Significance of endometrial dysfunction markers in the pathogenesis of chronic endometritis in women with reproductive losses

Abstract

Introduction. A review of the literature considering the problem of reproductive health against the background of chronic endometritis is presented. According to the literature, in the etiology and pathogenesis of infertility and habitual miscarriage, the main cause is the «uterine factor» (24-62%). Chronic inflammation in the uterine mucosa can lead to infertility, which increases the significance of this pathology. It is proved that most often the causative agents of this disease are representatives of conditionally pathogenic microflora. Chronic endometritis is an unexplored pathology associated with unfavorable reproductive outcomes, such as unsuccessful implantation and repeated miscarriage. Most scientists assume that inflammation develops against the background of a long-term persistence of an infectious agent. According to other scientists, the cause of the occurrence and development of chronic endometritis is an autoimmune process that contributes to the progression of inflammation. The article describes the mechanisms of impaired receptivity, endometrial microcirculation and changes in the ratio of cells of the immune system. In this article, we aim to give an overview of the diagnosis, etiology, pathophysiology and treatment of chronic endometritis, its effect on endometrial receptivity and its relationship with reproductive dysfunction.The aim of the study is to identify the main discussed aspects of the management of patients with chronic endometritis, to determine promising diagnostic methods.Materials and methods. The analysis and systematization of the data were carried out on the basis of scientific publications in the common database of Cyberleninka and PubMed.Results and Discussions. The article discusses the methods of laboratory, ultrasound and instrumental diagnostics used in Russia and abroad. The» gold standard « of diagnostics is a histological examination of the endometrial tissue material on the 7th10th day of the menstrual cycle. The article describes the mechanisms of impaired receptivity, endometrial microcirculation and changes in the ratio of cells of the immune system.Conclusion. Chronic endometritis remains an important problem in modern society, as it has a social significance: the frequency of reproductive losses is at a high level. There is a need to further study the features of the etiology and pathogenesis of chronic endometritis in order to improve the presentation of the course of the inflammatory process and improve the methods of therapy and prevention of this disease for the realization of reproductive function.