{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T17:01:07Z","timestamp":1791910867640,"version":"4.3.4"},"reference-count":71,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T00:00:00Z","timestamp":1637712000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Chronic endometritis (CE) and endometrial polyps (EPs) are common conditions in reproductive age women. CE is an infectious disorder of the endometrium characterized by signs of chronic inflammation at hysteroscopic and histological analyses. EPs are abnormal endometrial growths containing glands, stroma and blood vessels projecting from the lining of the uterus. During the last years, different authors have investigated the correlation between CE and EPs, with controversial results. The aim of this study was to summarize available evidence on the potential correlation between CE and EPs. Design: Systematic literature review and meta-analysis. Methods: Observational-studies were identified by searching electronic databases from their inception to September 2021. Only studies on pre-menopausal women were included. Statistical analysis was performed using MedCalc 16.4.3 (Ostend, Belgium) and Review Manager version 5.3 (Nordic Cochrane Centre, Cochrane Collaboration). The summary measures were reported as pooled proportion or odds ratio (OR) with 95% confidence interval (CI). The primary outcome was to evaluate the prevalence of CE in women with EPs. The secondary outcome was to determine the prevalence of CD-138-positive EPs among EPs. Tertiary outcomes were to compare the prevalence of CE in women with EPs versus women with a non-polypoid endometrium and to compare the prevalence of CE in women with a single EP versus women with multiple EPs. Results: Eight observational studies (n = 3225 patients) were included in quantitative synthesis. Pooled prevalence of CE among women with EPs was 51.35% (95% CI, 27.24\u201375.13%). Pooled proportion of CD-138-positive EPs among EPs was 70.73% (95% CI, 55.73\u201383.68%). Women with EPs showed higher prevalence of CE compared to women without EPs (OR 3.07, 95% CI 1.59\u20135.95). Women with \u22653 EPs had higher prevalence of CE then women with a single EP (OR 3.43, 95% CI 1.83\u20136.46). Conclusions: In pre-menopausal women, CE and EPs may have a dependent relationship and may represent two consequent steps of a common pathological process.<\/jats:p>","DOI":"10.3390\/diagnostics11122182","type":"journal-article","created":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T01:49:58Z","timestamp":1638150598000},"page":"2182","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Association between Endometrial Polyps and Chronic Endometritis: Is It Time for a Paradigm Shift in the Pathophysiology of Endometrial Polyps in Pre-Menopausal Women? Results of a Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2824-5435","authenticated-orcid":false,"given":"Amerigo","family":"Vitagliano","sequence":"first","affiliation":[{"name":"Department of Women and Children\u2019s Health, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariangela","family":"Cialdella","sequence":"additional","affiliation":[{"name":"Unit of Obstetrics and Gynecology, Department of Biomedical and Human Oncologic Science, University of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossana","family":"Cicinelli","sequence":"additional","affiliation":[{"name":"Unit of Obstetrics and Gynecology, Department of Biomedical and Human Oncologic Science, University of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7193-2858","authenticated-orcid":false,"given":"Carla Mariaflavia","family":"Santarsiero","sequence":"additional","affiliation":[{"name":"Unit of Obstetrics and Gynecology, Department of Biomedical and Human Oncologic Science, University of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pantaleo","family":"Greco","sequence":"additional","affiliation":[{"name":"Department of Translational and for Romagna Medicine, University of Ferrara, 44121 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9466-0178","authenticated-orcid":false,"given":"Giovanni","family":"Buzzaccarini","sequence":"additional","affiliation":[{"name":"Department of Women and Children\u2019s Health, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Noventa","sequence":"additional","affiliation":[{"name":"Department of Women and Children\u2019s Health, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ettore","family":"Cicinelli","sequence":"additional","affiliation":[{"name":"Unit of Obstetrics and Gynecology, Department of Biomedical and Human Oncologic Science, University of Bari, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1111\/j.1365-2559.2011.04099.x","article-title":"Histology of micro polyps in chronic endometritis","volume":"60","author":"Resta","year":"2012","journal-title":"Histopathology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.fertnstert.2018.04.012","article-title":"Endometritis: New time, new concepts","volume":"110","author":"Kitaya","year":"2018","journal-title":"Fertil. Steril."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e13369","DOI":"10.1111\/aji.13369","article-title":"Diagnosis of chronic endometritis: How many CD138+ cells\/HPF in endometrial stroma affect pregnancy outcome of infertile women?","volume":"85","author":"Li","year":"2021","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3474","DOI":"10.1093\/humrep\/des323","article-title":"Local mononuclear cell infiltrates in infertile patients with endometrial macropolyps versus micropolyps","volume":"27","author":"Kitaya","year":"2012","journal-title":"Hum. Reprod."},{"key":"ref_5","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":"Bouet","year":"2016","journal-title":"Fertil. Steril."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1111\/j.1600-0897.2011.01051.x","article-title":"Immunohistochemistrical and clinicopathological characterization of chronic endometritis","volume":"66","author":"Kitaya","year":"2011","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1016\/j.fertnstert.2007.03.074","article-title":"Chronic endometritis: Correlation among hysteroscopic, histologic, and bacteriologic findings in a prospective trial with 2190 consecutive office hysteroscopies","volume":"89","author":"Cicinelli","year":"2008","journal-title":"Fertil. Steril."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Molina, N.M., Sola-Leyva, A., Jose Saez-Lara, M., Plaza-Diaz, J., Tubic-Pavlovic, A., Romero, B., Clavero, A., Mozas-Moreno, J., Fontes, J., and Altm\u00e4e, S. (2020). New Opportunities for Endometrial Health by Modifying Uterine Microbial Composition: Present or Future?. Biomolecules, 10.","DOI":"10.3390\/biom10040593"},{"key":"ref_9","first-page":"1581","article-title":"Barcoded sequencing reveals diverse intrauterine microbiomes in patients suffering with endometrial polyps","volume":"8","author":"Fang","year":"2016","journal-title":"Am. J. Transl. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"4893437","DOI":"10.1155\/2019\/4893437","article-title":"Characterization of Microbiota in Endometrial Fluid and Vaginal Secretions in Infertile Women with Repeated Implantation Failure","volume":"2019","author":"Kitaya","year":"2019","journal-title":"Mediators Inflamm."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e12719","DOI":"10.1111\/aji.12719","article-title":"Live birth rate following oral antibiotic treatment for chronic endometritis in infertile women with repeated implantation failure","volume":"78","author":"Kitaya","year":"2017","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"208","DOI":"10.3389\/fimmu.2018.00208","article-title":"Uterine Microbiota: Residents, Tourists, or Invaders?","volume":"9","author":"Baker","year":"2018","journal-title":"Front. Immunol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.jmig.2019.02.016","article-title":"Evaluating Chronic Endometritis in Women with Recurrent Implantation Failure and Recurrent Pregnancy Loss by Hysteroscopy and Immunohistochemistry","volume":"27","author":"Zargar","year":"2020","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1093\/humrep\/deu292","article-title":"Prevalence of chronic endometritis in repeated unexplained implantation failure and the IVF success rate after antibiotic therapy","volume":"30","author":"Cicinelli","year":"2015","journal-title":"Hum. Reprod."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.ejogrb.2010.12.010","article-title":"The value of hysteroscopy in diagnosis of chronic endometritis in patients with unexplained recurrent spontaneous abortion","volume":"155","author":"Zolghadri","year":"2011","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.fertnstert.2018.03.017","article-title":"Effects of chronic endometritis therapy on in vitro fertilization outcome in women with repeated implantation failure: A systematic review and meta-analysis","volume":"110","author":"Vitagliano","year":"2018","journal-title":"Fertil. Steril."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2897","DOI":"10.1007\/s10815-020-01955-8","article-title":"Chronic endometritis and altered embryo implantation: A unified pathophysiological theory from a literature systematic review","volume":"37","author":"Buzzaccarini","year":"2020","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1111\/aji.12438","article-title":"Chronic Endometritis: Potential Cause of Infertility and Obstetric and Neonatal Complications","volume":"75","author":"Kitaya","year":"2016","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1016\/j.fertnstert.2010.09.061","article-title":"Prevalence of chronic endometritis in recurrent miscarriages","volume":"95","author":"Kitaya","year":"2011","journal-title":"Fertil. Steril."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1177\/1933719113508817","article-title":"Chronic endometritis due to common bacteria is prevalent in women with recurrent miscarriage as confirmed by improved pregnancy outcome after antibiotic treatment","volume":"21","author":"Cicinelli","year":"2014","journal-title":"Reprod. Sci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e12782","DOI":"10.1111\/aji.12782","article-title":"Chronic endometritis in patients with unexplained infertility: Prevalence and effects of antibiotic treatment on spontaneous conception","volume":"79","author":"Cicinelli","year":"2018","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1093\/humrep\/deh779","article-title":"Endometrial micropolyps at fluid hysteroscopy suggest the existence of chronic endometritis","volume":"20","author":"Cicinelli","year":"2005","journal-title":"Hum. Reprod."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1016\/j.jmig.2005.07.394","article-title":"Detection of chronic endometritis at fluid hysteroscopy","volume":"12","author":"Cicinelli","year":"2005","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.fertnstert.2019.03.004","article-title":"Unified diagnostic criteria for chronic endometritis at fluid hysteroscopy: Proposal and reliability evaluation through an international randomized-controlled observer study","volume":"112","author":"Cicinelli","year":"2019","journal-title":"Fertil. Steril."},{"key":"ref_25","first-page":"250","article-title":"Diagnosis value of hysteroscopy for chronic endometritis","volume":"40","author":"Guo","year":"2013","journal-title":"Clin. Exp. Obstet. Gynecol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1016\/j.fertnstert.2018.12.007","article-title":"Correlation between hysteroscopy findings and chronic endometritis","volume":"111","author":"Song","year":"2019","journal-title":"Fertil. Steril."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1080\/13697137.2020.1754387","article-title":"Hysteroscopy in postmenopause: From diagnosis to the management of intrauterine pathologies","volume":"23","author":"Fagioli","year":"2020","journal-title":"Climacteric"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1016\/j.jmig.2018.12.002","article-title":"Italian School of Minimally Invasive Gynecological Surgery Hysteroscopists Group. Effectiveness of Hysteroscopic Techniques for Endometrial Polyp Removal: The Italian Multicenter Trial","volume":"26","author":"Luerti","year":"2019","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e13392","DOI":"10.1111\/aji.13392","article-title":"Analysis of the therapeutic effects of hysteroscopic polypectomy with and without doxycycline treatment on chronic endometritis with endometrial polyps","volume":"85","author":"Kuroda","year":"2021","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_30","first-page":"16","article-title":"Endometrial Polyps in Women of Reproductive Age: Clinical and Pathogene-Tic Variations","volume":"273","author":"Kosei","year":"2017","journal-title":"Georgian Med. News"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., and PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med., 6.","DOI":"10.1371\/journal.pmed.1000097"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1016\/j.fertnstert.2011.08.001","article-title":"Endometrial polyps in infertile patients: Do high concentrations of interferon-gamma play a role?","volume":"96","author":"Mollo","year":"2011","journal-title":"Fertil. Steril."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.ejogrb.2013.05.012","article-title":"Functional endometrial polyps in infertile asymptomatic patients: A possible evolution of vascular changes secondary to endometritis","volume":"170","author":"Carvalho","year":"2013","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_34","first-page":"e192","article-title":"Does the Timing of Endometrial Biopsy Impact the Detection of Endometrial Plasma Cells?","volume":"114","author":"Tolani","year":"2020","journal-title":"Fertil. Steril."},{"key":"ref_35","first-page":"27","article-title":"Epidemiological Features of Chronic Endometritis in Reproductive Age Women with Disorders of Reproductive Health","volume":"304\u2013305","author":"Sklyarova","year":"2020","journal-title":"Georgian Med. News"},{"key":"ref_36","first-page":"1745506520952003","article-title":"Dienogest suppresses cellular proliferation status of endometrial polyps and acts differently depending on the morphological type","volume":"16","author":"Inaba","year":"2020","journal-title":"Women\u2019s Health"},{"key":"ref_37","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":"Song","year":"2018","journal-title":"Reprod. Biomed. Online"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1002\/rmb2.12394","article-title":"Endometrial polyps with increased plasma cells are associated with chronic endometritis in infertility patients: Hysteroscopic findings and post-polypectomy pregnancy rates","volume":"20","author":"Nomiyama","year":"2021","journal-title":"Reprod. Med. Biol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1111\/jog.14541","article-title":"Multiple endometrial polyps is associated with higher risk of chronic endometritis in reproductive-aged women","volume":"47","author":"Guo","year":"2021","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1016\/j.jmig.2019.01.012","article-title":"Chronic Endometritis, a Common Disease Hidden Behind Endometrial Polyps in Premenopausal Women: First Evidence From a Case-Control Study","volume":"26","author":"Cicinelli","year":"2019","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1016\/j.jmig.2019.08.017","article-title":"Chronic Endometritis in Fertile and Infertile Women Who Underwent Hysteroscopic Polypectomy","volume":"27","author":"Badeghiesh","year":"2020","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_42","first-page":"5","article-title":"The pathogenesis of endometrial polyps: A systematic semi-quantitative review","volume":"34","author":"Indraccolo","year":"2013","journal-title":"Eur. J. Gynaecol. Oncol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1016\/j.fertnstert.2021.03.025","article-title":"Antibiotic therapy for chronic endometritis and its reproductive implications: A step forward, with some uncertainties","volume":"115","author":"Cicinelli","year":"2021","journal-title":"Fertil. Steril."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.fertnstert.2021.06.022","article-title":"Consistent evidence on the detrimental role of severe chronic endometritis on in vitro fertilization outcome and the reproductive improvement after antibiotic therapy: On the other hand, mild chronic endometritis appears a more intricate matter","volume":"116","author":"Cicinelli","year":"2021","journal-title":"Fertil. Steril."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Vitagliano, A., Saccardi, C., Litta, P.S., and Noventa, M. (2017). Chronic endometritis: Really so relevant in repeated IVF failure?. Am. J. Reprod. Immunol., 78.","DOI":"10.1111\/aji.12758"},{"key":"ref_46","first-page":"672","article-title":"Autoimmunity, systemic inflammation, and their correlation with repeated implantation failure and recurrent miscarriage: Is chronic endometritis the missing piece of the jigsaw?","volume":"77","author":"Vitagliano","year":"2016","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Gelardi, M., Netti, G.S., Giancaspro, R., Spadaccino, F., Pennella, A., Fiore, V., La Gatta, E., Grilli, G.M., Cassano, M., and Ranieri, E. (2021). Chronic rhinosinusitis with nasal polyposis (CRSwNP): The correlation between expression of Galectin-10 and Clinical-Cytological Grading (CCG). Am. J. Rhinol. Allergy, 14.","DOI":"10.1177\/19458924211049867"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Ashktorab, H., Brim, H., Hassan, S., Nouraie, M., Gebreselassie, A., Laiyemo, A.O., Kibreab, A., Aduli, F., Latella, G., and Brant, S.R. (2020). Inflammatory polyps occur more frequently in inflammatory bowel disease than other colitis patients. BMC Gastroenterol., 20.","DOI":"10.1186\/s12876-020-01279-y"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1016\/j.juro.2012.12.010","article-title":"Polypoid\/Papillary cystitis","volume":"189","author":"Humphrey","year":"2013","journal-title":"J. Urol."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Cicinelli, E., Vitagliano, A., Loizzi, V., De Ziegler, D., Fanelli, M., Bettocchi, S., Nardelli, C., Trojano, G., Cicinelli, R., and Minervini, C.F. (2021). Altered Gene Expression Encoding Cytochines, Grow Factors and Cell Cycle Regulators in the Endometrium of Women with Chronic Endometritis. Diagnostics, 11.","DOI":"10.3390\/diagnostics11030471"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2101","DOI":"10.1053\/j.gastro.2010.01.058","article-title":"Inflammation and colon cancer","volume":"138","author":"Grivennikov","year":"2010","journal-title":"Gastroenterology"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1016\/j.jmig.2018.07.024","article-title":"Higher Prevalence of Endometrial Polyps in Patients with Fallopian Tube Obstruction: A Case-control Study","volume":"26","author":"Sun","year":"2019","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1876","DOI":"10.1016\/j.jmig.2021.04.011","article-title":"Is Chronic Endometritis Associated with Tubal Infertility? A Prospective Cohort Study","volume":"28","author":"Holzer","year":"2021","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"748447","DOI":"10.3389\/fimmu.2021.748447","article-title":"Interaction Between Chronic Endometritis Caused Endometrial Microbiota Disorder and Endometrial Immune Environment Change in Recurrent Implantation Failure","volume":"12","author":"Chen","year":"2021","journal-title":"Front. Immunol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"693267","DOI":"10.3389\/fcell.2021.693267","article-title":"Identification of Uterine Microbiota in Infertile Women Receiving in vitro Fertilization With and Without Chronic Endometritis","volume":"9","author":"Chen","year":"2021","journal-title":"Front. Cell Dev. Biol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"602.e1","DOI":"10.1016\/j.ajog.2018.02.012","article-title":"The diagnosis of chronic endometritis in infertile asymptomatic women: A comparative study of histology, microbial cultures, hysteroscopy, and molecular microbiology","volume":"218","author":"Moreno","year":"2018","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1016\/j.fertnstert.2020.12.010","article-title":"Endometrial causes of recurrent pregnancy losses: Endometriosis, adenomyosis, and chronic endometritis","volume":"115","author":"Pirtea","year":"2021","journal-title":"Fertil. Steril."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"7924021","DOI":"10.1155\/2018\/7924021","article-title":"The Role of Oxidative Stress and Membrane Transport Systems during Endometriosis: A Fresh Look at a Busy Corner","volume":"2018","author":"Vitale","year":"2018","journal-title":"Oxid. Med. Cell. Longev."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1007\/s00404-020-05679-z","article-title":"Are uterine natural killer and plasma cells in infertility patients associated with endometriosis, repeated implantation failure, or recurrent pregnancy loss?","volume":"302","author":"Freitag","year":"2020","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Noventa, M., Scioscia, M., Schincariol, M., Cavallin, F., Pontrelli, G., Virgilio, B., Vitale, S.G., Lagan\u00e0, A.S., Dessole, F., and Cosmi, E. (2019). Imaging Modalities for Diagnosis of Deep Pelvic Endometriosis: Comparison between Trans-Vaginal Sonography, Rectal Endoscopy Sonography and Magnetic Resonance Imaging. A Head-to-Head Meta-Analysis. Diagnostics, 9.","DOI":"10.3390\/diagnostics9040225"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Takebayashi, A., Kimura, F., Kishi, Y., Ishida, M., Takahashi, A., Yamanaka, A., Takahashi, K., Suginami, H., and Murakami, T. (2014). The association between endometriosis and chronic endometritis. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0088354"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.fertnstert.2017.05.016","article-title":"Higher prevalence of chronic endometritis in women with endometriosis: A possible etiopathogenetic link","volume":"108","author":"Cicinelli","year":"2017","journal-title":"Fertil. Steril."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/S1074-3804(05)60233-2","article-title":"High frequency of endometrial polyps in endometriosis","volume":"10","author":"Kim","year":"2003","journal-title":"J. Am. Assoc. Gynecol. Laparosc."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"2722","DOI":"10.1016\/j.fertnstert.2011.04.067","article-title":"High prevalence of endometrial polyps in endometriosis-associated infertility","volume":"95","author":"Shen","year":"2011","journal-title":"Fertil. Steril."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1093\/humupd\/dmz044","article-title":"Hypothetical roadmap towards endometriosis: Prenatal endocrine-disrupting chemical pollutant exposure, anogenital distance, gut-genital microbiota and subclinical infections","volume":"26","year":"2020","journal-title":"Hum. Reprod Update"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"3417","DOI":"10.1093\/humrep\/des331","article-title":"Role of prostaglandin E2 in bacterial growth in women with endometriosis","volume":"27","author":"Khan","year":"2012","journal-title":"Hum. Reprod."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"9","DOI":"10.3892\/mmr.2013.1755","article-title":"Pathogenesis of endometriosis: The role of initial infection and subsequent sterile inflammation (review)","volume":"9","author":"Kobayashi","year":"2014","journal-title":"Mol. Med. Rep."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1093\/humrep\/dez041","article-title":"Antibiotic therapy with metronidazole reduces endometriosis disease progression in mice: A potential role for gut microbiota","volume":"34","author":"Chadchan","year":"2019","journal-title":"Hum. Reprod."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/j.fertnstert.2018.04.040","article-title":"Endometrial scratch injury for women with one or more previous failed embryo transfers: A systematic review and meta-analysis of randomized controlled trials","volume":"110","author":"Vitagliano","year":"2018","journal-title":"Fertil. Steril."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1080\/09513590.2016.1190818","article-title":"Does adding endometrial scratching to diagnostic hysteroscopy improve pregnancy rates in women with recurrent in-vitro fertilization failure?","volume":"32","author":"Seval","year":"2016","journal-title":"Gynecol. Endocrinol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1016\/j.fertnstert.2018.12.008","article-title":"Endometrial scratching for infertile women undergoing a first embryo transfer: A systematic review and meta-analysis of published and unpublished data from randomized controlled trials","volume":"111","author":"Vitagliano","year":"2019","journal-title":"Fertil. 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