Diagnosis and clinical criteria for chronic endometritis

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 53-59
Author(s):  
K G Serebrennikova ◽  
N A Arutyunyan ◽  
A I Alekhin
Keyword(s):  
Reproductive Function ◽  
Antiviral Effect ◽  
Chronic Endometritis ◽  
Vitro Fertilization ◽  
Clinical Criteria ◽  
New Methods ◽  
And Function ◽  
Social Importance

Currently, the urgency of the problem of chronic endometritis is of medical and social importance, since it leads to impaired reproductive function. Among the risk factors there is a predominance of intrauterine devices and inflammatory complications after childbirth and abortion. Prolonged persistence of infectious agents in the endometrium in chronic endometritis leads to marked changes in the structure and function of the tissue, causes proliferative disorders, as well as disorders in cyclic transformation. Morphofunctional damage to the endometrium is not only the cause of infertility, unsuccessful attempts of in vitro fertilization (IVF) and embryo transfer (PE), miscarriage, and a decrease in the quality of life of women due to chronic pain, dyspareunia, uterine bleeding and discharge from the genital tract. Timely and accurate diagnosis is key to the success of the restoration of reproductive function. Treatment of chronic endometritis is a complex, phased process. One of the new methods is photodynamic therapy, which leads to the development of a photochemical reaction that destroys bacterial and tumor cells, and also has an antiviral effect.

scholarly journals CLINICAL AND MORPHOLOGICAL FEATURES OF CHRONIC ENDOMETRITIS IN INFERTILE WOMEN

2017 ◽  
Vol 4 (4) ◽  
pp. 208-213
Author(s):  
Ara L. Unanyan ◽  
Yu. M Kossovich ◽  
T. A Demura ◽  
D. V Baburin ◽  
I. S Sidorova ◽  
...  
Keyword(s):  
Reproductive Function ◽  
Occurrence Rate ◽  
Etiologic Factor ◽  
Chronic Endometritis ◽  
Vitro Fertilization ◽  
Anaerobic Microorganisms ◽  
Steady Growth ◽  
Clinically Significant ◽  
And Function

Morphofunctional state of the endometrium is one of the key factors determining both the successful implantation and full development of the embryo, including in cycles of «in vitro fertilization» (IVF). The most common cause of the impairment of the structure and function of the endometrium being chronic endometritis (CE), the frequency of its detection in infertile patients varies between 13 and 68%, reaching its maximum in women with tubal peritoneal factor and unsuccessful attempts of IVF in the anamnesis. The increasing prevalence and steady growth of the currently occurrence rate of CE cases in infertility is promoted by an increase in the role of intrauterine contraception and intrauterine interventions, including artificial abortions. On the other hand, happened in the last decades the evolution of the etiologic factor of CE towards the predominance of associations of facultative and obligate anaerobic microorganisms and viruses in the endometrium often leads to the development of erased, sluggish and atypical forms of the disease, which significantly hamper the diagnosis of CE and significantly reduce the effectiveness of traditional schemes of its treatment. CE is a clinically significant nosological form requiring the timely detection and treatment. The complex phased and pathogenetically substantiated therapy of CE in most cases leads to the restoration of the morphofunctional potential of the endometrium and, as a consequence, promotes the successful realization of the reproductive function.

scholarly journals Book review: “It Starts with the Egg” by Rebecca Fett

2019 ◽  
Vol 13 (3) ◽  
pp. 255-260
Author(s):  
A. D. Makatsariya
Keyword(s):  
Polycystic Ovary ◽  
Recurrent Miscarriage ◽  
Action Plan ◽  
Reproductive Function ◽  
Poor Quality ◽  
Vitro Fertilization ◽  
Wide Range ◽  
Based Medicine

The licensed edition of Rebecca Fett's book, “It Starts with the Egg” has been published in Russian. Given its medical contents, it seems important to evaluate the information contained in the book from the perspective of a practicing obstetrician-gynecologist, focusing on the problem of miscarriage and pregravid preparation. Importantly, the book is based on evidence-based medicine: although the book is intended for a wide scope of readers, it contains a list of primary references similarly to that in peer-reviewed journals.The author analyzed and summarized the data from over 60 scientific articles. Although based on primary academic sources, the author used a simple and understandable language to explain the complex pathogenesis of infertility and the manipulations used in the assisted reproductive technology (ART).The book consists of 3 parts; each of them contains several chapters reviewing the causes of reproductive disorders and the ways to correct them. The first part addresses the reasons for poor quality of women’s eggs. The second part describes nutraceuticals and dietary supplements that can improve the quality of eggs. The third part of the book examines the diet, which helps improve this quality. A step-by-step action plan for improving reproductive function is also presented. The basic plan is suitable for those who are just thinking about pregnancy and those who have no reason to expect any difficulties, as well as for couples who have been struggling with infertility for several years. The mid-level plan is intended for those who already have some concerns about conceiving, but are not yet aware of personal problems with their reproductive function, as well as for women with polycystic ovary syndrome (PCOS) or irregular ovulation. The plan for those having serious problems is intended for women with recurrent miscarriage, as well as for couples with a decrease in the ovarian reserve who are trying to get pregnant using in vitro fertilization (IVF).Despite some remarks regarding the role of vitamin D and magnesium in pregravid preparation, the book contains a large number of useful and balanced recommendations that can improve the woman’s health and increase her chances to get pregnant and give birth to a healthy baby. Therefore, the book can be recommended for a wide range of readers.

Restoring of the reproductive function as an important constituent of the psychological condition of oncological female patients

2011 ◽  
Vol 26 (S2) ◽  
pp. 982-982
Author(s):  
N. Bakunina
Keyword(s):  
Reproductive Function ◽  
Reproductive Age ◽  
Psychological Status ◽  
List Type ◽  
Vitro Fertilization ◽  
Female Patients ◽  
Hormonal Function ◽  
Antineoplastic Treatment

Estimation of clinical-and-psychological status was conducted among female patients with diagnosis of cervical carcinoma and endometrial cancer. There were 2 sample groups.The first group consisted of 16 patients of early reproductive age from 20 to 35, not having patient parity. Tissue retrieval of ovary with following criopreservation was carried out among the patients of this group during the surgery stage. To restore the hormonal function of the ovary and rehabilitate the reproduction function after finishing of the complex treatment all patients underwent autotransplantation of the unfrozen ovary tissues into the abdominolvesical wall. Rehabilitation of the reproductive function consists of centesis of Graafian follicle, obtaining of the ovule, in vitro fertilization and transmitting of the embryo of the surrogate mother.The following methods were applied:- Informal clinical interviewing,- Abridged Multiphasic Personality Inventory (MMPI),- The State trait Anxiety Inventory,- Personality Questionnaire of the Bechterev Institution.Conclusions1.There has been found out the high intensity of anxious reaction in both groups of oncological female patients, which makes it necessary to provide psychological rehabilitations for patients.2.Euphoric, balanced and ergopatic Types of Attitude to the Disease have been frequently observed.3.The exceeding rates in the scales of neurotic triad observed through the MMPI need adequate correction.4.Restoring of the possibility for a woman to enjoy her reproductive function - improves the quality of life of such patients. Probably this will also increase the efficiency of the antineoplastic treatment and the life expectancy for this patients.

scholarly journals CHRONIC ENDOMETRITIS AS A FACTOR OF FAILURE ATTEMPT IN ASSISTED REPRODUCTIVE TECHNOLOGIES

2019 ◽  
pp. 13-21
Author(s):  
O. V. Onysko ◽  
О. О. Korchynska ◽  
Stefania Andrashchikova ◽  
Sylvia Zhultakova ◽  
Alena Shlosserova
Keyword(s):  
Plasma Cells ◽  
Assisted Reproductive Technologies ◽  
Proteolytic Enzymes ◽  
Uterine Cavity ◽  
Reproductive Function ◽  
Reproductive Technologies ◽  
Careful Study ◽  
Chronic Endometritis ◽  
Vitro Fertilization

Increase in frequency of disorders of women's reproductive function justifies a careful study of the underlying pathological processes. In recent years, increased attention in solving fertility problems is paid to endometrial pathology when chronic endometritis plays an important role. Current worksarefeeding an in-depth study of the etiology and pathogenesis of chronic endometritis. However, results of research pose new questions with an imaginary comprehensive study of this problem. Chronic endometritis is one of the causes of infertility and may play a role in certain complications of pregnancy and childbirth (30.3 % in patients with repeated failures of in vitro fertilization, 9.3 % with recurrent miscarriages, 9.8 % in infertility). Clinically, chronic endometritis is often asymptomatic or accompanied by nonspecific symptoms such as pelvic pain, dyspareunia, abnormal uterine bleeding, and discharges. Previously, scientists considered the uterine cavity as a sterile container. But a team of Spanish scientists sought to test for the presence of intrauterine microflora, which differs from the vaginal. As a result, the study of endometrial fluid and vaginal samples from the same patients revealed different bacterial compositions. Microflora in the intrauterine fluid was classified as Lactobacillus, and women with non-lactobacillary flora of the endometrium had a significantly lower frequency of implantation. At the initial stage of endometrial inflammation is an activation of neutrophils and macrophages, increased cytokines synthesis, extracellular matrix degradation by proteolytic enzymes. Disorders of microcirculation and sclerotic processes in the area of ​​injury lead to the ischemia and tissue hypoxia, which activates the processes of sclerosis and angiogenesis. Chronization of the process increases the expression of chemokines and adhesion molecules, that is lead to migration of B-lymphocytes from the bloodstream and their differentiation into plasma cells, increases the activity of matrix metalloproteinases, changes local expression of estrogen and progesterone receptors. Lack of a pronounced specific clinical picture of chronic endometritis, its later detection causes impaired reproductive function. Untimely diagnosis and treatment of chronic endometritis has significant consequences in terms of the possibility of implantation of a fertilized egg in the programs of assisted reproductive technologies.

scholarly journals Ferredoxin 1b Deficiency Leads to Testis Disorganization, Impaired Spermatogenesis, and Feminization in Zebrafish

Endocrinology ◽  
2019 ◽  
Vol 160 (10) ◽  
pp. 2401-2416 ◽  
Author(s):  
James A Oakes ◽  
Nan Li ◽  
Belinda R C Wistow ◽  
Aliesha Griffin ◽  
Lise Barnard ◽  
...  
Keyword(s):  
Sex Differentiation ◽  
Reproductive Function ◽  
Gonadal Development ◽  
Sex Characteristics ◽  
Vitro Fertilization ◽  
Sex Development ◽  
Receptor Mutant ◽  
Predominantly Female ◽  
And Function

Abstract The roles of steroids in zebrafish sex differentiation, gonadal development, and function of the adult gonad are poorly understood. Herein, we used ferredoxin 1b (fdx1b) mutant zebrafish to explore such processes. Fdx1b is an essential electron-providing cofactor to mitochondrial steroidogenic enzymes, which are crucial for glucocorticoid and androgen production in vertebrates. Fdx1b−/− zebrafish mutants develop into viable adults in which concentrations of androgens and cortisol are significantly reduced. Adult fdx1b−/− mutant zebrafish display predominantly female secondary sex characteristics but may possess either ovaries or testes, confirming that androgen signaling is dispensable for testicular differentiation in this species, as previously demonstrated in androgen receptor mutant zebrafish. Adult male fdx1b−/− mutant zebrafish exhibit reduced characteristic breeding behaviors and impaired sperm production, resulting in infertility in standard breeding scenarios. However, eggs collected from wild-type females can be fertilized by the sperm of fdx1b−/− mutant males by in vitro fertilization. The testes of fdx1b−/− mutant males are disorganized and lack defined seminiferous tubule structure. Expression of several promale and spermatogenic genes is decreased in the testes of fdx1b−/− mutant males, including promale transcription factor sox9a and spermatogenic genes igf3 and insl3. This study establishes an androgen- and cortisol-deficient fdx1b zebrafish mutant as a model for understanding the effects of steroid deficiency on sex development and reproductive function. This model will be particularly useful for further investigation of the roles of steroids in spermatogenesis, gonadal development, and regulation of reproductive behavior, thus enabling further elucidation of the physiological consequences of endocrine disruption in vertebrates.

scholarly journals Introducing intrauterine antibiotic infusion as a novel approach in effectively treating chronic endometritis and restoring reproductive dynamics: a randomized pilot study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Konstantinos Pantos ◽  
Mara Simopoulou ◽  
Evangelos Maziotis ◽  
Anna Rapani ◽  
Sokratis Grigoriadis ◽  
...  
Keyword(s):  
Fertility Restoration ◽  
Statistical Significance ◽  
Antibiotic Administration ◽  
Oral Antibiotic ◽  
Treatment Rate ◽  
Chronic Endometritis ◽  
Vitro Fertilization ◽  
Significant Difference ◽  
Antibiotic Infusion

AbstractThe chronic nature of Chronic Endometritis (CE) along with the challenging management and infertility entailed, call for cutting-edge therapeutic approaches. This study introduces the novel treatment of intrauterine antibiotic infusion (IAI) combined with oral antibiotic administration (OAA), and it assesses respective performance against the gold standard treatment of OAA. Data sourced herein reports on treatment efficiency and fertility restoration for both patients aiming to conceive naturally or via In Vitro fertilization. Eighty CE patients, 40 presenting with recurrent implantation failure, and 40 with recurrent pregnancy loss, were enrolled in the IVF and the natural conception arm respectively. Treatment was subjected to randomization. Effectively treated patients proceeded with either a single IVF cycle or were invited to conceive naturally over a 6-month period. Combination of IAI and OAA provided a statistically significant enhanced effectiveness treatment rate (RR 1.40; 95%CI 1.07–1.82; p = 0.01). No statistically significant difference was observed regarding the side-effects rate (RR 1.33; 95%CI 0.80–2.22; p = 0.52). No statistically significant difference was observed for either arm regarding live-birth rate. Following an intention-to-treat analysis, employment of IAI corresponds to improved clinical pregnancy rate-albeit not reaching statistical significance. In conclusion, complimentary implementation of IAI could provide a statistically significant enhanced clinical treatment outcome.

scholarly journals Graphene and Reproduction: A Love-Hate Relationship

Nanomaterials ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 547
Author(s):  
Marina Ramal-Sanchez ◽  
Antonella Fontana ◽  
Luca Valbonetti ◽  
Alessandra Ordinelli ◽  
Nicola Bernabò ◽  
...  
Keyword(s):  
Graphene Oxide ◽  
Reproductive Function ◽  
Scientometric Analysis ◽  
Potential Toxicity ◽  
Good Tool ◽  
Vitro Fertilization ◽  
Number Of Publications ◽  
The Individual

Since its discovery, graphene and its multiple derivatives have been extensively used in many fields and with different applications, even in biomedicine. Numerous efforts have been made to elucidate the potential toxicity derived from their use, giving rise to an adequate number of publications with varied results. On this basis, the study of the reproductive function constitutes a good tool to evaluate not only the toxic effects derived from the use of these materials directly on the individual, but also the potential toxicity passed on to the offspring. By providing a detailed scientometric analysis, the present review provides an updated overview gathering all the research studies focused on the use of graphene and graphene-based materials in the reproductive field, highlighting the consequences and effects reported to date from experiments performed in vivo and in vitro and in different animal species (from Archea to mammals). Special attention is given to the oxidized form of graphene, graphene oxide, which has been recently investigated for its ability to increase the in vitro fertilization outcomes. Thus, the potential use of graphene oxide against infertility is hypothesized here, probably by engineering the spermatozoa and thus manipulating them in a safer and more efficient way.

Sexual Function and Fertility Quality of Life in Women Using In Vitro Fertilization

2015 ◽  
Vol 12 (4) ◽  
pp. 985-993 ◽  
Author(s):  
Nicole K. Smith ◽  
Jody Madeira ◽  
Heather R. Millard
Keyword(s):  
Quality Of Life ◽  
In Vitro Fertilization ◽  
Sexual Function ◽  
Vitro Fertilization
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