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.

<h4>Objectives</h4>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 t...

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Main Authors: Elaheh Pahlevan Falahy, Mohammad-Taha Pahlevan-Fallahy, Fatemeh Keikha
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0319294
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author Elaheh Pahlevan Falahy
Mohammad-Taha Pahlevan-Fallahy
Fatemeh Keikha
author_facet Elaheh Pahlevan Falahy
Mohammad-Taha Pahlevan-Fallahy
Fatemeh Keikha
author_sort Elaheh Pahlevan Falahy
collection DOAJ
description <h4>Objectives</h4>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.<h4>Study design</h4>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.<h4>Results</h4>Patients had a mean age of 34 ( ± 5.4) years and BMI of 25.8 ( ± 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's test, the two sampling methods had no significant difference (P = 1.0 and 0.317, respectively).<h4>Conclusion</h4>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.
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spelling doaj-art-1265ce8e9e434c20badb7d35dda0795a2025-08-20T03:47:44ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01203e031929410.1371/journal.pone.0319294Comparing 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.Elaheh Pahlevan FalahyMohammad-Taha Pahlevan-FallahyFatemeh Keikha<h4>Objectives</h4>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.<h4>Study design</h4>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.<h4>Results</h4>Patients had a mean age of 34 ( ± 5.4) years and BMI of 25.8 ( ± 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's test, the two sampling methods had no significant difference (P = 1.0 and 0.317, respectively).<h4>Conclusion</h4>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.https://doi.org/10.1371/journal.pone.0319294
spellingShingle Elaheh Pahlevan Falahy
Mohammad-Taha Pahlevan-Fallahy
Fatemeh Keikha
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.
PLoS ONE
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.
title_full 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.
title_fullStr 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.
title_full_unstemmed 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.
title_short 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.
title_sort 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
url https://doi.org/10.1371/journal.pone.0319294
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AT mohammadtahapahlevanfallahy comparingtheaccuracyofpipelleversushysteroscopyandcurettageinthediagnosisofchronicendometritisinwomenwithrecurrentimplantationfailureaprospectivecrosssectionalstudy
AT fatemehkeikha comparingtheaccuracyofpipelleversushysteroscopyandcurettageinthediagnosisofchronicendometritisinwomenwithrecurrentimplantationfailureaprospectivecrosssectionalstudy