This book chapter provides an overview of chronic endometritis (CE), a condition which is increasingly recognized as being associated with recurrent implantation failure, recurrent miscarriage, and fetal demise. The diagnosis of CE is challenging due to the presence of various cell types in the endometrial stroma, making the identification of plasma cells essential. The optimal timing and diagnostic evaluation of endometrial biopsy are still being researched, while immunohistological staining may improve the identification of plasma cells. Hysteroscopy and endometrial culture may also aid in diagnosis and guide antibiotic selection. Although antibiotic treatment has shown improved pregnancy outcomes in cases of CE, there is no established ideal regimen. Overall, this chapter provides valuable information on CE and highlights the need for continued research to improve diagnosis and treatment.

Intramural myomas, the most common type of uterine leiomyoma, develop within the uterine wall and expand either inwards or outwards. According to the FIGO [1] leiomyoma classification system, fibroid types range from 0 to 8. Types 0, 1 and 2 are submucosal myomas, and subserosal myomas refer to type 5 to 7. Both type 3 and type 4 myomas are known as intramural myomas with no involvement of the endometrial cavity (Figure 13.1). The type 3 myomas, which are in the uterine wall but in contact with the endometrium, are more likely to distort the cavity under certain stimulations. Type 4 myomas stay entirely within the myometrium, which does not expand to either the endometrium or the serosa.

Uterine fibroids or leiomyomas are the most common benign gynaecological tumours; up to 25–30% of women may be diagnosed with fibroids during their lifetime [1]. Women with uterine fibroids may be asymptomatic, or they may present with menstrual symptoms such as menorrhagia and dysmenorrhoea, pressure symptoms, infertility, recurrent miscarriage or complications during pregnancy like red degeneration.

Heinrich Fritsch reported the first case of intrauterine adhesions (IUAs) at the end of the nineteenth century. Since 1948, a series of papers on this condition have been published by Joseph G. Asherman, which describe the frequency, aetiology and symptoms of IUA

Congenital uterine anomalies (CUAs) are gaining increasing attention in the field of gynaecological ultrasound for a number of reasons: first, they appear to be of relatively high prevalence in both selected and unselected groups of women ; second, they appear to have a significant impact on reproductive outcomes and, on occasion, in adolescent symptomatology ; third, there has been a recent surge in relevant publications, which has culminated in a new international classification , and also a new international consensus for diagnosis. Three-dimensional (3D) ultrasound is now recommended as the gold standard method for diagnosis, which implies that gynaecologists and/or sonographers may be expected to attain the correct diagnoses and classification of CUA for women presenting to them with, and even without, symptomatology.