Treatment following hysteroscopy and endometrial diagnostic biopsy increases chance for live birth in women with chronic endometritis.

Mitter, Vera R.; Meier, Sheila; Rau, Tilman T.; Gillon, Tessa; Mueller, Michael D.; Zwahlen, Marcel; von Wolff, Michael; Kohl Schwartz, Alexandra S. (2021). Treatment following hysteroscopy and endometrial diagnostic biopsy increases chance for live birth in women with chronic endometritis. American journal of reproductive immunology, 86(5), e13482. Blackwell Publishing 10.1111/aji.13482

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Problem Repeated implantation failure and recurrent pregnancy loss are associated with chronic endometritis, a persistent endometrial inflammation. Its diagnosis and treatment may increase pregnancy and live birth rates. The aim of this study was to assess the effectiveness of endometrial diagnostic biopsy and subsequent antibiotic treatment in cases of chronic endometritis on reproductive outcomes over a long observation period. Method of Study We conducted a historical cohort study (2014-2018) at our University-based infertility center that included women (n = 108) with repeated implantation failure or recurrent pregnancy loss without known pathologies associated with either condition. Forty-one women underwent a hysteroscopy only (reference group); the remaining 67 women underwent, in addition to the hysteroscopy, an endometrial diagnostic biopsy with immunohistochemically staining for CD138 to detect plasma cells (biopsy group). If one or more plasma cells were detected, the women were treated with doxycycline 100 mg twice a day orally for two weeks. We performed stratified survival analysis (Kaplan-Meier) and Cox regression. Results The biopsy group had higher chances of pregnancy (hazard ratio 2.28; 95% confidence interval 1.23-4.24; P = .009) and of live birth (hazard ratio 2.76; 95% confidence interval 1.30-5.87; P = .008) compared to the reference group. In the sensitivity analysis, repeated implantation failure or recurrent pregnancy loss did not affect the outcome. Conclusions Endometrial diagnostic biopsy followed by antibiotic treatment in case of chronic endometritis in women with repeated implantation failure or recurrent pregnancy loss may increase chances for live birth.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)
04 Faculty of Medicine > Service Sector > Institute of Pathology > Clinical Pathology

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Mitter, Vera Ruth, Rau, Tilman, Mueller, Michael, Zwahlen, Marcel, von Wolff, Michael, Kohl Schwartz, Alexandra


600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services




Blackwell Publishing




Andrea Flükiger-Flückiger

Date Deposited:

07 Jul 2021 23:01

Last Modified:

07 Feb 2023 08:52

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Endometrial diagnostic biopsy chronic endometritis plasma cells recurrent pregnancy loss repeated implantation failure time to live birth time to pregnancy




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