menstrual blood (134, 135), with vaginal infections (136), and with chronic endometritis (137).”
From Pathogenesis of endometriosis: The genetic/epigenetic theory (2019) · cites this paper as [137]
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Metadata
- Authors
- Cicinelli, E., Trojano, G., Mastromauro, M., Vimercati, A., Marinaccio, M., Mitola, P. C., Resta, L., & de Ziegler, D.
- Affiliations
- University of Bari Aldo Moro (IT)
- Corresponding author
- Cicinelli, Ettore
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2017-08
- Volume
- 108
- Issue
- 2
- Pages
- 289-295.e1
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2626018945
- Cited by
- 147
- References
- 44
- Citations by year
- 2026: 16 · 2025: 19 · 2024: 17 · 2023: 22 · 2022: 19 · 2021: 15 · 2020: 17 · 2019: 12 · 2018: 10
- FWCI
- 12.38
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion, cc-by-nc-nd)
- INFM-OAR (INFN Catania) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
- Keywords
- chronic endometritis, endometriosis, CD138+ cells, syndecan-1, hysterectomy, parity, abnormal uterine bleeding, endometritis, etiopathogenesis
- MeSH terms
- Adult, Chronic Disease, Endometriosis, Endometritis, Female, Humans, Hysterectomy, Italy, Retrospective Studies, Risk Factors, Uterine Hemorrhage, Comorbidity, Causality, Prevalence
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