Interactive Session - Recurrent Pregnancy Loss: One Should Evaluate for Chronic Endometritis Debate
Time:1:15 pm - 2:15 pm
Location:HCC318 - Hawaii Convention Center
Danny J. Schust, M.D. (Chair), University of Missouri
Mary D. Stephenson, M.D., University of Illinois at Chicago
Steven L. Young, M.D., University of North Carolina School of Medicine
Needs Assessment and Description
A timed, luteal-phase endometrial biopsy was part of the
standard evaluation for recurrent pregnancy loss for many
years. Data demonstrating its poor predictive value for
histological evaluation of the “luteal-phase defect” caused
it to be dropped from this workup by most practitioners.
New data have suggested that this procedure should again
be employed in evaluations for recurrent pregnancy loss—
however, now for the diagnosis of chronic endometritis.
This debate will address the utility of the endometrial
biopsy for the diagnosis of chronic endometritis in
this diagnostically and therapeutically difficult patient
population. The session is designed for clinicians involved
in the care of infertile women and those with recurrent
At the conclusion of this session, participants should be
- Determine whether the diagnosis of chronic
endometritis has prognostic or diagnostic value in a
patient with a history of recurrent pregnancy loss.
- Discuss the utility of adding this test to the recurrent
pregnancy loss workup in clinical practice.
A 33-year-old, gravida 3, para 0030 female has had a
history of 2 miscarriages and 1 fetal demise of 10 weeks’
size. Karyotypes on the last 2 pregnancy losses were 46,XY
and 46,XX (maternal contamination excluded using
single-nucleotide polymorphism [SNP] analysis). After
participating in this session, in my practice I will:
a. Perform an endometrial biopsy as part of her
b. Recommend maternal karyotyping only.
c. Recommend paternal karyotyping only.
d. Evaluate the uterine cavity.
e. Not applicable to my area of practice