Use of low-frequency ultrasound in the combination treatment of the hypoplastic type of chronic endometritis
Objective. To evaluate the efficiency of treatment in patients with the hypoplastic type of chronic endometritis (CE) by uterine cavity irrigation with cavitation drug solutions exposed to low-frequency ultrasound (LFUS).Bogdanova A.M., Glukhov E.Yu., Dikke G.B.
Subjects and methods. 128 women diagnosed with the hypoplastic type of CE were examined. hypoplastic option. 64 patients of a study group (Group 1) received drug therapy and irrigation with a 0.05% cavitation chlorhexidine solution exposed to LFUS and with an immunomodulator solution (a total of 3 cycles). 64 patients of a comparison group (Group 2) had drug therapy only. The results were assessed by the time course of changes in the size of M-echo, endometrial histological examination before and after treatment, the occurrence of pregnancy and its outcomes.
Results. The pretreatment endometrial thickness (M-echo data) was 5.8±0.8 mm in Group 1 and 5.8±0.5 mm in Group 2 (p = 0.899), the posttreatment one was 8.6±0.3 and 6.4±0.9 mm, respectively (p = 0.000). In the patients of the study group, the histological pattern in the endometrial biopsy specimens was observed to normalize in 11 (17.2±0.05) and 64 (100%) patients after cycle treatments 2 and 3, respectively. In the comparison group, the endometrium after 4 and 6 months of treatment corresponded to the phase of the cycle in 2 (3.1%±0.02) and 18 (28.1%±0.06) women, respectively. In the first year after the end of therapy, pregnancy occurred substantially more commonly in Group 1 than in the comparison group (45.3 versus 28.15%). Pregnancy ended in childbirth in 89.7% of the patients in Group 1 and in 44.4% in Group 2; in these groups, there were miscarriages in 10.3 and 55.6%, respectively.
Conclusion. Thus, LFUS used in patients with the hypoplastic type of CE promotes the adequate growth of the endometrium and the creation of favorable conditions for ovum implantation.
Keywords
infertility
chronic endometritis
endometrial hypoplasia
endometrial irrigation
cavitation solutions
low-frequency ultrasound
Supplementary Materials
References
1. Serov V.N., Sukhikh G.T., eds. Clinical guidelines. Obstetrics and gynecology. 4th ed. Moscow: GEOTAR-Media; 2014. 1024p. (in Russian)
2. Sukhikh G.T., Shurshalina A.V. Chronic endometritis. Guidelines for doctors. Moscow: GEOTAR-Media; 2010. 64p. (in Russian)
3. Danusevich I.N. The incidence of chronic endometritis in women with different variations of reproductive disorders. Byulleten VSNTs SO RAMN. 2013; 4: 18-20. (in Russian)
4. Lebedev V.A., Pashkov V.M., Klinduhov I.A. Modern principles of therapy in patients with chronic endometritis. Trudnyiy patsient. 2012; 10(5): 38-43. (in Russian)
5. Motovilova T.M., Kachalina T.S., Anikina T.A. An alternative approach to the treatment of patients with chronic nonspecific endometritis. RMJ. Akusherstvo i ginekologiya. 2013; 21(14): 751-4. (in Russian)
6. Romero R., Espinoza J., Mazor M. Can endometrial infection/ inflammation explain implantation failure, spontaneous abortion, and preterm birth after in vitro fertilization? Fertil. Steril. 2004; 82(4): 799-804.
7. Pobedinskaya O.S. Chronic endometritis in the genesis of miscarriage (spontaneous abortion and developing pregnancy). Diss. Moscow; 2011. 26p. (in Russian)
8. Sharfi Yu.N. The role of hemodynamic and molecular-biological factors of endometrial receptivity in IVF programs. Diss. St. Petersburg; 2015. 38p. (in Russian)
9. Melkozerova O.A., Bashmakova N.V., Patsyuk O.V., Pogorelko D.V. Low-frequency ultrasound energy in the treatment and prevention of chronic endometritis as a pathogenetic factor of developing pregnancy. Rossiyskiy vestnik akushera-ginekologa. 2012; 12(5): 31-5. (in Russian)
10. Melkozerova O.A., Bashmakova N.V., Pogorelko D.V., Chistyakov M.A. Low-frequency ultrasound energy in the restoration of an endometrial receptive field following non-developing pregnancy. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2014; (7): 61-7. (in Russian)
11. Volkova E.Yu. Pregravid training for women with reproductive dysfunction and „thin endometrium. Diss. Moscow; 2014. 26p. (in Russian)
12. Petrov Yu.A. Chronic endometritis in the reproductive age: etiology, pathogenesis, diagnosis, treatment and prevention. Diss. Moscow; 2012. 47p. (in Russian)
13. Porubova Ya.P. Clinical and laboratory and morphological features of endometrial status of infertility in patients with failure of assisted reproductive technology in history. Diss. Khabarovsk; 2014. 25p. (in Russian)
14. Acharya S., Yasmin E., Balen A.H. The use of a combination of pentoxifylline and tocopherol in women with a thin endometrium undergoing assisted conception therapies - a report of 20 cases. Hum. Fertil. (Camb.). 2009; 12(4): 198-203.
15. Lédée-Bataille N., Olivennes F., Lefaix J.L., Chaouat G., Frydman R., Delanian S. Combined treatment by pentoxifylline and tocopherol for recipient women with a thin endometrium enrolled in an oocyte donation programme. Hum. Reprod. 2002; 17(5): 1249-53.
16. Spirina Yu.V. Combination therapy of chronic endometritis in women with infertility and miscarriage. Diss. Tomsk; 2009. (in Russian)
17. Melkozerova O.A., Bashmakova N.V., Pogorelko D.V., Chistyakova G.N. Ultrasonic Cavitation effect on the receptor field of the endometrium: the possibility of rehabilitation after regressing pregnancy. In the book .: Proceedings VII All-Russian seminar „Reproductive potential of Russia: the version and kontraversii” (September 6-9, 2014, Sochi). 2014: 59-60. (in Russian)
18. Shishkova Yu.S., Kipriyanova I.I., Uzlova T.V., Lipskaya A.D. The antimicrobial effect of low-frequency ultrasound in the prevention of postpartum endometritis. Bulletin of South Ural State University. Series: Education, health, physical culture. 2013; 13(2): 102-4. (in Russian)
19. Glukhov E.Yu., Bogdanova A.M., Kozyireva E.N., Buchok G.Ya., Kononov Yu.V., Lokshin S.L., Pochinschikova M.S. A method of treating infertility with chronic endometritis with hypoplastic endometrium. The patent for the invention № 2571236 from 11.19.2015. Published on 20.12.2015. Bulletin number 35. (in Russian)
Received 16.12.2016
Accepted 23.12.2016
About the Authors
Bogdanova A.M., Competitor of the Department of Obstetrics and Gynecology, Ural State Medical University, Ministry of Health of Russia;Physician of the Department of General Gynecology, Central City Hospital № 7.
620028, Russia, Ekaterinburg, Repina str. 3. Tel.: +73433417409. E-mail: 79122408573@yandex.ru
Glukhov E.Yu., MD, PhD, Associate Professor, Department of Obstetrics and Gynecology, Ural State Medical University, Ministry of Health of Russia; Head Doctor of Operative Gynecology Center "Women's Clinic". 620137, Russia, Ekaterinburg, Botanicheskaya str. 19. Tel.: +73432394713. E-mail: 9222241411@mail.ru
Dikke G.B., Honored Worker of Science and Education, Ph.D., Professor, Department of Obstetrics, Gynecology and Reproductive Medicine Faculty training of health workers, Peoples’ Friendship University of Russia. 117198, Russia, Moscow, Miklukho-Maklaya str. 8. Tel.: +74954345300. E-mail: galadikke@yandex.ru
For citations: Bogdanova A.M., Glukhov E.Yu., Dikke G.B. Use of low-frequency ultrasound in the combination treatment of the hypoplastic type of chronic endometritis. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (2): 90-6. (in Russian)
http://dx.doi.org/10.18565/aig.2017.2.90-6
Similar Articles
