Clinical and microbiological characteristics and features of hysteroscopic intervention in cases of infertility and intrauterine pathology
DOI:
https://doi.org/10.15574/HW.2023.169.58Keywords:
intrauterine pathology, infertility, hysteroscopy, women, pregnancy, vaginal microbiotaAbstract
This article examines the features of microbiocenosis of the vagina and endometrium in women with infertility and intrauterine pathology.
Purpose - to study the peculiarities of the spectrum of microorganisms of the vagina and endometrium in women with infertility and intrauterine pathology in order to increase the effectiveness and prevention of complications of hysteroscopic interventions in such women.
Materials and methods. An examination and dynamic observation of women was carried out for 6 months. The results of clinical-morphological, ultrasound, immunohistochemical and bacteriological monitoring are included. All patients underwent diagnostic and therapeutic hysteroscopy followed by bacteriological, morphological and immunohistochemical examination.
Results. The study of quantitative indicators and species composition of the microbial flora of the uterine endothelium in women with infertility and intrauterine pathology showed a much wider spectrum of pathogenic and opportunistic microorganisms. Among the detected microorganisms are Esherichia coli (4%), Staphylococcus aureus (6%), Streptococcus B (2%), Lactobacillus spp. (2%). In a much larger number of women, pathogens of sexually transmitted infections were noted - Chlamydia trachomatis (12%), Mycoplasma hominis (14%), Ureaplasma urealyticum (10%). Obviously, one of the causes of the inflammatory process in the endometrium of the uterus is the imbalance of the microbiocenosis. Bacteriological research data showed a significant proportion of deviations in the vaginal biocenosis in the presence of intrauterine pathology, which is manifested by a significant decrease in the frequency of excretion of the main acid-forming lactobacilli compared to healthy patients. Thus, lactobacilli (21 strains) were detected in only 23 (46%) patients of the study group at a concentration of 6.2±1.1 lg CFU/ml, while in the control group - in 17 (85%) women at an average concentration of 6.8±1.2 lg CFU/ml.
Conclusions. The obtained research results make it possible to determine the scientific position regarding the important role of an infectious factor in the development of intrauterine pathology, and the normalization of the microbiota of the genital tract is not only an important component of the treatment of hyperplastic processes, but also contributes to the prevention of possible relapses, the treatment of morphofunctional disorders in the endometrium of women with infertility.
The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the women was obtained for the research.
No conflict of interests was declared by the author.
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