MODERN ASPECTS OF THE TREATMENT OF CHRONIC ENDOMETRITIS AS A CAUSE OF INFERTILITY

Kushnir E. K., Ivanchenkova V. V., Muravlyantseva M. M., Shalyapina A. V.

Chronic endometritis is one of the leading pathologies in gynecological practice, leading to a violation of the reproductive function of a woman. The frequency of occurrence of this pathology among patients ranges from 2.8% to 56.8%, and in patients diagnosed with infertility - 45%. Risk factors for the development of chronic endometritis include: the onset of sexual activity at an early age, invasive procedures on the pelvic organs, infectious diseases of the reproductive and urinary systems. In establishing the diagnosis of chronic endometritis, the leading role is played by "pipel" biopsy and hysteroscopy. Successful pregnancy requires a comprehensive approach in the treatment of chronic endometritis, which includes traditional methods such as antibiotic therapy and physiotherapy, as well as alternative options: autoimmune stem cell therapy, autologous platelet-rich plasma therapy, cytokine therapy. Treatment with autoimmune stem cells can increase the thickness of the endometrium. Cytokine therapy, especially colony-stimulating factors, also affect the thin endometrium, contributing to its increase. Platelets produce growth factors that can stimulate cell division, and also have neovascular and anti-inflammatory effects. Physiotherapeutic methods, such as ultrasonic intrauterine cavitation, low-frequency ultrasound and magnetic laser stimulation, improve the blood supply to the pelvic organs, eliminate chronic hypoxia, which increases the chance for successful implantation of a fertilized egg.

Keywords:chronic endometritis, infertility, cytokine therapy, stem cells, physiotherapy