Ultrasound assessment of the effect of chronic endometritis treatment
Ozerskaya I.A., Kazaryan G.G., Gus A.I.
Objective: To assess the dynamics of echographic changes in the endometrium in patients receiving complex treatment for chronic endometritis using cytokine therapy.
Materials and methods: This was a retrospective analysis of 298 reproductive-aged women diagnosed with chronic endometritis. The main group consisted of 140 patients who received standard anti-inflammatory treatment supplemented with cytokine therapy. The comparison group included 158 women who were treated with a similar complex but they did not receive cytokine therapy. There was an assessment of the ultrasound parameters which were used for ultrasound diagnosis of chronic endometritis.
Results: After therapy there was a statistically significant decrease (p<0.05) in the thickness and volume of the endometrium, as well as a decrease in the frequency of detection of most ultrasound signs of chronic endometritis. The disappearance of fluid and gas bubbles from the uterine cavity turned out to be the most pronounced effect of the treatment. The echogenicity of the endometrium and its heterogeneous structure did not change much (p>0.05).
Conclusion: The use of cytokine therapy in the complex treatment of chronic endometritis makes it possible to bring the ultrasound criteria closer to the standard parameters; the changes in the criteria indicate the partial restoration of the endometrium.
Authors’ contributions: Ozerskaya I.A. – developing the concept and design of the study, statistical data processing, supervising research, editing the text; Kazaryan G.G. – searching for literary sources, collecting and analyzing data, writing the article; Gus A.I. – developing the concept of the study, editing the article.
Conflicts of interest: The authors declare no possible conflicts of interest.
Funding: The study was conducted without sponsorship.
Ethical Approval: The study was approved by the Ethical Review Board of the Peoples’ Friendship University of 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 I.A. Ozerskaya.
For citation: Ozerskaya I.A., Kazaryan G.G., Gus A.I.
Ultrasound assessment of the effect of chronic endometritis treatment.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (4): 132-138 (in Russian)
https://dx.doi.org/10.18565/aig.2024.40
Keywords
ultrasound diagnosis
chronic endometritis
exogenous cytokine therapy
References
- Оразов М.Р., Михалева Л.М., Семенов П.А., Орехов Р.Е., Лагутина Е.В. Эффективность лечения хронического эндометрита у женщин с неудачами имплантации в анамнезе. Трудный пациент. 2020; 18 (8-9): 7-12. [Orazov M.R., Mikhaleva L.M., Semenov P.A., Orekhov R.E., Lagutina E.V. The effectiveness of treatment of chronic endometritis in women with a history of implantation failure. Difficult patient. 2020; 18 (8-9): 7-12. (in Russian)]. https://dx.doi.org/10.24411/2074-1995-2020-10053.
- Puente E., Alonso L., Lagana A.S., Ghezzi F., Casarin J., Carugno J. Chronic endometritis: old problem, novel insights and future challenges. Int. J. Fertil. Steril. 2020; 13(4): 250-6. https://dx.doi.org/10.22074/ijfs.2020.5779.
- Зароченцева Н.В., Аршакян А.К., Меньшикова Н.С., Титченко Ю.П. Хронический эндометрит: этиология, клиника, диагностика, лечение. Российский вестник акушера-гинеколога. 2013; 13(5): 21-7. [Zarochentseva N.V., Arshakyan A.K., Menshikova N.S., Titchenko Yu.P. Chronic endometritis: etiology, clinical picture, diagnosis, treatment. Russian Bulletin of Obstetrician-Gynecologist. 2013; 13(5): 21-7. (in Russian)].
- Kimura F., Takebayashi A., Ishida M., Nakamura A., Kitazawa J., Morimune A. et al. Review: Chronic endometritis and its effect on reproduction. J. Obstet. Gynaecol. Res. 2019; 45(5): 951-60. https://dx.doi.org/10.1111/jog.13937.
- Радзинский В.Е., Оразов М.Р., Токтар Л.Р. Михалева Л.М., Семенов П.А., Орехов Р.Е. и др. Эффект «разбросанных пазлов»: имплантационные нарушения при хроническом эндометрите. Гинекология. 2020; 22(6): 24-31. [Radzinsky V.E., Orazov M.R., Toktar L.R., Mikhaleva L.M., Semenov P.A., Orekhov R.E. et al. The effect of “scattered puzzles”: implantation disorders in chronic endometritis. Gynecology. 2020; 22(6): 24-31. (in Russian)]. https://dx.doi.org/10.26442/20795696.2020.6.200493.
- Краснопольский В.И., Буянова С.Н., Щукина Н.А. Гнойная гинекология. М.: МЕДпресс; 2001. 288с. [Krasnopolsky V.I., Buyanova S.N., Shchukina N.A. Purulent gynecology. Moscow: MEDpress; 2001. 288 p. (in Russian)].
- Прошин С.Н., Глушаков Р.И., Семенова И.В., Воробцова И.Н., СайковскаяЛ.А., Тапильская Н.И. Клинико-иммунологические критерии эффективности нуклеоспермата натрия в лечении хронического эндометрита у пациенток с бесплодием и папилломавирусной инфекцией. Экспериментальная и клиническая фармакология. 2013; 76(3): 27-30. [Proshin S.N., Glushakov R.I., Semenova I.V., Vorobtsova I.N., Saykovskaya L.A., Tapilskaya N.I. Clinical and immunological criteria for the effectiveness of sodium nucleospermate in the treatment of chronic endometritis in patients with infertility and human papillomavirus infection. Experimental and Clinical Pharmacology. 2013; 76(3): 27-30. (in Russian)]. https://dx.doi.org/10.30906/0869-2092-2013-76-3-27-30.
- Espinoza J., Erez O., Romero R. Preconceptional antibiotic treatment to prevent preterm birth in women with a previous preterm delivery. Am. J. Obstet. Gynecol. 2006; 194(3): 630-7. https://dx.doi.org/10.1016/j.ajog.2005.11.050.
- Краснопольская К.В., Оразов М.Э, Ершова И.Ю., Федоров А.А. Тонкий эндометрий и бесплодие. 2-е изд. М.: ГЕОТАР-Медиа; 2022. 208с. [Krasnopolskaya K.V., Orazov M.E., Ershova I.Yu., Fedorov A.A. Thin endometrium and infertility. 2nd ed. Moscow: GEOTAR-Media; 2022. 208 p. (in Russian)]. https://dx.doi.org/10.33029/9704-6559-2-TEI-2022-1-208.
- Kitaya K., Matsubayashi H., Yamaguchi K., Nishiyama R., Takaya Y., Ishikawa T. et al. Chronic endometritis: potential cause of infertility and obstetric and neonatal complications. Am. J. Reprod. Immunol. 2016; 75(1): 3-22. https://dx.doi.org/10.1111/aji.12438.
- Cicinelli E., Tinelli R., Lepera A., Pinto V., Fucci M., Resta L. Correspondence between hysteroscopic and histologic findings in women with chronic endometritis. Acta Obstet. Gynecol. Scand. 2010; 89(8): 1061-5. https://dx.doi.org/10.3109/00016349.2010.498496.
- Cicinelli E., Vitagliano A., Kumar A., Lasmar R.B., Bettocchi S., Haimovich S.; International Working Group for Standardization of Chronic Endometritis Diagnosis. Unified diagnostic criteria for chronic endometritis at fluid hysteroscopy: proposal and reliability evaluation through an international randomized-controlled observer study. Fertil. Steril. 2019; 112(1): 162-73e2. https://dx.doi.org/10.1016/j.fertnstert. 2019.03.004.
- Vitagliano A., Saccardi C., Litta P.S., Noventa M. Chronic endometritis: really so relevant in repeated IVF failure? Am. J. Reprod. Immunol. 2017; 78(6). https://dx.doi.org/10.1111/aji.12758.
- Дикке Г.Б., Суханов А.А., Остроменский В.В., Кукарская И.И. Течение и исходы беременности у пациенток с хроническим эндометритом и нарушением репродуктивной функции, получавших комплексное лечение с использованием препарата «Суперлимф» (рандомизированное контролируемое испытание в параллельных группах «ТЮЛЬПАН»). Акушерство и гинекология. 2023; 4: 132-44. [Dikke G.B., Sukhanov A.A., Ostromensky V.V., Kukarskaya I.I. Course and outcomes of pregnancy in patients with chronic endometritis and impaired reproductive function after receiving complex treatment with drug Superlymph: randomized control trial in parallel groups “TULIP”. Obstetrics and Gynecology. 2023; (4): 132-44. (in Russian)]. https://dx.doi.org/10.18565/aig.2023.74.
- Доброхотова Ю.Э., Боровкова Е.И., Нугуманова О.Р. Улучшение процессов ангиогенеза и репродуктивных исходов у пациенток с хроническим эндометритом. Акушерство и гинекология. 2021; 3: 145-52. [Dobrokhotova Yu.E., Borovkova E.I., Nugumanova O.R. Improvement of angiogenesis and reproductive outcomes in patients with chronic endometritis. Obstetrics and Gynecology. 2021; (3): 145-52. (in Russian)]. https://dx.doi.org/10.18565/aig.2021.3.145-152.
- Дикке Г.Б., Остроменский В.В. Нарушение иммунного статуса при хроническом эндометрите и опыт его коррекции посредством локальной цитокинотерапии. Акушерство и гинекология. 2019; 9: 139-46. [Dikke G.B., Ostromensky V.V. Immune dysfunction in chronic endometritis and the experience of its correction using local cytokine therapy. Obstetrics and Gynecology. 2019; (9): 139-46. (in Russian)]. https://dx.doi.org/10.18565/aig.2019.9.139-146.
- Кореева Н.В., Доброхотова Ю.Э. Локальная цитокинотерапия в гинекологической практике (обзор литературы). Проблемы репродукции. 2013; 4: 21-6. [Koreeva N.V., Dobrokhotova Iu.É. Topical cytokinotherapy in gynecological practice (a review). Russian Journal of Human Reproduction. 2013; (4): 21‑6. (in Russian)].
- Доброхотова Ю.Э., Ганковская Л.В., Боровкова Е.И., Зайдиева З.С., Скальная В.С. Модулирование локальной экспрессии факторов врожденного иммунитета у пациенток с хроническим эндометритом и бесплодием. Акушерство и гинекология. 2019; 5: 125-32. [Dobrokhotova Yu.E., Gankovskaya L.V., Borovkova E.I., Zaidieva Z.S., Skalnaya V.S. Modulation of the local expression of innate immune factors in patients with chronic endometritis and infertility. Obstetrics and Gynecology. 2019; (5): 125-32. (in Russian)]. https://dx.doi.org/10.18565/aig.2019.5.125-132.
- Martins R.S., Oliani A.H., Oliani D.V., de Oliveira J.M. Continuous endometrial volumetric analysis for endometrial receptivity assessment on assisted reproductive technology cycles. BMC Pregnancy Childbirth. 2020; 20(1): 663. https://dx.doi.org/10.1186/s12884-020-03372-2.
- A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. URL https://www.R-project.org/.
- Cicinelli E., Vitagliano A., Loizzi V., De Ziegler D., Fanelli M., Bettocchi S. et al. Altered gene expression encoding cytochines, grow factors and cell cycle regulators in the endometrium of women with chronic endometritis. Diagnostics (Basel). 2021; 11(3): 471. https://dx.doi.org/10.3390/diagnostics11030471.
- Демидов В.Н., Гус А.И. Патология полости матки и эндометрия. ВМК. Практическое пособие. Выпуск третий. М.; 2001. 138 с. [Demidov V.N., Gus A.I. Pathology of the uterine cavity and endometrium. IUC. Practical guide. Issue three. Moscow; 2001. 138 p. (in Russian)].
- Доброхотова Ю.Э., Ганковская Л.В., Боровкова Е.И., Нугуманова О.Р. Экзогенная цитокинотерапия в лечении пациенток с хроническим эндометритом. Акушерство и гинекология. 2021; 2: 119-26. [Dobrokhotova Yu.E., Gankovskaya L.V., Borovkova E.I., Nugumanova O.R. Exogenous cytokine therapy in the treatment of patients with chronic endometritis. Obstetrics and Gynecology. 2021; (2): 119-26. (in Russian)]. https://dx.doi.org/10.18565/aig.2021.2.119-126.
- Толибова Г.Х., Траль Т.Г., Коган И.Ю., Олина А.А. Эндометрий. Атлас. М.: Редакция журнала StatusPraesens; 2022. 184 с. [Tolibova G.Kh., Tral T.G., Kogan I.Yu., Olina A.A. Endometrium. Atlas. Moscow: StatusPraesens; 2022. 184 p. (in Russian)].
Received 27.02.2024
Accepted 04.04.2024
About the Authors
Irina A. Ozerskaya, Dr. Med. Sci., Professor, Department of Ultrasound Diagnostics, RUDN University, 117198, Russia, Moscow, Miklukho-Maklaya str., 6, +7(499)936-87-87, ozerskaya_usd@mail.ru, https://orcid.org/0000-0001-8929-6001Gayane G. Kazaryan, PhD, Ultrasound Diagnostics Doctor, Medscan, 119421, Russia, Moscow, Obrucheva str., 21A, +7(495)859-29-45, 79165521271@yandex.ru,
https://orcid.org/0000-0002-1198-8187
Alexander I. Gus, Dr. Med. Sci., Professor, Chief Researcher, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str., 4; Head of the Department of Ultrasound Diagnostics, RUDN University,
https://orcid.org/0000-0003-1377-3128
Corresponding author: Irina A. Ozerskaya, ozerskaya_usd@mail.ru
Similar Articles
