Features of Chronic Endometritis in Women of Reproductive Age with Polycystic Ovary Syndrome

Background. The prevalence of chronic endometritis among women of reproductive age reaches 68 %. Polycystic ovary syndrome (PCOS) is a common cause of reproductive disorders. Data on the characteristics of the manifestation of chronic endometritis in patients with PCOS are incredibly insufficient. PCOS is known as closely associated with metabolic syndrome and chronic systemic inflammation. However, there is no information on the role of chronic systemic inflammation in the pathogenesis of chronic endometritis in women with PCOS.

The objective. Determination of the clinical and morphological features of chronic endometritis in women  with polycystic ovary syndrome and to establish the role of systemic inflammation and hormones of the  hypothalamic-pituitaryovarian axis in chronic endometritis associated with PCOS. 

Materials and methods. We performed a cross-sectional study from May 2017 to December 2019 and examined 198 women of reproductive age (33.71 ± 5.93 years) during annual preventive examinations. We used clinical, instrumental, and laboratory research methods, including hormonal, biochemical,  immunohistochemical techniques, and statistical analysis.

Results. Of the 198 women examined chronic endometritis was diagnosed in 76 patients, including 15 patients with PCOS. Chronic endometritis in PCOS is characterized by a relative decrease in the duration of the menstrual cycle and less pronounced lymphoid infiltration of endometrial tissue. The risk of chronic endometritis in women of reproductive age is not associated with changes in gonadotropins, prolactin, and  manifestations of clinical and biochemical hyperandrogenism. Chronic endometritis is not accompanied by an increase in the concentration of C-reactive protein. At the same time, BMI, waist circumference, and leptin are considered «anti-risk» factors for chronic endometritis.

Conclusion. The specific clinical manifestations of chronic endometritis in PCOS allows us to consider them as diagnostically significant. The revealed negative associations of chronic endometritis with BMI, waist  circumference, and leptin require further investigation of the role of adipose tissue products in the control of local and systemic inflammation. 

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