{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T19:06:15Z","timestamp":1789153575100,"version":"build-2803163510"},"reference-count":50,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Military Institute of Medicine, Warsaw, Poland","award":["609"],"award-info":[{"award-number":["609"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Chronic endometritis (CE) is a subclinical inflammation of the endometrium that affects female fertility. Although awareness of its impact on reproductive outcomes has increased significantly, clinical management\u2014especially the diagnostic value of hysteroscopy and the effectiveness of perioperative antibiotic prophylaxis in improving fertility\u2014remains unclear. Methods: This retrospective analysis involved 136 infertile women (30\u201344 years) who underwent diagnostic hysteroscopy between 2022 and 2023 at the Military Institute of Medicine in Warsaw. Women with intrauterine pathologies or other infertility factors were excluded. Hysteroscopic indicators of chronic endometritis (CE) included micropolyps and endometrial hyperemia. Endometrial biopsies were stained with CD138 and CE was diagnosed based on \u22655 plasma cells per 10 high-power fields. A single oral dose of azithromycin was administered post-procedure and pregnancy outcomes were assessed 12 months later. Results: CE was histologically confirmed in 29.2% of patients. The presence of micropolyps demonstrated a strong correlation with CE (p &lt; 0.0001), although CE was also found in 21% of patients with normal hysteroscopic findings. While CE status did not significantly influence pregnancy rates, patients who received azithromycin exhibited a significantly higher conception rate (53% vs. 21%, p = 0.022). Additionally, secondary infertility was associated with higher reproductive success compared to primary infertility (54% vs. 24%, p = 0.022). Conclusions: Micropolyps are a specific hysteroscopic marker of CE. However, histologic inflammation markers may be present even in the absence of abnormal hysteroscopic findings. Furthermore, the routine use of antibiotic prophylaxis is associated with improved reproductive outcomes.<\/jats:p>","DOI":"10.3390\/jcm14186435","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T12:08:16Z","timestamp":1757678896000},"page":"6435","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Micropolyps, Plasma Cells, and Pregnancy: Reevaluating Diagnostic and Therapeutic Strategies in Chronic Endometritis"],"prefix":"10.3390","volume":"14","author":[{"given":"Monika","family":"Szafarowska","sequence":"first","affiliation":[{"name":"Department of Gynecology and Oncological Gynecology, Military Institute of Medicine National Research Institute, 128 Szaser\u00f3w Street, 04-141 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martyna","family":"Chirzy\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Oncological Gynecology, Military Institute of Medicine National Research Institute, 128 Szaser\u00f3w Street, 04-141 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karolina","family":"Kurlenko","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Oncological Gynecology, Military Institute of Medicine National Research Institute, 128 Szaser\u00f3w Street, 04-141 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Biela","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Oncological Gynecology, Military Institute of Medicine National Research Institute, 128 Szaser\u00f3w Street, 04-141 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacek","family":"Doniec","sequence":"additional","affiliation":[{"name":"Robotic Surgery Center, Military Institute of Medicine National Research Institute, 128 Szaser\u00f3w Street, 04-141 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof","family":"\u0141uszczy\u0144ski","sequence":"additional","affiliation":[{"name":"Laboratory of Molecular Oncology and Innovative Therapies, Military Institute of Medicine National Research Institute, 128 Szaser\u00f3w Street, 04-141 Warsaw, Poland"},{"name":"Department of Histology and Embryology, Medical University of Warsaw, 02-004 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0438-2678","authenticated-orcid":false,"given":"Aneta","family":"\u015acie\u017cy\u0144ska","sequence":"additional","affiliation":[{"name":"Laboratory of Molecular Oncology and Innovative Therapies, Military Institute of Medicine National Research Institute, 128 Szaser\u00f3w Street, 04-141 Warsaw, Poland"},{"name":"Department of Histology and Embryology, Medical University of Warsaw, 02-004 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawe\u0142","family":"Kami\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Oncological Gynecology, Military Institute of Medicine National Research Institute, 128 Szaser\u00f3w Street, 04-141 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"key":"ref_1","first-page":"250","article-title":"Chronic Endometritis: Old Problem, Novel Insights and Future Challenges","volume":"13","author":"Puente","year":"2020","journal-title":"Int. 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