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臨床婦人科産科78巻1号

2024年01月発行

文献概要

合併増大号 今月の臨床 産婦人科医のための感染症最新レクチャー 各論 : 生殖医療

慢性子宮内膜炎と不妊・不育

著者: 山中彰一郎1 木村文則1

所属機関: 1奈良県立医科大学医学部産婦人科学講座

ページ範囲:P.40 - P.45

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●慢性子宮内膜炎は,自覚症状は乏しいものの,生殖医療,周産期予後に影響を及ぼす可能性が示唆されている.

●慢性子宮内膜炎の診断に統一された基準はないものの,「子宮内膜間質領域への形質細胞(CD138陽性)の出現」が診断に有用である.

●現状,慢性子宮内膜炎に対する一般的な治療は広域抗菌薬の投与であるが,耐性菌や子宮内以外の細菌叢への影響などが懸念されており,新規治療の開発が期待されている.

参考文献

1)Kimura F, et al : Review : Chronic endometritis and its effect on reproduction. J Obstet Gynaecol Res 45 : 951-960, 2019
2)Cicinelli E, et al : Chronic endometritis : correlation among hysteroscopic, histologic, and bacteriologic findings in a prospective trial with 2190 consecutive office hysteroscopies. Fertil Steril 89 : 677-684, 2008
3)Moreno I, et al : The diagnosis of chronic endometritis in infertile asymptomatic women : a comparative study of histology, microbial cultures, hysteroscopy, and molecular microbiology. Am J Obstet Gynecol 218 : 602.e1-602.e16, 2018
4)Xiong Y, et al : Impact of oral antibiotic treatment for chronic endometritis on pregnancy outcomes in the following frozen-thawed embryo transfer cycles of infertile women : a cohort study of 640 embryo transfer cycles. Fertil Steril 116 : 413-421, 2021
5)Cicinelli E, et al : Antibiotic therapy versus no treatment for chronic endometritis : a case-control study. Fertil Steril 115 : 1541-1548, 2021
6)Johnston-MacAnanny EB, et al : Chronic endometritis is a frequent finding in women with recurrent implantation failure after in vitro fertilization. Fertil Steril 93 : 437-441, 2010
7)McQueen DB, et al : Chronic endometritis in women with recurrent early pregnancy loss and/or fetal demise. Fertil Steril 101 : 1026-1030, 2014
8)Kuroda K, et al : Analysis of the therapeutic effects of hysteroscopic polypectomy with and without doxycycline treatment on chronic endometritis with endometrial polyps. Am J Reprod Immunol 85 : e13392, 2021
9)Kitaya K, et al : Live birth rate following oral antibiotic treatment for chronic endometritis in infertile women with repeated implantation failure. Am J Reprod Immunol 78 : doi 10.1111/aji.12719, 2017
10)Cicinelli E, et al : Prevalence of chronic endometritis in repeated unexplained implantation failure and the IVF success rate after antibiotic therapy. Hum Reprod 30 : 323-330, 2015
11)McQueen DB, et al : Pregnancy outcomes in women with chronic endometritis and recurrent pregnancy loss. Fertil Steril 104 : 927-931, 2015
12)Morimune A, et al : The effects of chronic endometritis on the pregnancy outcomes. Am J Reprod Immunol 85 : e13357, 2021
13)Luncan M, et al : The effectiveness of intrauterine antibiotic infusion versus oral antibiotic therapy in the treatment of chronic endometritis in patients during IVF(in vitro fertilization) procedures. BMC Women's Health(2022)22 : 5292022 Dec 17 ; 22(1): 529
14)Pantos K, et al : Introducing intrauterine antibiotic infusion as a novel approach in effectively treating chronic endometritis and restoring reproductive dynamics : a randomized pilot study. Sci Rep 11 : 15581, 2021

掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1882-1294

印刷版ISSN:0386-9865

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