Infertility against the background of chronic endometritis and vaginal dysbiosis: preimplantation preparation experience

Abstract

Introduction. Vaginal infections of nonspecific etiology caused by microbiocenosis disorder is one of the leading aspects of gynecological morbidity in recent times. According to research statistics, the incidence of such disease varies from 30 to 80% among all inflammatory lower genital tract diseases in women. Aim of the study: to present the experience of preparation for ART in patients with chronic endometritis against the background of mixed forms of vaginal dysbiosis. Material and methods. The results of treatment with a drug containing metronidazole and miconazole nitrate (vaginal suppositories once a day at bedtime for 7 days) were studied in combination with natural micronized progesterone in 36 women with infertility caused by endometrial receptivity disorder due to chronic endometritis against the background of vaginal dysbiosis, in whom pre-implantation preparation with embryo transfer was carried out after the end of the therapy. The following were used: assessment of microbiota status of urogenital tract – PCR (femoflor-16), measurement of vaginal environment pH, Hay/Ison criteria, endometrial pipelle biopsy and endometrial immunohistochemical evaluation of endometrial receptivity (LIF, LIF-R) on the 3rd and 7th days after LH peak. Conclusion. The presented experience of complex local therapy of women diagnosed with “Infertility against the background of chronic endometritis and vaginal dysbiosis“ using a drug containing metronidazole and miconazole and natural micronized progesterone in the form of vaginal gel can be useful for practicing obstetricians-gynecologists and other interested specialists.

Keywords

• vaginal dysbiosis
• chronic endometritis
• decontamination
• pre-implantation preparation
• metronidazole
• miconazole
• natural progesterone