Comparing the Frequency of Endometritis in Unexplained Infertility and Anovulatory Infertility

Document Type : Original Article

Authors

Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Acute pelvic inflammatory disease (PID) is a common reason for infertility. This study aimed to evaluate the frequency distribution of endometritis in women with unexplained infertility and comparison with frequency distribution of endometritis in anovulatory infertility to identify the importance of endometritis due to subacute PID evaluation in the case of infertility. Materials and Methods: This case–control study was done on 100 women with unexplained infertility and ovulatory infertility who referred to Shahid Beheshti clinic in 2013 in Isfahan, Iran. They were divided into two groups of unexplained infertility and anovulatory infertility. Endometrial samples were given from all the patients by Pipelle biopsy under sterile conditions, and then prepared samples were sent to the pathology laboratory to evaluate the existence of plasma cells by a pathologist to diagnose endometritis. Results: Frequency distribution of acute PID history among the patients in both groups showed a significant difference (P < 0.05). Prevalence of endometritis in unexplained infertility group was 34% and in anovulatory group was 21% (P < 0.05). Prevalence of vaginitis was 46% in unexplained group and 40% in anovulatory group (P < 0.05), and prevalence of PID was 4% in unexplained infertility group and 0% in anovulatory infertility group. Conclusion: The prevalence of endometritis and vaginitis was more in the unexplained infertility group rather than the anovulatory infertility group that may reveal the importance of endometritis evaluation in the cases of unexplained infertility.

Keywords

1.
Eckert LO, Hawes SE, Wölner-Hanssen PK, Kiviat NB, Wasserheit JN, Paavonen JA, et al. Endometritis: The clinical-pathologic syndrome. Am J Obstet Gynecol 2002;186:690-5.  Back to cited text no. 1
    
2.
Johnston-MacAnanny EB, Hartnett J, Engmann LL, Nulsen JC, Sanders MM, Benadiva CA. Chronic endometritis is a frequent finding in women with recurrent implantation failure after in vitro fertilization. Fertil Steril. 2010;93:437-41.  Back to cited text no. 2
    
3.
Bulun SE. Endometriosis. N Engl J Med 2009;360:268-79.  Back to cited text no. 3
[PUBMED]    
4.
Allaire C. Endometriosis and infertility: A review. J Reprod Med 2006;51:164-8.  Back to cited text no. 4
[PUBMED]    
5.
Available from: http://www.cdc.gov/std/treatment/2010/default.htm. [Last accessed on 2011 Jan 03].  Back to cited text no. 5
    
6.
U.S. Department of Health and Human Services Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance, 2009. Atlanta, GA: U.S. Department of Health and Human Services; 2010. Available from: http://www.cdc.gov/std/stats09/Exordium.htm#copy. [Last accessed on 2011 Aug 02].  Back to cited text no. 6
    
7.
Owusu-Edusei K Jr., Bohm MK, Chesson HW, Kent CK. Chlamydia screening and pelvic inflammatory disease: Insights from exploratory time-series analyses. Am J Prev Med 2010;38:652-7.  Back to cited text no. 7
    
8.
Practice Committee of American Society for Reproductive Medicine. Diagnostic evaluation of the infertile female: A committee opinion. Fertil Steril 2012;98:302-7.  Back to cited text no. 8
[PUBMED]    
9.
Cousineau TM, Domar AD. Psychological impact of infertility. Best Pract Res Clin Obstet Gynaecol 2007;21:293-308.  Back to cited text no. 9
[PUBMED]    
10.
Haggerty CL, Ness RB, Amortegui A, Hendrix SL, Hillier SL, Holley RL, et al. Endometritis does not predict reproductive morbidity after pelvic inflammatory disease. Am J Obstet Gynecol 2003;188:141-8.  Back to cited text no. 10
[PUBMED]    
11.
Eggert J, Li X, Sundquist K. Country of birth and hospitalization for pelvic inflammatory disease, ectopic pregnancy, endometriosis, and infertility: A nationwide study of 2 million women in Sweden. Fertil Steril 2008;90:1019-25.  Back to cited text no. 11
[PUBMED]    
12.
Ness RB, Brunham RC, Shen C, Bass DC; PID Evaluation Clinical Health (PEACH) Study Investigators. Associations among human leukocyte antigen (HLA) class II DQ variants, bacterial sexually transmitted diseases, endometritis, and fertility among women with clinical pelvic inflammatory disease. Sex Transm Dis 2004;31:301-4.  Back to cited text no. 12
[PUBMED]