Chronic Endometritis and Reproductive Health Outcomes
Summary
Chronic endometritis (CE) is a persistent, often asymptomatic inflammation of the uterine lining characterised by stromal infiltration of plasma cells. While historically underestimated, CE is now recognised as a contributor to infertility, recurrent pregnancy loss and implantation failure in assisted reproduction. Its aetiology encompasses a spectrum of microbial pathogens—including common bacteria and genital mycoplasmas—and perturbations of the endometrial microbiome. The resulting inflammatory milieu disrupts normal decidualisation, alters cytokine profiles and impairs endometrial receptivity, thereby compromising embryo adhesion and placental development. Diagnosis relies on histological identification of CD138-positive plasmacytes and hysteroscopic findings, yet standardisation of sampling and interpretation remains a challenge. Antibiotic and immunomodulatory therapies have demonstrated potential to restore a receptive endometrium, improve pregnancy rates and reduce miscarriage risk. As research advances, integrating microbiome analysis, immune profiling and novel biomaterials offers promise for precision interventions. Given the global burden of infertility and growing use of assisted reproductive technologies, addressing CE has significant implications for reproductive success and maternal–fetal health worldwide.
Research from Nature Portfolio
No recent Nature Portfolio content available.
Chronic Endometritis and Reproductive Health Outcomes publication trend
The graph below shows the total number of articles in chronic endometritis and reproductive health outcomes across all publications each year (not limited to Nature Index journals).
Technical terms
Chronic endometritis (CE): A long-standing inflammation of the endometrial lining marked by the presence of plasma cells.
Decidualisation: The process by which endometrial stromal cells undergo morphological and functional transformation to support embryo implantation.
Macrophage polarisation: The functional shift of macrophages between pro-inflammatory (M1) and anti-inflammatory/reparative (M2) states.
Plasma cell: A differentiated B-lymphocyte that produces antibodies, identified in CE by CD138 expression.
Recurrent implantation failure (RIF): The failure to achieve clinical pregnancy after several high-quality embryo transfers under in vitro fertilisation protocols.
Recurrent pregnancy loss (RPL): The occurrence of two or more consecutive miscarriages before 20 weeks’ gestation, often linked to endometrial factors.
References
- Recombinant humanized collagen remodels endometrial immune microenvironment of chronic endometritis through macrophage immunomodulation. Regenerative Biomaterials (2023).
- Chronic endometritis and recurrent reproductive failure: a systematic review and meta-analysis. Frontiers in Immunology (2024).
- Antibiotics combined with vaginal probiotics in the embryo transfer cycle of infertile patients with chronic endometritis. Frontiers in Cellular and Infection Microbiology (2024).
About these summaries
This Nature Research Intelligence Topic summary is created with the cited references and a large language model. We take care to ground generated text with facts, and have systems in place to gain human feedback on the overall quality of the process in line with our AI principles. We strive to create accurate and useful summaries for people unfamiliar with the research topic and that supports this goal. These pages are a beta release and will be updated as we learn how best to help people gain value from a research topic summary.
Turn complex research questions into confident strategic decisions
When you're under pressure to set direction, justify investment, or understand your competitive position, you need more than raw data — you need trusted insights you can act on.
Benchmark your performance against global peers using robust, methodologically sound analysis.
Combine quantitative metrics with qualitative expert insight to uncover strengths, gaps and emerging opportunities.
Gain tailored, decision-ready recommendations aligned to your strategic priorities.
Talk to us to learn more about our data dashboards and bespoke strategy reports.
Grow research skills, confidence and careers with training built for every stage of the research lifecycle.
Developed with Nature Portfolio journal Editors and internationally renowned experts. Discover three ways to learn:
Self-paced, online courses in convenient bite-sized units, covering key skills across scientific writing, publishing, grant writing, data analysis, and more.
Expert trainer-led workshops with hands-on exercises and real-time feedback across core research skills, delivered via interactive group sessions.
Editor-led workshops combining core principles in writing and publishing, personalised 1:1 feedback from Nature Portfolio Editors and hands-on exercises.
Explore course catalogues and workshop agendas, enquire about the options or request institutional pricing.