Chronic Endometritis and How It Affects Implantation
Chronic endometritis is a persistent, usually silent inflammation of the lining of the uterus. Because it often causes no symptoms, it can go unrecognised.
It is one of the areas investigated in patients with repeated implantation failure or recurrent pregnancy loss. The following is an informational overview.
What is chronic endometritis?
The endometrium is the layer lining the uterus that renews with each cycle. When a long-standing inflammatory response persists in that layer, it is described as chronic endometritis.
Unlike an acute infection there is usually no fever or severe pain, which is why it is most often found during investigation rather than presenting on its own.
Are there symptoms?
Most patients have no clear symptoms. Possible findings include:
- Spotting between periods
- Abnormal or increased vaginal discharge
- Mild pelvic discomfort
- A change in the menstrual pattern
The absence of symptoms does not mean the condition is absent.
How can it affect implantation?
For an embryo to implant, the endometrium needs a suitable structure and a suitable immune balance. An ongoing inflammatory environment can alter that balance.
This is why chronic endometritis is among the factors assessed when implantation repeatedly fails, see why IVF fails.
How is it diagnosed?
A small tissue sample is taken from the endometrium and examined by a pathologist, looking for the presence of inflammatory cells.
Certain appearances of the endometrial surface seen at hysteroscopy can also be supportive. Your doctor decides which approach applies.
How is it treated?
Where the diagnosis is made, treatment is usually a course of antibiotics chosen by your doctor. A follow-up sample may be taken once the course is complete.
The aim is to resolve the inflammatory environment and provide a more suitable uterine setting before transfer. Response varies between individuals.
Who is investigated for it?
It generally comes up in these situations:
- Repeated implantation failure
- Recurrent pregnancy loss
- Unexplained infertility
- A history of intrauterine procedures
The decision is made by your doctor after looking at the whole picture.
Related Reading
- Endometrial Lining and Implantation: What Matters
- Why Does IVF Fail? Common Reasons and What to Do Next
- Recurrent Miscarriage and Implantation Failure: Causes and What Can Help
Sources and references
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