Correlation between endometriosis and chronic endometritis : A retrospective cohort study
- 1Department of Gynaecology, Guangzhou Women and Children’s Medical Center Liuzhou Hospital, Liuzhou, Guangxi, China
- 2Guangxi Clinical Research Center for Obstetrics and Gynecology, Liuzhou, Guangxi, China.
Abstract
This single-center retrospective cohort study included infertile patients treated between October 2019 and December 2024, comparing an endometriosis (EMS) cohort (n = 250, laparoscopically and histopathologically confirmed) with a control cohort (n = 750, tubal-factor infertility only, EMS excluded by laparoscopy). All patients underwent laparoscopy, hysteroscopy, and endometrial biopsy; chronic endometritis (CE) was diagnosed by cluster of differentiation 38/cluster of differentiation 138 immunohistochemistry, and EMS was staged by revised American Society for Reproductive Medicine. CE detection rate was significantly higher in the EMS cohort than in controls (P < .001). Within the EMS cohort, CE prevalence was 45.1% in moderate-to-severe (stage III–IV) disease versus 24.0% in mild (stage I–II) disease (P = .001). Factors independently associated with concurrent CE were moderate-to-severe EMS, repeated intrauterine procedures, infertility duration ≥ 3 years, chronic pelvic pain, and higher gravidity (all P < .05). At 1 year, the EMS cohort had a lower clinical pregnancy rate (70.0% vs 80.0%), higher persistent infertility rate (30.0% vs 20.0%), and higher early pregnancy loss rate (16.0% vs 9.2%) than controls (all P < .05). Within the EMS cohort, concurrent CE was associated with a lower clinical pregnancy rate (56.0% vs 76.0%), higher persistent infertility rate (44.0% vs 24.0%), and higher early pregnancy loss rate (31.0% vs 11.3%) than EMS alone (all P = .002). These findings demonstrate a significant cross-sectional association between EMS and CE, with higher CE detection in advanced-stage EMS; however, causality and temporal sequence cannot be determined, reproductive outcomes were exploratory and unadjusted, and this single-center retrospective dataset is insufficient to support universal diagnostic or therapeutic guidelines.
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BibTeX
@article{fan2026correlation,
title = {{Correlation between endometriosis and chronic endometritis : A retrospective cohort study}},
author = {HuiLiu Fan and Bei Liu and XiaoXia Wu and HongLan Wei},
journal = {Medicine},
year = {2026},
month = oct,
doi = {10.1097/md.0000000000051450},
url = {https://europepmc.org/article/PMC/PMC13727181},
note = {CC BY},
}
RIS
TY - JOUR
TI - Correlation between endometriosis and chronic endometritis : A retrospective cohort study
AU - HuiLiu Fan
AU - Bei Liu
AU - XiaoXia Wu
AU - HongLan Wei
PY - 2026
DA - 2026/10/30
JO - Medicine
DO - 10.1097/md.0000000000051450
UR - https://europepmc.org/article/PMC/PMC13727181
AB - This single-center retrospective cohort study included infertile patients treated between October 2019 and December 2024, comparing an endometriosis (EMS) cohort (n = 250, laparoscopically and histopathologically confirmed) with a control cohort (n = 750, tubal-factor infertility only, EMS excluded by laparoscopy). All patients underwent laparoscopy, hysteroscopy, and endometrial biopsy; chronic endometritis (CE) was diagnosed by cluster of differentiation 38/cluster of differentiation 138 immunohistochemistry, and EMS was staged by revised American Society for Reproductive Medicine. CE detection rate was significantly higher in the EMS cohort than in controls (P < .001). Within the EMS cohort, CE prevalence was 45.1% in moderate-to-severe (stage III–IV) disease versus 24.0% in mild (stage I–II) disease (P = .001). Factors independently associated with concurrent CE were moderate-to-severe EMS, repeated intrauterine procedures, infertility duration ≥ 3 years, chronic pelvic pain, and higher gravidity (all P < .05). At 1 year, the EMS cohort had a lower clinical pregnancy rate (70.0% vs 80.0%), higher persistent infertility rate (30.0% vs 20.0%), and higher early pregnancy loss rate (16.0% vs 9.2%) than controls (all P < .05). Within the EMS cohort, concurrent CE was associated with a lower clinical pregnancy rate (56.0% vs 76.0%), higher persistent infertility rate (44.0% vs 24.0%), and higher early pregnancy loss rate (31.0% vs 11.3%) than EMS alone (all P = .002). These findings demonstrate a significant cross-sectional association between EMS and CE, with higher CE detection in advanced-stage EMS; however, causality and temporal sequence cannot be determined, reproductive outcomes were exploratory and unadjusted, and this single-center retrospective dataset is insufficient to support universal diagnostic or therapeutic guidelines.
SN - 0304-5412
SN - 1536-5964
SN - 0025-7974
ER -