Objective: To establish a hysteroscopic chronic endometritis (hCE) scoring system for patients with chronic endometritis, and observe the correlation of hCE score with in vitro fertilization-embryo transfer (IVF-ET) pregnancy outcomes in infertile women. Methods: The study retrospectively investigated the correlation of morphologic features and hCE score with pregnancy outcomes during IVF-ET in infertile women with CE (n=429) at Yantai Yuhuangding Hospital between January 2017 and September 2018. The clinical pregnancy rate and live birth rate with different score levels (1-3,4-7 and 8-14) after IVF-ET treatment were analyzed. Multivariate regression analysis was performed to adjust for confounding factors. The correlation and regression between hCE score and pregnancy outcomes was analyzed by curve fitting. Results: The age of 429 patients [M(Q1, Q3)] was 31 (29, 35) years. There were 50.6% (217 cases), 35.4% (152 cases), and 14.0% (60 cases) of patients with hCE score of 1-3, 4-7, and 8-14, respectively. The pregnancy rates of the three groups were 60.8% (132 cases), 44.7% (68 cases) and 16.7% (10 cases), P<0.001; The live birth rates were 51.2% (111 cases), 36.8% (56 cases) and 13.3% (8 cases), respectively (P<0.001). Compared with patients with hCE of 1-3, pregnancy rates in those with hCE of 4-7 and 8-14 were lower, and the OR values were 0.521 (0.342-0.793) and 0.129 (0.062-0.268). The live birth rates in patients with hCE of 4-7 and 8-14 were lower than that in patients with hCE of 1-3, and the OR values were 0.570 (0.372-0.873) and 0.162 (0.073-0.360), all P<0.05. Quadratic curve fitting results showed that clinical pregnancy rate and live birth rate decreased with the increase of hCE score. Conclusions: With the increase of hCE score, the clinical pregnancy rate and live birth rate of patients gradually decrease. hCE 4 is an important cut-off threshold significantly affecting the pregnancy outcome.
目的： 建立慢性子宫内膜炎患者宫腔镜评分系统并分析其与子宫内膜炎不孕症患者体外受精-胚胎移植（IVF-ET）妊娠结局的关系。 方法： 回顾性收集烟台毓璜顶医院生殖医学中心自2017年1月至2018年9月因不孕症进行宫腔镜检查诊断为慢性子宫内膜炎（CE）并进行IVF-ET（鲜胚移植）的患者，共429例，进行宫腔镜CE（hCE）评分，比较不同分值等级（1~3、4~7、8~14分）IVF-ET治疗后患者的临床妊娠率及活产率，采用多因素logistic回归模型分析妊娠结局的相关因素，并曲线拟合分析hCE评分与妊娠结局的相关性。 结果： 429例患者年龄［M（Q1，Q3）］为31（29，35）岁，hCE评分1~3分患者占50.6%（217例），4~7分占35.4%（152例），8~14分占14.0%（60例）；3组患者的妊娠率分别为60.8%（132例）、44.7%（68例）、16.7%（10例），P<0.001；活产率分别为 51.2%（111例）、36.8%（56例）、13.3%（8例），P<0.001。与1~3分组比，4~7和8~14分组妊娠率降低，其OR值（95%CI）分别是0.521（0.342~0.793）和0.129（0.062~0.268）；与1~3分组相比，4~7和8~14分组活产率降低，其OR值（95%CI）分别是0.570（0.372~0.873）和0.162（0.073~0.360）；均P<0.05。二次项曲线拟合结果显示，患者临床妊娠率及活产率均随着hCE评分的增加而下降。 结论： hCE评分与不孕症CE患者IVF-ET后妊娠结局相关，hCE高于4分时影响妊娠结局；随着hCE分值的升高，患者临床妊娠率及活产率均逐渐降低。.