[Identification and treatment of endometritis]

Endometritis represent a debatable entity because genital infectious disease is a contre-indication of endoscopy. So, the diagnosis is rarely realized by hysteroscopy. Two kinds of endometritis are discerned: acute endometritis characterized by an oedema of bleeding endometrium, covered by an abnormal mucus; chronic endometritis with areas of red endometrium, flushed, with a white central point, localized or scattered out the cavity. This is the "strawberry aspect". Whereas, the correlation between hysteroscopic aspect and histologic or bacteriologic samples exists in only 35% of cases. According to R. Frydman and J. Hamou, chronic endometritis is occurred among 22% of patients in IVF program, in 14% of unexplained infertility and 23.6% of women with an history of first trimester miscarriages. Chlamydiae an Ureaplasma seem to be the most frequent germs. In this way, in case of unexplained infertility, the hysteroscopic diagnosis of chronic endometritis can lead to an antibiotic treatment test.