{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:26:20Z","timestamp":1790191580562,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate how diagnostic methods, criteria, and treatment for chronic endometritis (CE) changed in Japan after introducing health insurance coverage of assisted reproductive technology (ART).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted two nationwide, web\u2010based facility surveys targeting all 616 registered ART facilities. The surveys were administered before ART insurance coverage (December 2021 to February 2022) and after coverage (December 2023 to January 2024). Facilities that responded to both surveys (283 facilities) were included. We evaluated whether facility\u2010level CE diagnostic methods, CD138\u2010positive plasma cell cutoff values, and first\u2010 and second\u2010line treatment choices changed between surveys.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      CE testing was implemented by 238 facilities in the precoverage and 244 postcoverage periods. The adoption of diagnostic methods did not significantly change. Although the overall number of facilities that adopted CD138 immunohistochemical staining was stable (145 vs. 149 facilities), 23 facilities discontinued CD138 staining postcoverage while 27 newly introduced it; discontinuation occurred predominantly in clinics (91.3%), whereas 44% of new adopters were hospitals\/university hospitals (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The cutoff value of CD138\u2010positive cells (6\u201310 cells\/20 high\u2010power fields) increased between the surveys (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). Doxycycline remained the first\u2010line therapy. Regarding second\u2010line therapy, ciprofloxacin plus metronidazole remained the most frequent, while probiotics significantly increased (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>After ART insurance coverage in Japan, overall CE diagnostic methods and CD138 adoption remained largely unchanged. However, facilities tended to adopt higher CD138 cutoff values and treatment selections shifted. Establishing unified diagnostic criteria and treatment protocols is warranted to support standardized CE care for future health insurance coverage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.70271","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T05:39:36Z","timestamp":1775626776000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Changes in Diagnostic Methods, Criteria, and Treatment for Chronic Endometritis After National Health Insurance Coverage of Assisted Reproductive Technology in Japan: A Nationwide Follow\u2010up Survey (\n                    <scp>IZANAMI<\/scp>\n                    Project)"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8815-5714","authenticated-orcid":false,"given":"Seung Chik","family":"Jwa","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Jichi Medical University  Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2759-9159","authenticated-orcid":false,"given":"Keiji","family":"Kuroda","sequence":"additional","affiliation":[{"name":"Center for Reproductive Medicine and Endoscopy Sugiyama Clinic Marunouchi  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5300-0037","authenticated-orcid":false,"given":"Hiromitsu","family":"Shirasawa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Akita University Graduate School of Medicine  Akita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miyuki","family":"Harada","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Graduate School of Medicine The University of Tokyo  Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Osuga","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Graduate School of Medicine The University of Tokyo  Japan"},{"name":"Teikyo Academic Research Center Teikyo University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7560-316X","authenticated-orcid":false,"given":"Mitsutoshi","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Keio University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2018.04.012"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.13937"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2015.09.025"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deu292"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2018.01.022"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.02.012"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2019.03.004"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoad023"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/aji.12719"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics12092250"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2022.01.001"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.16051"},{"issue":"11","key":"e_1_2_11_14_1","article-title":"Japanese Health Insurance Coverage of Fertility Treatment in 2022: Does Coverage Change Patient Perspectives?","volume":"16","author":"Yoshida T.","year":"2024","journal-title":"Cureus"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.16292"},{"issue":"6","key":"e_1_2_11_16_1","article-title":"The Role of Plasma Cells as a Marker of Chronic Endometritis: A Systematic Review and Meta\u2010Analysis","volume":"11","author":"Santoro A.","year":"2023","journal-title":"Biomedicine"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10815-015-0614-z"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10815-019-01630-7"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40168-021-01184-w"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/rmb2.12105"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2018.03.017"}],"container-title":["Journal of Obstetrics and 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