CHRONIC ENDOMETRITIS, CD 138 AND REPEATED IMPLANTATION FAILURES
DOI:
https://doi.org/10.11603/24116-4944.2025.2.15791Keywords:
office hysteroscopy, CD 138, chronic endometritis, minor gynecological surgeryAbstract
The aim of the study – to evaluate the correlation between visual signs of chronic endometritis (CE) during office hysteroscopy and CD 138 in the diagnosis of CE.
Materials and Methods. A prospective study was conducted from 2021 to 2023 at the “Damiya” Reproductive Health Center, Ivano-Frankivsk, Ukraine. Office hysteroscopy was performed as a routine procedure at the stage of endometrial preparation for embryo cryotransfer. Photo- and video-recording of hysteroscopy was performed. Endometrial samples were stored for 24 hours in neutral buffered formalin and then embedded in paraffin according to standard procedures. Statistical analysis was performed using SPSS (Statistical Package for the Social Sciences), version 22.0 (IBM Corp., Armonk, New York, USA).
Results and Discussion. The mean age of the patients was 32.5±1.2 years, 94 (47 %) patients with primary and 106 (53 %) with secondary infertility. According to hysteroscopy, histological and immunohistochemical analysis, 90 patients were diagnosed with HE. 50 patients were diagnosed with HE using visual criteria. These patients were divided into two groups depending on the severity of visual signs: Group I (25 patients) with pronounced signs and Group II (25 patients) with minimal or no signs. In Group I, we included patients with three or more visual signs of HE (focal or diffuse micropolyps with a vascular axis, stromal edema, hyperemia with a large number of white spots and blood vessels on the surface – «strawberry sign», as well as focal and diffuse hyperemia of the endometrium). In group II, we included patients only with criteria such as local isolated micropolyps or isolated focal hyperemia. In the group of women with pronounced visual signs of chronic endometritis, CD 138 was positive in 92 % of patients, while in the group II with weak visual signs of chronic endometritis, CD 138 was negative in 60 % of patients. Comparison of CD 138 indices between the groups of patients with pronounced and almost absent signs of CE demonstrates a clear statistically significant correlation (p<0.05) between the severity of visual signs of chronic endometritis and the CD 138 index. Integration of hysteroscopic findings with histopathological and immunohistochemical analysis (e.g., CD 138 staining) may improve diagnostic accuracy and clinical outcomes. Our results demonstrate a statistically significant correlation between the severity of hysteroscopic visual signs and CD 138, suggesting that office hysteroscopy may serve as a reliable preliminary diagnostic tool for HE.
Conclusions. Office hysteroscopy is a valuable tool for the diagnosis of HE, offering a minimally invasive and cost-effective method of evaluating the uterine cavity. Our study demonstrates a significant correlation (p<0.05) between the severity of visual signs observed during hysteroscopy and CD 138, reinforcing the diagnostic value of hysteroscopic criteria for HE. Based on our results, the presence of three out of five of these visual features is sufficient to establish a hysteroscopic diagnosis of HE.
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