Problematic issues related to the phenotypic characteristics, persistence and progression of chronic endometritis

Chronic endometritis is defined as mild persistent inflammation of the endometrium, characterised histologically by inflammatory cells in the endometrial stroma, including plasma cells, lymphocytes, eosinophils, and even lymphoid follicles. Diagnosing chronic endometritis is difficult for a variety of reasons. Most patients are asymptomatic, and ultrasound features are nonspecific. Microbiological examination is often not informative because most pathogens are non-cultivable. Chronic endometritis can be diagnosed by hysteroscopy based on detecting specific endometrial changes, such as focal or diffuse hyperemia, stromal edema, and micropolyps. Histopathological identification of plasma cells in endometrial biopsy specimens is considered the gold standard for the diagnosis of chronic endometritis. There is a hypothesis that chronic endometritis may be related to endometriosis, although studies in this direction are very scarce. There are different opinions about the persistence and progression of chronic endometritis, which require further research.