Discussion issues in the treatment of chronic endometritis

Abstract

The prevalence of chronic endometritis (CE) in the general population ranges from 14.1 to 24.4% and is 2–3 times higher in patients with impaired reproductive function. The treatment of CE presents certain difficulties due to different approaches and conflicting information about the effectiveness of the methods used. According to studies, the cure rate of CE with antibiotics (AB) is 82.6–87.9% with a live birth rate of 56–62.4%. In ART programs in patients who have undergone a course of AB-therapy, there is a 5-fold increase in the frequency of live births. The need to reach a consensus on the diagnostic criteria for CE was noted to exclude the influence of study heterogeneity on treatment outcomes. In recent years, the need to restore immune protection in CE has been widely discussed. Of the immunomodulators available in the Russian Federation with proven efficacy is a complex of exogenous natural cytokines and chemokines, the use of which in combination with AB allows to achieve elimination of pathogens in 86% of patients with CE of viral and bacterial aetiology (56% in the treatment of AB alone) and achieve pregnancy, ended in childbirth, in 60% of cases (29% without cytokines). Immune function can be improved by addressing micronutrient deficiencies, in particular the vitamin and mineral complex Pregnoton, which can contribute to increased resistance to infection, faster recovery, and improved reproductive function. Treatment of CE should include broad-spectrum antibiotic therapy and antiviral therapy aimed at reducing the activity of viruses. The complex of exogenous natural cytokines and chemokines for topical application helps to increase the rates of pregnancy and live births. Biologically active supplements, including the Pregnoton vitaminmineral complex, can be used as additional means to improve the functions of innate and acquired immunity.