Chronic endometritis and fertility

This review was based on the databases https://cyberleninka.ru/, PubMed, MedArt, and CSML. In recent decades, chronic endometritis has received increasing attention as a potential factor in unexplained infertility or recurrent pregnancy loss, especially in cases of unsuccessful in vitro fertilization programs or repeated early miscarriages. At the same time, the nosological entity of «chronic endometritis» remains insufficiently defined.From a pathogenetic perspective, two variants of chronic endometritis development are identified: an infectious-inflammatory process and an autoimmune pathology, in which the initial triggering factor that started the process is leveled. Immunologic changes associated with processes that affect the outcome of implantation, determining fertility impairment, are nonspecific and cannot be considered as diagnostic criteria for chronic endometritis. The exception is, with reservations, infiltration of CD138 (+) plasmacytes by endometrial stroma. The endometrial receptor disorder detected in chronic endometritis appears to be a nonspecific result of a large number of heterogeneous pathologic conditions.If the infectious-inflammatory pathway of chronic endometritis development is proven, etiotropic therapy aimed at elimination of the infectious agent is justified. In other cases, it is necessary to identify the causes and/or maintenance of secondary autoimmune process.The objective of the review was to facilitate the physicians’ search for the most effective ways to overcome infertility and pregnancy failure associated with chronic endometritis.