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This study aimed to establish the minimum number of immunohistochemical analysis of CD138<jats:sup>+<\/jats:sup> plasma cells to identify a clinically relevant CE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method of study<\/jats:title><jats:p>We performed a retrospective study on 716 infertile patients who never did CE analysis and respective antibiotic treatment before. Samples were obtained by endometrial scratching in the mid\u2010luteal phase before IVF\u2010ET treatment. The number and distribution of CD138<jats:sup>+<\/jats:sup> cells were analyzed by immunohistochemistry. Thirty high\u2010power fields (HPF) were evaluated for each sample. Patients were classified in 2 main groups: (a) CD138<jats:sup>low<\/jats:sup> (&lt;5 CD138<jats:sup>+<\/jats:sup> cells in all HPFs), (b) CD138<jats:sup>high<\/jats:sup> (\u22655 CD138<jats:sup>+<\/jats:sup> cells in at least one HPF). Pregnancy outcome was compared among the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the CD138<jats:sup>high<\/jats:sup> group, \u03b2\u2010hCG positive rate, clinical pregnancy rate and live birth rate were significantly decreased (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.04, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.01, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.04, respectively). Also after adjusting for patient age, body mass index (BMI), and clinical characteristics, the \u03b2\u2010hCG positive rate (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.05), clinical pregnancy rate (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.01) and live birth rate (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.02) were significantly lower in the CD138<jats:sup>high<\/jats:sup> than those in the CD138<jats:sup>low<\/jats:sup> group. Within the CD138<jats:sup>low<\/jats:sup> group, these parameters were not significantly different between patients without any plasma cells and patients with up to 4 plasma cells\/HPF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We conclude that immunohistochemical analysis of CD138<jats:sup>+<\/jats:sup> cells is a reliable method to detect CE which can be identified by the presence of \u22655 plasma cells in at least one out of 30 HPF.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aji.13369","type":"journal-article","created":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T18:25:30Z","timestamp":1604600730000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":99,"title":["Diagnosis of chronic endometritis: How many CD138<sup>+<\/sup> cells\/HPF in endometrial stroma affect pregnancy outcome of infertile women?"],"prefix":"10.1111","volume":"85","author":[{"given":"Yuye","family":"Li","sequence":"first","affiliation":[{"name":"Shenzhen Key Laboratory of Reproductive Immunology for Peri\u2010implantation Shenzhen Zhongshan Institute for Reproduction and Genetics Fertility Center Shenzhen Zhongshan Urology Hospital Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiru","family":"Xu","sequence":"additional","affiliation":[{"name":"Shenzhen Key Laboratory of Reproductive Immunology for Peri\u2010implantation Shenzhen Zhongshan Institute for Reproduction and Genetics Fertility Center Shenzhen Zhongshan Urology Hospital Shenzhen China"},{"name":"Center for Reproductive Medicine National Research Center for Assisted Reproductive Technology and Reproductive Genetics The Key Laboratory of Reproductive Endocrinology (Shandong University) Ministry of Education Shandong University Jinan 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