Journal
FERTILITY AND STERILITY
Volume 89, Issue 3, Pages 677-684Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.fertnstert.2007.03.074
Keywords
infectious agents; chronic endometritis; infertility; bacteria; Ureaplasma; Chlamydia
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Objective: To evaluate the type and etiopathogenic role of infectious agents detected in endometrial cultures obtained from women with chronic endometritis (CE). Design: Prospective controlled study. Setting: University hospital. Patient(s): 2190 women undergoing hysteroscopy for different indications. Intervention(s): Vaginal and endometrial samples were collected from 438 women with a CE diagnosis at hysteroscopy and 100 women with no signs of CE (controls). Main Outcome Measure(s): Histology and cultures for common bacteria, Neisseria gonorrhoeae and Mycoplasma, and molecular biology testing for Chlamydia were performed. Result(s): We compared results of vaginal and intrauterine cultures obtained from women with and without CE. Histologic results were positive in 388 of these cases (88.6%), and at least one microorganism was found in 320 endometrial samples (73.1%). In the control group, histologic results and endometrial culture were positive in only 6% and 5% of cases, respectively. The most frequent infectious agents detected at the endometrial level were common bacteria (58% of cases). Ureaplasma urealyticum was detected in 10% and Chlamydia in only 2.7% of positive endometrial cultures. In only 143 (32.6%) cases were the same infectious agent isolated in endometrial and vaginal cultures. Conclusion(s): More than 70% of CE cases resulted from nongonococcal, nonchlamydial infections. Common bacteria and Mycoplasma were the most frequent etiologic agents. Vaginal cultures have low concordance with endometrial cultures.
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