Both endometriosis and chronic endometritis are often associated with infertility. But is there a correlation between these two clinical entities? A recent review of the existing literature attempted to provide the answer (Kalaitzopoulos et al., 2025).
Chronic endometritis, a chronic inflammation of the endometrium (inner lining of the uterus), often does not give any symptoms at all to the patient. Therefore, it is likely to go undiagnosed while, in fact, it may be more common than we think. It is often the result of an infection of the endometrium by common pathogens and the diagnosis is histological (presence of plasma cells, the number of which seems to be associated with the risk of recurrent miscarriages). Hyperemia (focal or diffuse) of the endometrium, and micro-polyps are often observed, negatively affecting the receptivity of the endometrium.
On the other hand, endometriosis is a chronic inflammatory disease, with a possible negative effect on endometrial receptivity. Infertility is very common in women with endometriosis.
In this meta-analysis, the authors found that the incidence of chronic endometritis in endometriosis cases was around 30%. In other words, 1 in 3 patients with endometriosis has chronic endometritis. They also found that the incidence of chronic endometritis was higher in cases of more “advanced” endometriosis (stages III and IV, compared to stages I and II). Finally, comparing patients with endometriosis with those without a diagnosis of endometriosis, the authors observed that the former had higher rates of chronic endometritis.
If you are facing infertility problems, with or without endometriosis, do not hesitate to contact us for further consultation.