{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T19:24:28Z","timestamp":1783970668706,"version":"3.55.0"},"reference-count":45,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T00:00:00Z","timestamp":1742515200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec>\n<jats:title>\nObjectives\n<\/jats:title>\n<jats:p>Chronic endometritis (CE) is defined as chronic inflammation in the endometrium; when treated, implantations significantly improve. The standard test for CE confirmation is an endometrial biopsy, but the appropriate sampling method needs to be clarified. We conducted this study to compare pipelle biopsy and hysteroscopy with curettage.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>\nStudy design\n<\/jats:title>\n<jats:p>This is a prospective cross-sectional study with all (40 patients) RIF patients under 40 referred to our tertiary center between December 2021, and December 2022 who underwent pipelle biopsy and hysteroscopy with curettage between days twelve to fifteen of their menstruation cycle. We then compared the diagnostic accuracy, demographics, and previous IVF history between the CE and non-CE groups.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Patients had a mean age of 34 (\u2009\u00b1 5.4) years and BMI of 25.8 (\u2009\u00b1 3.6). Thirteen patients (32.5%) were diagnosed with CE. There was no significant difference between CE and non-CE groups regarding maternal or paternal age, BMI, number of IVFs and embryos, and interval from the last IVF. Pipelle biopsy had 100% accuracy for CE diagnosis, while hysteroscopy with curettage had a sensitivity of 92.3% (95% CI: 77.8% - 100%) and specificity of 100%. Based on McNemar\u2019s test, the two sampling methods had no significant difference (P\u2009=\u20091.0 and 0.317, respectively).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>\nConclusion\n<\/jats:title>\n<jats:p>There is no significant difference between the two methods in the diagnosis accuracy of CE in RIF patients. Since pipelle is more cost-effective and has fewer complications than hysteroscopy with curettage, pipelle biopsy may replace curettage for CE diagnosis.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0319294","type":"journal-article","created":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T17:59:12Z","timestamp":1742579952000},"page":"e0319294","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparing the accuracy of Pipelle versus hysteroscopy and curettage in the diagnosis of chronic endometritis in women with recurrent implantation failure: A prospective cross-sectional study"],"prefix":"10.1371","volume":"20","author":[{"given":"Elaheh Pahlevan","family":"Falahy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2426-6340","authenticated-orcid":true,"given":"Mohammad-Taha","family":"Pahlevan-Fallahy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Keikha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,3,21]]},"reference":[{"issue":"1","key":"pone.0319294.ref001","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1186\/s12958-018-0414-2","article-title":"Recurrent Implantation Failure-update overview on etiology, diagnosis, treatment and future directions","volume":"16","author":"A Bashiri","year":"2018","journal-title":"Reprod Biol Endocrinol"},{"issue":"3","key":"pone.0319294.ref002","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/S1472-6483(10)61014-0","article-title":"Towards better quality research in recurrent implantation failure: standardizing its definition is the first step","volume":"12","author":"T El-Toukhy","year":"2006","journal-title":"Reprod Biomed Online"},{"issue":"1","key":"pone.0319294.ref003","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.fertnstert.2015.09.025","article-title":"Chronic endometritis in women with recurrent pregnancy loss and recurrent implantation failure: prevalence and role of office hysteroscopy and immunohistochemistry in diagnosis","volume":"105","author":"P-E Bouet","year":"2016","journal-title":"Fertil Steril"},{"issue":"4","key":"pone.0319294.ref004","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1016\/j.fertnstert.2019.02.009","article-title":"What exactly is endometrial receptivity?","volume":"111","author":"BA Lessey","year":"2019","journal-title":"Fertil Steril"},{"issue":"4","key":"pone.0319294.ref005","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1016\/j.fertnstert.2004.05.076","article-title":"Can endometrial infection\/inflammation explain implantation failure, spontaneous abortion, and preterm birth after in vitro fertilization?","volume":"82","author":"R Romero","year":"2004","journal-title":"Fertil Steril"},{"issue":"2","key":"pone.0319294.ref006","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/j.fertnstert.2008.12.131","article-title":"Chronic endometritis is a frequent finding in women with recurrent implantation failure after in vitro fertilization","volume":"93","author":"EB Johnston-MacAnanny","year":"2010","journal-title":"Fertil Steril"},{"issue":"5","key":"pone.0319294.ref007","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1111\/jog.13937","article-title":"Review: Chronic endometritis and its effect on reproduction","volume":"45","author":"F Kimura","year":"2019","journal-title":"J Obstet Gynaecol Res"},{"issue":"5","key":"pone.0319294.ref008","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1016\/j.fertnstert.2018.01.022","article-title":"Comparison of the prevalence of chronic endometritis as determined by means of different diagnostic methods in women with and without reproductive failure","volume":"109","author":"Y Liu","year":"2018","journal-title":"Fertil Steril"},{"issue":"1","key":"pone.0319294.ref009","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.rbmo.2017.09.008","article-title":"Prevalence and confounders of chronic endometritis in premenopausal women with abnormal bleeding or reproductive failure","volume":"36","author":"D Song","year":"2018","journal-title":"Reprod Biomed Online"},{"issue":"2","key":"pone.0319294.ref010","doi-asserted-by":"crossref","first-page":"44","DOI":"10.5935\/1518-0557.20150012","article-title":"Repeated implantation failure in oocyte donation. 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