Current approaches to diagnosing and treating endometrial receptor apparatus disorders in patients with recurrent implantation failures

Maslova M.A., Pavlovich S.V., Smolnikova V.Yu.

1) I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia; 2) Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Moscow, Russia
The given review analyzes the data available in the literature on the main etiological factors and pathogenetic mechanisms of endometrial susceptibility disorders in patients with recurrent implantation failures in assisted reproductive technology programs. The paper includes the publications available in the Pubmed database (https://pubmed.ncbi.nlm.nih.gov/) on this topic. It gives information on modern molecular genetic methods for determining the personalized window of implantation and for correcting the timing of embryo transfer, for identifying the pathogenic microorganisms that cause chronic endometritis, and for analyzing the species and quantitative composition of the endometrial microbiota. It summarizes the results of the most effective methods of immunotherapy, which are aimed at improving the receptive properties of the endometrium, by using platelet-rich plasma, mononuclear cells, granulocyte-stimulating factor, growth hormone, and the drugs dexamethasone and letrozole. The paper reflects the expediency of etiotropic antibacterial therapy in patients with chronic endometritis and recurrent implantation failures at the stage of preparation for assisted reproductive technology programs. It shows an association between endometrial scratching and improved reproductive outcomes in patients with recurrent implantation failures. Special attention in overcoming infertility is paid to the possibilities of cell therapy using mesenchymal stem cells in women with Asherman’s syndrome and endometrial hypoplasia.
Conclusion. Patients with multiple implantation failures in assisted reproductive technology programs require the in-depth diagnosis of the endometrial receptor apparatus and the application of personalized approach to preparing the endometrium.

Keywords

assisted reproductive technologies
endometrial receptivity
recurrent implantation failures
chronic endometritis
endometrial microbiota
immunotherapy
mesenchymal stem cells
scratching

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Received 02.10.2020

Accepted 08.12.2020

About the Authors

Maya M. Maslova, MD, PhD, Department of Obstetrics, Gynecology, Perinatology and Reproductology, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University). Tel.: +7(495)438-24-00. E-mail: mayay2012@mail.ru. 119435, Russia, Moscow, Bolshaya Pirogovskaya str., 2-4.
Veronika Yu. Smolnikova, MD, PhD, leading researcher, Department of assistive reproductive technology in the treatment of infertility, Academician V.I. Kulakov National Medical Recearch Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia. Tel.: +7(495)531-44-44. E-mail: veronika.smolnikova@mail.ru.
117997, Russia, Moscow, Ac. Oparina str., 4.
Stanislav V. Pavlovich, MD, Academic Secretary, Academician V.I. Kulakov National Medical Recearch Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; Professor of the Department of Obstetrics, Gynecology, Perinatology and Reproductology, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University). Теl.: +7(495)438-20-88. Е-mail: s_pavlovich@oparina4.ru.
117997, Russia, Moscow, Ac. Oparina str., 4; 119435, Russia, Moscow, Bolshaya Pirogovskaya str., 2-4.

For citation: Maslova M.A., Pavlovich S.V., Smolnikova V.Yu. Current approaches to diagnosing and treating endometrial receptor apparatus disorders in patients with recurrent implantation failures.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 3: 26-35 (in Russian)
https://dx.doi.org/10.18565/aig.2021.3.26-35

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