{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T21:05:36Z","timestamp":1791579936935,"version":"4.3.4"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T00:00:00Z","timestamp":1688428800000},"content-version":"vor","delay-in-days":184,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["18K09273"],"award-info":[{"award-number":["18K09273"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Reprod Medicine &amp; Biology"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To identify the efficacy of endometrial curettage on antibiotic\u2010resistant chronic endometritis (CE) in infertile women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Of 1580 women with CE, 87 with antibiotic\u2010resistant CE after two to five cycles of antibiotic treatment were recruited between 2019 and 2021. The women who underwent endometrial curettage without applying any force and, in the subsequent menstrual cycle, endometrial sampling for CD138 immunostaining without antibiotic use. Pregnancy outcomes after in vitro fertilization treatment were analyzed in women who did not desire endometrial curettage and in those with cured and persistent CE after endometrial curettage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 64 women who underwent endometrial curettage, the number of CD138\u2010positive cells decreased from 28.0\u2009\u00b1\u200935.3 to 7.7\u2009\u00b1\u200914.0 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), and CE in 41 women (64.1%) was cured (&lt;5 CD138\u2010positive cells). The pathological findings detected 3.1% of endometrial hyperplasia and 1.6% of endometrial cancer. The ongoing pregnancy rates in women aged \u226442 without endometrial curettage were significantly lower than those of women with cured and persistent CE (26.7%, 67.6%, and 57.1%, respectively, <jats:italic>p<\/jats:italic>\u2009=\u20090.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Gentle endometrial curettage for antibiotic\u2010resistant CE significantly decreased the number of CD138\u2010positive cells, resulting in improved pregnancy outcomes regardless of remaining CE. Endometrial curettage is also important as a screening for endometrial malignancy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/rmb2.12525","type":"journal-article","created":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T08:54:50Z","timestamp":1688460890000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Therapeutic efficacy of gentle endometrial curettage on antibiotic\u2010resistant chronic endometritis in infertile women"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2759-9159","authenticated-orcid":false,"given":"Keiji","family":"Kuroda","sequence":"first","affiliation":[{"name":"Center for Reproductive Medicine and Endoscopy Sugiyama Clinic Marunouchi  Tokyo Japan"},{"name":"Center for Reproductive Medicine and Implantation Research Sugiyama Clinic Shinjuku  Tokyo Japan"},{"name":"Department of Obstetrics and Gynecology Juntendo University Faculty of Medicine  Tokyo 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