Copyright: © 2025 by the authors. Licensee: Pirogov University.
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ORIGINAL RESEARCH

Pipelle and endobrush catheters do not prevent contamination of endometrial samples by cervical microbiota

Zornikov DL1 , Bekhter AA1 , Kornilov DO1 , Simarzina VM1 , Nechaeva DM1 , Karyakina AE1 , Leshukova MA1 , Amineva PG1,3 , Voroshilina ES1,2
About authors

1 Ural State Medical University, Yekaterinburg, Russia

2 Medical Center “Garmonia”, Yekaterinburg, Russia

3 LLC “Quality Med”, Yekaterinburg, Russia

Correspondence should be addressed: Danila L. Zornikov
Kluchevskaya, 17, Yekaterinburg, Russia, 620109; moc.liamg@ldvokinroz

About paper

Author contribution: Zornikov DL — study organization, data analysis, statistical analysis, writing and editing of the article; Bekhter AA — development and creation of in vitro cervical models; Kornilov DO — development and creation of in vitro cervical models, preparation of illustrations; Simarzina VM — execution of experimental work (sampling from models), manuscript preparation; Nechaeva DM — execution of experimental work (sampling from models), performance of molecular genetic studies (PCR), manuscript preparation; Karyakina AE — performance of molecular genetic studies (PCR), preparation of the manuscript and illustrations; Leshukova MA — manuscript preparation; Amineva PG — preparation and provision of bacterial cultures for analysis; Voroshilina ES — scientific supervision and coordination, analysis and interpretation of data, writing and editing of the article.

Compliance with ethical standards: the study was approved by the Ethics Committee of Ural State Medical University (Protocol № 3 dated June 20, 2025).

Received: 2025-11-18 Accepted: 2025-12-05 Published online: 2025-12-13
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The risk of contamination by cervical microbiota during transcervical sampling represents a fundamental methodological challenge in endometrial microbiome research. This study aimed to experimentally evaluate the efficacy of Pipelle and Endobrush endometrial sampling catheters in preventing this contamination. An in vitro cervix model with two anatomically distinct canal types (cylindrical and slit-like) was developed and filled with a synthetic cervical mucus containing a defined quantity of bacterial DNA. After catheter passage through the model cervical canal, a simulated ‘endometrial’ sample (sterile air) was collected and subjected to quantitative PCR analysis. Both catheter types facilitated substantial transfer of bacterial DNA from the cervical mucus into the endometrial sample. The median transfer of total bacterial DNA was 81.6% [54.4–107] for the Pipelle catheter and 29.8% [14.8–56.3] for the Endobrush catheter (p = 0.009), indicating that neither device provided sufficient protection for reliable characterization of the endometrial microbiota. Catheter efficacy was further dependent on cervical canal morphology and the specific microbial group analyzed. These findings demonstrate that transcervical sampling with either catheter type introduces a significant and variable degree of cervical contamination, thereby confounding the interpretation of endometrial microbiota data and underscoring the need to conceptualize and study a combined cervico-endometrial microbiota.

Keywords: cervical canal, real-time PCR, molecular diagnostics, endometrial microbiota, contamination, Pipelle catheter, Endobrush catheter

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