Restoration of reproductive function in patients with uterine infertility due to chronic endometritis
G.B. Dikke, A.A. Sukhanov, I.I. Kukarskaya, V.V. Ostromensky
1) Academy of Medical Education n.a. F.I. Inozemtsev, St. Petersburg, Russia;
2) Perinatal Center of the Tyumen region, Tyumen, Russia;
3) Tyumen State Medical University of the Ministry of Health of Russia, Tyumen, Russia
Background. The prevalence of chronic endometritis (CE) in the population is recorded at the level of 14.1 to 24.4% but is significantly higher in patients with impaired reproductive function. CE is accompanied by increased production of cytokines and chemokines at the local level, the normalization of the secretion of which can contribute to the restoration of endometrial receptivity in infertile patients.
Objective. Evaluation of the effectiveness of local immunotherapy using a complex of exogenous natural cytokines in patients with infertility caused by CE, according to follow-up data.
Methods. A prospective randomized clinical trial was carried out. 76 women with CE (confirmed histologically) and infertility who under¬went causal antibiotic therapy were examined. Further, group I (n=36) received Superlymph 25 IU vaginally daily for 20 days; group II (n=40) - no additional treatments. Treated patients were followed-up for 12 months. Data were available for 30 patients in group I and 24 in group II who became pregnant during this period. The data of history of childbirth, developmental histories of newborns and personal interviews were used.
Results. Treatment with Superlymph had high clinical efficacy and the onset of pregnancy in 83.3% of patients within 12 months of follow-up versus 60% in patients who received only antibiotic therapy, and improved pregnancy outcomes - a 2-fold reduction in the frequency of preterm birth (60 versus 29 %, respectively; P=0.02) and spontaneous miscarriages by 2.5 times (17 vs. 42% at the early stages and 7 vs. 13% at the late ones, respectively; P=0.04). There was no effect of the drug on the course of pregnancy and the condition of the newborn.
Conclusion. The use of Superlymph, which modulates the activity of cytokines, increases the body’s resistance and improves the results of treatment of patients with infertility in CE of a viral-bacterial nature.
About the Autors
Corresponding author: Galina B. Dikke, Dr. Sci. (Med.), Associate Professor, Professor at the Department of Obstetrics and Gynecology with a Course in Reproductive Medicine, Academy of Medical Education n.a. F.I. Inozemtsev, St. Petersburg, Russia; firstname.lastname@example.org