IMR Press / CEOG / Volume 50 / Issue 5 / DOI: 10.31083/j.ceog5005093
Open Access Review
Gynecopathology in the Diagnosis and Assessment of Chronic Endometritis
Yimeng Ge1,2,3,4Shuo Yang1,2,3,4Yang Yu1,2,3,4Yan Liu5,6Rong Li1,2,3,4,*
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1 Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, 100191 Beijing, China
2 National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, 100191 Beijing, China
3 Key Laboratory of Assisted Reproduction, Ministry of Education, Peking University Third Hospital, 100191 Beijing, China
4 Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, 100191 Beijing, China
5 Department of Pathology, School of Basic Medical Sciences, Peking University Health Science Center, 100191 Beijing, China
6 Department of Pathology, Peking University Third Hospital, 100191 Beijing, China
*Correspondence: roseli001@sina.com (Rong Li)
Clin. Exp. Obstet. Gynecol. 2023, 50(5), 93; https://doi.org/10.31083/j.ceog5005093
Submitted: 17 December 2022 | Revised: 10 January 2023 | Accepted: 17 January 2023 | Published: 5 May 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Objectives: To summarize the gynecopathology findings in the diagnosis and assessment of chronic endometritis (CE) and provide insights into the therapeutics of CE. Mechanism: Chronic endometritis (CE) refers to the inflammatory state of the endometrium, which might alter endometrial receptivity and impact embryo implantation. As a relatively asymptomatic disease, the diagnosis and assessment of CE mainly lies in endometrial biopsy and further morphological and functional examinations. The authors searched the electronic database with a combination of key terms including chronic endometritis, histopathology, hysteroscopy, microbiota, inflammation, vascularization, decidualization as well as autophagy and summarized the current findings.in the diagnosis and assessment of CE. Findings in Brief: Plasma cell infiltration with immune staining, hysteroscopic manifestations including swelling, hyperemia and micropolyps, and pathogenic diagnosis were the main criteria for diagnosing CE. Further assessment of CE revealed the release of proinflammatory cytokines, leukocyte infiltration, enhanced vascularization and autophagy. These factors all contribute to an inflammatory state of the endometrium and decreased flow reserve supplying the embryo, which lead to the pathway explaining implantation failure in CE patients. Conclusions: Gynecopathology plays an essential role in the diagnosis and assessment of CE. Understanding such methods can help to screen out asymptomatic patients and initiate proper treatment, which eventually promotes better knowledge of the relationship between CE and embryo implantation and a higher successful implantation rate.

Keywords
chronic endometritis
gynecopathology
histopathology
hysteroscopy
inflammation
autophagy
Funding
81925013/National Science Fund for Distinguished Young Scholars
Figures
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