Vitaly A Kushnir1,2, Shirley Solouki3, Tal Sarig-Meth4, Mario G Vega5, David F Albertini1,6, Sarah K Darmon1, Liane Deligdisch7, David H Barad1,5,8, Norbert Gleicher1,8,9. 1. The Center for Human Reproduction, New York, NY, USA. 2. Wake Forest School of Medicine, Winston-Salem, NC, USA. 3. Lenox Hill Hospital, New York, NY, USA. 4. Sackler School of Medicine, Tel Aviv, Israel. 5. Albert Einstein College of Medicine, Bronx, NY, USA. 6. University of Kansas Medical Center, Kansas City, KS, USA. 7. Icahn School of Medicine at Mount Sinai, New York, NY, USA. 8. Foundation for Reproductive Medicine, New York, NY, USA. 9. The Rockefeller University, New York, NY, USA.
Abstract
PROBLEM: To determine in women with recurrent pregnancy loss (RPL) and/or implantation failure (RIF) the prevalence of chronic endometritis (CE), systemic inflammation and autoimmunity, and whether they relate. METHOD OF STUDY: This retrospective study examined inflammatory (adiponectin, CRP, leptin, and IL6) and autoimmune (total immunoglobulins, ANA, thyroid antibodies, antiphospholipid antibodies) markers in a group of 55 women with RPL/RIF. A diagnosis of CE was reached by endometrial biopsy, demonstrating CD138-positive plasma cells on histology. The prevalence of markers of systemic inflammation and autoimmunity was compared between women with and without CE. RESULTS: Among all RPL/RIF patients, 32.7% demonstrated at least one positive inflammatory marker, 61.8% at least one autoimmune marker, and 45.5% CE. Moreover, CE patients did not differ in systematic inflammatory or autoimmune profiles from those without CE. CONCLUSIONS: Endometritis and elevated inflammatory and autoimmune markers are common in women with RPL/RIF, but endometritis cannot be predicted based on either peripheral inflammatory or autoimmune markers.
PROBLEM: To determine in women with recurrent pregnancy loss (RPL) and/or implantation failure (RIF) the prevalence of chronic endometritis (CE), systemic inflammation and autoimmunity, and whether they relate. METHOD OF STUDY: This retrospective study examined inflammatory (adiponectin, CRP, leptin, and IL6) and autoimmune (total immunoglobulins, ANA, thyroid antibodies, antiphospholipid antibodies) markers in a group of 55 women with RPL/RIF. A diagnosis of CE was reached by endometrial biopsy, demonstrating CD138-positive plasma cells on histology. The prevalence of markers of systemic inflammation and autoimmunity was compared between women with and without CE. RESULTS: Among all RPL/RIFpatients, 32.7% demonstrated at least one positive inflammatory marker, 61.8% at least one autoimmune marker, and 45.5% CE. Moreover, CE patients did not differ in systematic inflammatory or autoimmune profiles from those without CE. CONCLUSIONS:Endometritis and elevated inflammatory and autoimmune markers are common in women with RPL/RIF, but endometritis cannot be predicted based on either peripheral inflammatory or autoimmune markers.
Authors: Andrea Weghofer; David H Barad; Sarah K Darmon; Vitaly A Kushnir; David F Albertini; Norbert Gleicher Journal: Arch Gynecol Obstet Date: 2020-02-27 Impact factor: 2.344