Chronic endometritis and endometriosis: what do they have in common?

Authors

DOI:

https://doi.org/10.18370/2309-4117.2024.71.29-32

Keywords:

endometriosis, chronic endometritis, adenomyosis, abnormal uterine bleeding, endometrial pathology, uterine myoma

Abstract

Background. Chronic endometritis and endometriosis are difficult illnesses to diagnose, due to their non-specific manifestations, but at the same time they are quite common and often result in impaired fertility. Both endometritis and endometriosis are chronic inflammatory diseases that could affect the receptivity of the endometrium, precisely it affects the implantation process, as well as it contributes to early pregnancy losses, which makes a challenge for reproductive specialists. In addition, these diseases negatively affect the social and psychological aspects of a modern woman’s life due to the fact that such common symptoms as pelvic pain, dyspareunia, abnormal uterine bleeding exhaust and deprive the woman at her usual activity and lead to a deterioration of her psycho-emotional state, that requires modern approaches in diagnosis and treatment.
Objectives of the study: to identify and investigate the relationship between chronic endometritis and endometriosis.
Materials and methods. Endometrial samples taken during pipelle biopsy from 105 women were studied, among them 45 patients without endometriosis and 60 with endometriosis. All women were of reproductive age, had not taken oral contraceptives, progestins, or antibiotics in the past 6 months, and had no neoplastic pathology.
A pathohistological examination of the obtained material was performed in all cases. Logistic regression analysis was performed on variables such as age, body mass index, parity, presence of uterine fibroids, and endometriosis.
Results. Chronic endometritis was confirmed in 86.7% of patients with endometriosis and in 44.4% of women without signs of endometriosis. Considering these data, it can be argued that chronic endometritis is more common among women with endometriosis compared to women without this pathology. It was also established histologically that the frequency of chronic endometritis in adenomyosis is 2.6 times higher than in other pathologies without endometriosis (52 confirmed cases versus 20).
Conclusions. The results of this study indicate a strong connection betISSN 2309-4117ween chronic endometritis and endometriosis.

Author Biography

R.A. Ruda, P.L. Shupyk National University of Health Care of Ukraine, Kyiv

Postgraduate student, Department of Obstetrics, Gynecology and Perinatology

References

  1. Hickey M, Ballard K, Farquhar C. Endometriosis. BMJ 2014 Mar 19:348:29–34. DOI: 10.1136/bmj.g1752
  2. Greene AD, Lang SA, Kendziorski JA, et al. Endometriosis: where are we and where are we going? Reproduction 2016 Sep;152(3):R63–78. DOI: 10.1530/REP-16-0052
  3. Oosterlynck DJ, Cornillie FJ, Waer M, Koninckx PR. Immunohistochemical characterization of leucocyte subpopulations in endometriotic lesions. Arch Gynecol Obstet 1993;253(4):197–206. DOI: 10.1007/BF02766646
  4. Wu MY, Ho HN. The role of cytokines in endometriosis. Am J Reprod Immunol 2003 May;49:285–96. DOI: 10.1034/j.1600-0897.2003.01207.x
  5. Berbic M, Schulke L, Markham R, et al. Macrophage expression in endometrium of women with and without endometriosis. Hum Reprod. 2009 Feb;24(2): 325–32. DOI: 10.1093/humrep/den393
  6. Khan KN, Masuzaki H, Fujishita A, et al. Differential macrophage infiltration in early and advanced endometriosis and adjacent peritoneum. Fertil Steril 2004 Mar;81(3):652–61. DOI: 10.1016/j.fertnstert.2003.07.037
  7. Cicinelli E, Resta L, Nicoletti R, et al. Endometrial micropolyps at fluid hysteroscopy suggest the existence of chronic endometritis. Hum Reprod 2005 May;20:1386–9. DOI: 10.1093/humrep/deh779. Epub 2005 Feb 25
  8. Cicinelli E, de Ziegler D, Nicoletti R, et al. Chronic endometritis: correlation among hysteroscopic, histologic, and bacteriologic findings in a prospective trial with 2190 consecutive office hysteroscopies. Fertil Steril 2008 Mar;89:677–84. DOI: 10.1016/j.fertnstert.2007.03.074
  9. Lorenz J. Chronische Endometritis bei rezidivierendem Abortgeschehen. Geburtshilfe und Frauenheilkunde 81.12 (2021):1279–80.
  10. Kitaya K. Prevalence of chronic endometritis in recurrent miscarriages. Fertil Steril. 2011 Mar 1;95(3):1156–8. DOI: 10.1016/j.fertnstert.2010.09.061
  11. Sahasrabudhe, N., Mobasseri, M., Reznik, S.E. et al. Chronic Endometritis and Recurrent Pregnancy Loss. Curr Obstet Gynecol Rep 2017;6:55–61. https://doi.org/10.1007/s13669-017-0189-z.
  12. McQueen DB, Perfetto CO, Hazard FK, Lathi RB. Pregnancy outcomes in women with chronic endometritis and recurrent pregnancy loss. Fertil Steril. 2015 Oct;104(4):927–931. DOI: 10.1016/j.fertnstert.2015.06.044.
  13. Puente E, Alonso L, Laganà AS, et al. Chronic Endometritis: Old Problem, Novel Insights and Future Challenges. Int J Fertil Steril. 2020;13(4):250–6. DOI:10.22074/ijfs.2020.5779
  14. Kitaya K, Matsubayashi H, Yamaguchi K, et al. Chronic endometritis: potential cause of infertility and obstetric and neonatal complications. Am J Reprod Immunol. 2016 Jan;75(1):13–22. DOI: 10.1111/aji.12438
  15. Wu D, Kimura F, Zheng L, et al. Chronic endometritis modifies decidualization in human endometrial stromal cells. Reprod Biol Endocrinol. 2017;15(1):16.
  16. Pinto V, Matteo M, Tinelli R, et al. Altered uterine contractility in women with chronic endometritis. Fertil Steril. 2015 Apr;103(4):1049–52. DOI: 10.1016/j.fertnstert.2015.01.007
  17. Coughlan C, Ledger W, Wang Q, et al. Recurrent implantation failure: definition and management. Reprod Biomed Online. 2014;28(1):14–38.
  18. Pellicer A, Oliveira N, Ruiz A, et al. Exploring the mechanism(s) of endometriosis-related infertility: an analysis of embryo development and implantation in assisted reproduction. Hum Reprod. 1995 Dec;10:91–7. DOI: 10.1093/humrep/10.suppl_2.91
  19. Li X, Large MJ, Creighton CJ, et al. COUP-TFII regulates human endometrial stromal genes involved in inflammation. Mol Endocrinol. 2013 Dec;27(12):2041–54. DOI: 10.1210/me.2013-1191.
  20. de Ziegler D, Pirtea P, Ayoubi JM. Inflammation and uterine fibrosis: the possible role of chronic endometritis. Fertil Steril. 2019 May;111(5):890–1. DOI: 10.1016/j.fertnstert.2019.02.005.
  21. Lessey BA, Palomino WA, Apparao KB, et al. Estrogen receptor-alpha (ER-alpha) and defects in uterine receptivity in women. Reprod Biol Endocrinol. 2006;4 Suppl 1(Suppl 1):S9. DOI: 10.1186/1477-7827-4-S1-S9.
  22. Gregory CW, Wilson EM, Apparao KB, et al. Steroid receptor coactivator expression throughout the menstrual cycle in normal and abnormal endometrium. J Clin Endocrinol Metab. 2002 Jun;87(6):2960–6. DOI: 10.1210/jcem.87.6.8572.
  23. Lessey BA, Lebovic DI, Taylor RN. Eutopic endometrium in women with endometriosis: ground zero for the study of implantation defects. Semin Reprod Med. 2013 Mar;31(2):109–24. DOI: 10.1055/s-0032-1333476.
  24. Bruner-Tran KL, Herington JL, Duleba AJ, et al. Medical management of endometriosis: emerging evidence linking inflammation to disease pathophysiology. Minerva Ginecol. 2013 Apr;65(2):199-213.
  25. Nie J, Liu X, Guo SW. Promoter hypermethylation of progesterone receptor isoform B (PR-B) in adenomyosis and its rectification by a histone deacetylase inhibitor and a demethylation agent. Reprod Sci. 2010 Nov;17(11):995–1005. DOI: 10.1177/1933719110377118.
  26. Nie J, Lu Y, Liu X, Guo SW. Immunoreactivity of progesterone receptor isoform B, nuclear factor kappaB, and IkappaBalpha in adenomyosis. Fertil Steril. 2009 Sep;92(3):886–9. DOI: 10.1016/j.fertnstert.2009.01.084.
  27. Munro MG. Uterine polyps, adenomyosis, leiomyomas, and endometrial receptivity. Fertil Steril. 2019 Apr;111(4):629–40. DOI: 10.1016/j.fertnstert.2019.02.008.
  28. Takebayashi A, Kimura F, Kishi Y, et al. The association between endometriosis and chronic endometritis. PLoS One. 2014;9(2):e88354. DOI:10.1371/journal.pone.0088354
  29. Munro MG, Critchley HO, Broder MS, Fraser IS. FIGO Working Group on Menstrual Disorders. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet. 2011 Apr;113(1):3–13. DOI: 10.1016/j.ijgo.2010.11.011.
  30. Lin WC, Chang CY, Hsu YA, et al. Increased Risk of Endometriosis in Patients With Lower Genital Tract Infection: A Nationwide Cohort Study. Medicine (Baltimore). 2016 Mar;95(10):e2773. DOI: 10.1097/MD.0000000000002773.
  31. Khan KN, Fujishita A, Ogawa K, et al. Occurrence of chronic endometritis in different types of human adenomyosis. Reprod Med Biol. 2022 Jan-Dec;21(1):e12421. DOI: 10.1002/rmb2.12421.

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Published

2024-03-15

How to Cite

Ruda, R. (2024). Chronic endometritis and endometriosis: what do they have in common?. REPRODUCTIVE ENDOCRINOLOGY, (71), 29–32. https://doi.org/10.18370/2309-4117.2024.71.29-32

Issue

No. 71 (2024)

Section

Gynecology

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Copyright (c) 2024 Р.А. Руда

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