Reviewer’s report
Title: 
Histological diagnostic criterion for chronic endometritis based on the clinical outcome.
Version: 
0 
Date: 
06 Sep 2020
Reviewer's report:
Dear Authors,
I read the article entitled 'Histological diagnostic criterion for chronic endometritis based on the clinical
outcome'
Abstract
1. Please reduce Background and Methods.
2. 'P values for pregnancy rates, live birth rates, and miscarriage rates were smallest when the diagnostic
criterion of chronic endometritis was defined as the presence of on'. Please clearly state the results.
Key Words: Please delete 'implantation failure' in Key Words
Introduction
1. In many previous clinical studies 91 of CE, the study subjects were patients with RIF, and the clinical
outcomes were 92 compared between the group cured with antibiotics and the persistent group. Which
studies?
2. The sentences 'In this study, participants with RIF, RPL, and diseases suspected to cause implantation
101 failure were excluded when participants were enrolled, and 4 different diagnostic criteria 102 for CE,
based on the number of plasma cells in 10 high-power fields (HPFs) (field 103 magnified 400x with
microscope) for the same group of participants in which tissue was 104 collected immediately before
single frozen-thawed blastocyst transfer, were evaluated.' Are not related Introduction section
3. Please add the aim of the study as a last sentence of Introduction.
Methods
1. Please add the Ethical approval number.
2. Why did the authors accept 
age 41 as 
inclusion criteria 
3. Please add more sociodemografic information about study participants (BMI,smoking habits, undelying
cause of infertility, etc.)?
4. Please add a flowchart for exclusion criteria.
5. The sentences 'The first aim of the present study was to determine if the pregnancy rate and ongoing 138
pregnancy rate were different when CE was diagnosed with one or more plasma cells 139 found in 10
HPFs of the endometrial stromal tissue at the implantation phase, which 140 exactly matches the
histological diagnosis, compared with the patients without any 141 plasma cells found. The next research
aim was to examine whether the pregnancy rate, 142 live birth rate, and miscarriage rate differ between
Non-CE and CE when the diagnostic 143 criteria for CE are changed.' Are not related to Materials
Method section. Please 
replace sentences at the end of the introduction
6. The scientific rationale for the number of 
plasma cells must be added.
7. The sentence is not clear (one or more plasma cells in 10 HPFs; 2 or more plasma cells) ; 3 or more
plasma cells in 10 HPFs; and 5 or more plasma cells in 10 HPFs).Please correct this?
8. It is true When hCG was detected, ultrasonography was performed within one week from that day, and
those with a gestational sac in utero 
were defined as pregnant? One week from hCG detection.
9. Please create a subtitle 
'statistically method' (with sample size calculation ) in Materials Methods.
10. Multivariate analysis must be done.
11. Are there any association between number of plasma cells and ART outcome?
Results
1. The sentence 'Of these, patients who wanted treatment with antibiotics, two-step embryo transfer, two-
embryo transfer, or stimulated endometrium embryo transfer (SEET) were excluded'. Is not clear.
2. Was antibiotic therapy recommended to all patients with CE? Was it ethically appropriate not to
administer treatment?
3. Why the authors accept the patients with plasma cells as a controls. The authors must be accepted only
women without plasma cells of endometrium as controls.
4. Tables. Please add live birth rate all Tables.
5. Mean +SD or median (Inter quartile range) are a standard notation.
Discussion
1. 
1. The discussion section is very complex and unclear. This section should be rewritten as suggested
below.
- Findings and interpretation
- 
Differences and similarities in relation to other studies
- Strengths and weaknesses
- Open questions and future research.
- Conclusion
Yours sincerely,
Publons Reviewer Recognition
. Springer Nature can send verification of this review directly to Publons
(a subsidiary of Clarivate Analytics). If you would like to take advantage of this service, please click on
the “Yes” option below. Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted to Publons after the final
decision on the manuscript has been made. If you have already registered at Publons, they will notify you
of the receipt of this review and update your profile 
as per your settings and their policy. If you are not
registered with Publons, you will receive an email from them asking you to register in order for them to
be able to recognize your review on your new profile page. Publons may use the Review Data to generate
derivative metadata for the benefit of Publons and you as a reviewer, carefully considering the sensitivity
of such information. For example, Publons may verify your record as a reviewer by updating your profile
published on its webservice if you have registered for such service or help editors to identify candidate
reviewers. Please find the details of processing in Publons’ privacy policy
https://publons.com/about/terms
Yes
Declaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of this manuscript,
either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an organization that holds or has
applied for patents relating to the content of the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below. If your
reply is yes to any, please give details below.
I declare that I have no competing interests
Reviewer Publication Consent.
 I agree for my report to be made available under an Open Access
Creative Commons CC-BY License (
 http://creativecommons.org/licenses/by/4.0
) if this manuscript is
accepted for publication. Any comments that I do not wish to be included in the published report have
been included as confidential comments to the editor, which will not be published.
If you are not happy for us to publish this report, please contact the editorial office before completing
the review.
If you wish, you can include your name in your published report. Please note you must decide whether
to include your name at the start of the process and confirm this decision whenever prompted. If you
change your decision later, we will not be able to publish your name.
I agree to the terms of the CC-BY 4.0 license; please 
do not
 publish my name with my report. (default)
Is the study design appropriate to answer the research question (including the use of appropriate controls),
and are the conclusions supported by the evidence presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free from apparent
manipulation?
Yes