Preparation of patients with chronic endometritis for the procedure of assisted reproductive technologies

DOI

https://dx.doi.org/10.18565/aig.2023.291

Karakhalis L.Yu., Zhigalenko A.R., Dotsenko S.V., Voronkova V.V.
1) Kuban State Medical University, Ministry of Health of Russia, Krasnodar, Russia; 2) Regional Center for Family Health and Reproduction, Krasnodar, Russia

Objective: To evaluate the ability of L. paracasei CNCM I-1572 in Enterolactis Duo to influence the course of chronic endometritis (CE) and the level of cholecalciferol in patients undergoing ART.
Materials and methods: A total of 68 patients with CE were examined. Group 1 (n=40) received standard therapy for CE, cholecalciferol and Enterolactis Duo; group 2 (n=28) received standard therapy for CE and cholecalciferol. A general clinical study was conducted before and after the end of therapy. The study included physical examination, complete blood count and urine tests, measurement of the level of thyroid-stimulating hormone, vitamin D, Femoflor 16, ultrasound examination of the uterus and thyroid gland, measurement of CD-138.
Results: Before administration of therapy, there were no significant differences in vitamin D levels: 24.4 (15–38) ng/ml in group 1 and 25.6 (16–41) ng/ml in group 2. Dysbiosis was diagnosed in 19/40 (47.5%) patients of group 1 and in 1/28 (3.6%) patient of group 2; moderate anaerobic dysbiosis was revealed only in patients of group 1 (4/40 (10%), and anaerobic dysbiosis was found only in group 2 (11/28 (39.3%)). Ultrasound signs of CE were detected in 30/40 (75.0%) patients of group 1 and in 19/28 (67.9%) patients of group 2. Histological verification of CE was performed in the first phase of the menstrual cycle in all patients; the marker of chronic endometritis, namely plasma cell membrane protein CD-138, was detected in 100% of cases in both groups. The level of vitamin D significantly differed between the groups in 12 weeks after the beginning of therapy: it was 34.4 ng/ml in group 1 and 28.4 ng/ml in group 2. After treatment, normocenosis was observed in 26/40 (65.0%) and absolute normocenosis was in 14/40 (35.0%) patients in group 1. Among patients of group 2, there were 2/28 (7.1%) patients with anaerobic dysbiosis, normocenosis was observed in 26/28 (92.9%) women. Ultrasound signs of CE were absent in 29/40 (72.5%) patients of group 1 and in 13/28 (46.4%) patients of group 2. According to the results of histological verification of CE, CD-138 was absent in group 1 and remained in 1/28 (3.6%) patient in group 2.
Conclusion: The use of Enterolactis Duo synbiotic which was administered together with standard therapy of CE contributes to the normalization of vaginal biocenosis. The patients of both groups took vitamin D, but in group 1 using the Enterolactis Duo synbiotic, vitamin D levels increased significantly more compared to the group 2; this allowed us to conclude that the absorption of oral vitamin D increased when the patients received Enterolactis Duo. Besides, the histological and ultrasound findings of the study showed the ability of L. paracasei CNCM I-1572 in Enterolactis Duo to have a beneficial effect on the course of CE.

Authors’ contributions: Karakhalis L.Yu. – development of the concept, design and methodology, analysis and interpretation of the obtained data, preparation and editing of the text, approval of the final version of the article; Zhigalenko A.R., Dotsenko S.V. – analysis and interpretation of the obtained data, preparation and editing of the text; Voronkova V.V. – development of design and methodology, preparation and editing of the text, approval of the final version of the article.
Conflicts of interest: Authors declare lack of the possible conflicts of interests.
Funding: The study was conducted without sponsorship.
Ethical Approval: The study was approved by the Ethical Review Board of the Regional Center for Family Health and Reproduction, Krasnodar, Russia.
Patient Consent for Publication: The patients provided an informed consent for the publication of their data.
Authors’ Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Karakhalis L.Yu., Zhigalenko A.R., Dotsenko S.V., Voronkova V.V. Preparation of patients with chronic endometritis for the procedure of assisted reproductive technologies.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (12): 152-157 (in Russian)
https://dx.doi.org/10.18565/aig.2023.291

chronic endometritis

synbiotic

vitamin D

Full text (in Russian)

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Received 12.12.2023

Accepted 22.12.2023

Lyudmila Yu. Karakhalis, Dr. Med. Sci., Professor, Professor of the Department of Obstetrics, Gynecology and Perinatology, Faculty of Continuing Education and Professional Retraining of Specialists, Kuban State Medical University, Ministry of Health of Russia, 4, Mitrofana Sedina str., Krasnodar, 350063, Russia; Regional Clinical Hospital #2, Ministry of Health of Krasnodar Region, +7(988)244-40-44, lomela@mail.ru, https://orcid.org/0000-0003- 1040-6736
Angela R. Zhigalenko, PhD, Chief Physician, Krasnodar Regional Centre of Family Health Protection and Reproduction, Ministry of Health of Krasnodar Region; Assistant of the Department of Obstetrics, Gynecology and Perinatology, Faculty of Continuing Education and Professional Retraining of Specialists, Kuban State Medical University, Ministry of Health of Russia, 4, Mitrofana Sedina str., Krasnodar, 350063, https://orcid.org/0000-0002-4202-2350
Svetlana V. Dotsenko, Head of the Department of Reproductive Health Care, Krasnodar Regional Centre of Family Health Protection and Reproduction, Ministry of Health of Krasnodar Region, https://orcid.org/0009-0003-4571-9967
Viktoriya V. Voronkova, postgraduate student, Department of Obstetrics, Gynecology and Perinatology, Faculty of Continuing Education and Professional Retraining of Specialists, Kuban State Medical University, Ministry of Health of Russia, 4, Mitrofana Sedina str., Krasnodar, 350063, v.v.fomenko@yandex.ru
Corresponding author: Lyudmila Yu. Karakhalis, lomela@mail.ru

Preparation of patients with chronic endometritis for the procedure of assisted reproductive technologies

Karakhalis L.Yu., Zhigalenko A.R., Dotsenko S.V., Voronkova V.V.

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