慢性子宫内膜炎治疗后免疫组化标志物转阴与FET结局的相关性研究OA

Objectives:To evaluate the impact of chronic endometritis(CE)on frozen-thawed embryo transfer(FET)outcomes and to determine whether achieving immunohistochemical(IHC)negativity for CD38 and CD138 following anti-inflammatory treatment could improve reproductive outcomes. Methods:This retrospective study included patients who underwent FET and received hysteroscopy with diagnostic curettage at the Reproductive Center of Women and Children's Hospital of Chongqing Medical University between January 2018 and December 2023.Based on IHC results,patients were classified into five groups:dual-negative(CD38-/CD138-),single positive(post-treatment CD38+),conversion to negative(CD138+with conversion to negative),persistent CD138+(CD138+without conversion to negative),and no repeat biopsy(CD138 without repeat biopsy).Pregnancy outcomes were compared among groups.Logistic regression analysis was used to identify factors associated with pregnancy outcomes of FET. Results:Patients' age and anti-Müllerian hormone(AMH)levels differed significantly among the groups(P＜0.05),while body mass index(BMI)was comparable(P＞0.05).The proportion of the positive results of hysteroscopy and the endometrial thickness on the day of embryo transfer also varied significantly(P＜0.05).However,there were no significant differences in the implantation rate,the clinical pregnancy rate,the early miscarriage rate and the live birth rate(P＞0.05).Logistic regression results showed that the positivity for CD38 and/or CD138 was independently associated with a lower likelihood of live birth(P＜0.05).In contrast,achieving IHC conversion to negativity and undergoing a post-treatment re-examination had no significant impact on live birth rate. Conclusions:The presence of CD38+and/or CD138+was associated with reduced live birth rate among patients with CE.However,confirmation of inflammation resolution through post-treatment IHC conversion to negativity and a post-treatment re-examination had no impact on pregnancy outcomes.