Treatment of the Hypoplastic Variant of Chronic Endometritis: Arguments Against Antibacterial Therapy

Abstract

The aim of the investigation was to provide a rationale for refusal from antibacterial therapy in the hypoplastic variant of chronic endometritis.Materials and Methods. The study involved 116 patients with burdened reproductive history (infertility, miscarriage, IVF and ET failures), who were diagnosed with the hypoplastic variant of chronic endometritis after complex examination (hysteroscopy, morphology and immunohistochemistry of the endometrium). The study was carried out in two stages. At the first stage, the patients were examined and the autoimmune genesis of the disease was proved. At the second stage, the patients were divided into two groups, the main group (84 women) and the control (32 women). The patients in the control group received conventional antibiotic therapy with simultaneous administration of trophotropic medications (placenta hydrolysate laennec, phlebotonic diosmin 600). In the main group we used no antibiotic therapy having included only immunomodulating trophotropic agents in the treatment.Results. It was established that conventional therapy exerted no effect on the endometrial cell composition (CD3 + , CD4 + , CD8 + , CD56 + ) and humoral immunity indices. When using only immunomodulating trophotropic agents, positive tendencies were observed in normalization of the endometrial cell composition, autoimmunization indices decreased (IgG), the myometrium and endometrium blood supply improved, the endometrium proved to increase in thickness.Conclusion. The hypoplastic variant of chronic endometritis is a typical autoimmune process, in which administration of antibiotics is useless. At the same time, the positive tendencies revealed while using immunomodulating trophotropic agents have demonstrated expediency of their introduction.

Local Immunity Status and Apoptosis Reactions in Endometrium of Women with a History of Non-Developing Pregnancy

“…By consensus of obstetricians and gynaecologists in 2006 each case of nondeveloping pregnancy is regarded as being associated with chronic endometritis, both at the cause and the effect levels [7] Latest research has shown that chronic pelvic inflammatory diseases are not accompanied by disruption of parameters of cellular and humoral immunity detected in peripheral blood. Thus, in order to determine functional status of endometrium, we need to assess the local immunity [8][9][10]. Bacterium-virus colonization of endometrium is the result of failure of the immune system to eliminate infectious agent; but at the same time its spread is limited due to effector properties of Tlymphocytes, NK-cells and macrophages.…”