Andrea Fabiani¹*, Pasquale Scarano², Alessandro Valdisseri³ and Alessandra Filosa⁴

¹Urology Unit, Surgery Department, Macerata Civic Hospital, AST Marche Macerata, Italy
²Urology Unit, Ospedale degli Infermi, Rimini, Italy
³Gynecologist, Bologna, Italy
⁴Pathology Anatomy, Marche Polytechnic University, Ancona, Italy

*Corresponding Author: Andrea Fabiani, Urology Unit, Surgery Department, Macerata Civic Hospital, AST Marche Macerata, Italy.

Received: September 17, 2025; Published: October 17, 2025

Abstract

Background: Chronic endometritis (CE) plays a significant role in couple infertility, affecting female reproductive health. While CE directly impacts the uterine environment, there's no direct evidence suggesting it causes male factor infertility.

Objective: The aim of this study is to examine the relationship between CE seen during hysteroscopy and spermiogram alterations (rising white blood cell counts and pH, asthenospermia, hyperviscosity, modified fluidification.

Methods: This study involved 22 infertile couples who had hysteroscopy during fertility evaluation of recurrent implant failure (RIF), recurrent pregnancy loss (RPL) or idiopatic infertility. The semen analysis was conducted at least twice over a two-week period, one from the other in accordance with WHO criteria. Hysteroscopy was conducted at the time of endometrial growth.

Results: The result showed that in case of CE, the high endometrial inflammation intensity correlate with the high number of spermiogram alterations. Leukocytospermia, high pH and asthenospermia are the most common altered factors in semen analysis.

Conclusion: In case of RIF, RPL or idiopatic couple infertility, flogistic alterations in sperm may lead to suspicious of CE in women

Keywords: PAS; Placenta; Cesarean Section; Challenges; Hysterectomy

References

1. Park HJ., et al. “Chronic endometritis and infertility”. Clinical and Experimental Reproductive Medicine 4 (2016): 185-192.
2. Franasiak JM. “Chronic endometritis is associated with an altered microbiome, but what about treatment and clinical outcomes?” Fertility and Sterility4 (2019): 649-650.
3. Vitagliano A., et al. “Chronic endometritis: really so relevant in repeated IVF failure?”. American Journal of Reproductive Immunology 78 (2017): e12758.
4. Cicinelli E., et al. “Chronic endometritis due to common bacteria is prevalent in women with recurrent miscarriage as confirmed by improved pregnancy outcome after antibiotic treatment”. Reproductive Science 5 (2014): 640-647.
5. Vitagliano A., et al. “Chronic Endometritis in Infertile Women: Impact of Untreated Disease, Plasma Cell Count and Antibiotic Therapy on IVF Outcome-A Systematic Review and Meta-Analysis”. Diagnostics (Basel)9 (2022): 2250.
6. Zizolfi B., et al. “Endometriosis and dysbiosis: State of art”. Frontiers in Endocrinology (Lausanne) 14 (2023): 1140774.
7. Singh N and Sethi A. “Endometritis - Diagnosis, Treatment and its impact on fertility - A Scoping Review”. JBRA Assisted Reproduction3 (2022): 538-546.
8. Ughade PA and Shrivastava D. “Unveiling the Role of Endometrial CD-138: A Comprehensive Review on Its Significance in Infertility and Early Pregnancy”. Cureus 2 (2024): e54782.
9. Gu J., et al. “The effect of chronic endometritis and treatment on patients with unexplained infertility”. BMC Womens Health 1 (2023): 345.
10. Kaltsas A., et al. “From Diagnosis to Treatment: Comprehensive Care by Reproductive Urologists in Assisted Reproductive Technology”. Medicina 59 (2023): 1835.

Citation

Citation: Andrea Fabiani., et al. “Is there a Relationship between Chronic Endometritis Diagnosis and Spermiogram Alterations?". Acta Scientific Women's Health 7.11 (2025): 03-06.

Copyright

Copyright: © 2025 Andrea Fabiani., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.