Chronic endometritis is usually presents in a silent way, becoming an incidental finding when performing endometrial biopsy for other reasons.
The use of hysteroscopy with liquid distention media of the uterine cavity has been shown to be an effective method for the diagnosis of chronic endometritis. A common hysteroscopic finding in chronic endometritis is the presence of a thickened endometrial edematous mucosa. Also, a thin hyperemic micropolyps layer (less than 1 mm) that appears to float in the endometrial cavity can be seen.
Using these criteria, the hysteroscopic diagnosis of chronic endometritis has a sensitivity up to 93%.