[Endometrial dysfunction caused by chronic endometritis: сlinical and morphological aspects]

Area of Science:

• Reproductive Medicine
• Gynecology
• Pathology

Background:

• Chronic endometritis (CE) is a condition affecting the uterine lining.
• CE can lead to reproductive health issues, including infertility and abnormal uterine bleeding.
• Understanding the clinical and morphological aspects of CE is crucial for effective management.

Purpose of the Study:

• To investigate the clinical and morphological characteristics of endometrial dysfunction in patients with chronic endometritis (CE).
• To identify the impact of CE on endometrial receptivity, hormone response, and local immunity.
• To explore the role of CE in infertility and abnormal uterine bleeding.

Main Methods:

• Studied 239 reproductive-aged women, including those with abnormal uterine bleeding, infertility, and a control group.
• Utilized hysteroscopy, separate diagnostic curettage, and aspiration biopsy for tissue sampling.
• Performed histopathological examination, immunohistochemistry for steroid hormone receptivity and glycodelin, and immune cell analysis (CD4, CD8, CD20).

Main Results:

• Chronic endometritis (CE) was diagnosed in 55.9% of patients with abnormal uterine bleeding and 56.9% with infertility.
• CE patients exhibited impaired endometrial glandular and surface epithelium function, with altered glycodelin expression.
• CE was associated with decreased CD4+ T-cells and increased CD8+ T-cells, indicating local immune dysregulation.

Conclusions:

• Endometrial dysfunction in CE is characterized by reduced steroid hormone reception, impaired glycodelin secretion, and immune system disorders.
• These findings highlight the pathogenic role of CE in infertility.
• Pre-conceptional preparation for patients with CE should consider these endometrial changes.