Volume 6, Issue 4, July 2018, Page: 98-107
The Efficiency of Intrauterine Irrigation of the Cavitated Drug Solutes in Patients with Endometrial Receptivity Disorders
Oxana Alexandrovna Melkozerova, Ural Research Institute of Maternity and Child Care Russian Ministry of Health, Ekaterinburg, Russia
Evgeniy Yuryevich Gluchov, Ural State Medical University Russian Ministry of Health, Ekaterinburg, Russia
Nadezda Vasilyevna Bashmakova, Ural Research Institute of Maternity and Child Care Russian Ministry of Health, Ekaterinburg, Russia
Guzel Nuchovna Chistyakova, Ural Research Institute of Maternity and Child Care Russian Ministry of Health, Ekaterinburg, Russia
Alena Valeryevna Lvova, Ural Research Institute of Maternity and Child Care Russian Ministry of Health, Ekaterinburg, Russia
Anna Michaylovna Bogdanova, Ural State Medical University Russian Ministry of Health, Ekaterinburg, Russia
Aigul Adipovna Giniyatova, Ural Research Institute of Maternity and Child Care Russian Ministry of Health, Ekaterinburg, Russia
Olga Germanovna Barlit, Ural State Medical University Russian Ministry of Health, Ekaterinburg, Russia
Received: Jun. 6, 2018;       Accepted: Jul. 12, 2018;       Published: Sep. 17, 2018
DOI: 10.11648/j.jgo.20180604.15      View  301      Downloads  12
Abstract
Evaluate the efficiency of intrauterine irrigation of cavitated low-frequency sonication drug solution in restoring of endometrial receptivity in patients with uterine infertility. 92 women with uterine infertility due to endometrial hypoplasia were examined in the dynamics of therapy including irrigation of the uterine cavity with cavitated low-frequency ultrasound with drug solutions. The control group consisted of 28 healthy fertile women. An ultrasound examination of the pelvic organs with color dopplerogragy, histological and immunohistochemical study of the endometrium was performed on the "implantation window" LH + 7, in dynamics before the start of therapy and in the next cycle after the end of treatment. After cavitation irrigation of the uterine cavity, 62 (67.39%) women with infertility in the endometrial specimens had adequate vascularization of the stroma (before treatment, 36.95%, p=0.017, in control 78.57%), in 68 (73, 91%) women - a decrease in the density of the stromal matrix, in 64 (69.56%) - according to light microscopy data, mature pinopodia were determined (initially 28.26%, p=0.0015). On the background of therapy, the ratio of ERα / PR expression in the stroma of the implantation endometrium was normalized, which was characterized by the prevalence of the PR pool (1.01±0.34 before treatment, 0.36 ± 0.03 after therapy, p = 0.040, in control 0.34±0.06, p> 0.05). The parameters of stromal expression of natural uterine killers CD56 + bright against the background of treatment in patients with infertility come in accordance with the indices of healthy fertile women (from 35.21 ± 2.14 cells in l/s to 45.75±3.18 cells l/s; in the control 47.8±2.13 cells in l/s; p> 0.05). A significant decrease in stromal expression of CD3+ is noted: 78.17±6.89 cells in l/s versus 23.83±3.63 cells in l/s; p=0.004. The expression level of CD34 in the endometrial stroma after the treatment was significantly increased (20.88±0.77 cells in l/s versus 33.83±3.63 cells in l/s, p=0.035). The use of G-CSF cavitaion solutions for irrigation of the uterine cavity appears to be effective in restoring tissue and molecular endometrial receptivity in patients with uterine infertility due to endometrial hypoplasia.
Keywords
Uterine Infertility, Endometrial Hypoplasia, Cavitation Irrigation of Uterine Cavity, Granulocyte Colony-Stimulating Factor
To cite this article
Oxana Alexandrovna Melkozerova, Evgeniy Yuryevich Gluchov, Nadezda Vasilyevna Bashmakova, Guzel Nuchovna Chistyakova, Alena Valeryevna Lvova, Anna Michaylovna Bogdanova, Aigul Adipovna Giniyatova, Olga Germanovna Barlit, The Efficiency of Intrauterine Irrigation of the Cavitated Drug Solutes in Patients with Endometrial Receptivity Disorders, Journal of Gynecology and Obstetrics. Vol. 6, No. 4, 2018, pp. 98-107. doi: 10.11648/j.jgo.20180604.15
Copyright
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
The European health report 2015. Targets and beyond – reaching new frontiers in evidence. Copenhagen: WHO Regional Office for Europe. 2015. Accessed July 08. 2018. http://www.euro.who.int/en/data-andevidence
[2]
Health-2020: a European policy framework and strategy for the 21st century. Copenhagen: WHO Regional Office for Europe; 2013. Accessed July 08. 2018. http://www.euro.who.int/en/publications/abstracts/health-2020-a-european-policy-framework-and-strategy-for-the-21stcentury
[3]
Ermolenko. K. S. Radzinskij V. E. Rapoport S. I. The current state of the problem of the realization of the fertile function of women of late reproductive age. [Klinicheskaya medicina]. 2016; 94(1):10-15. (In Russ.). Accessed July 08. 2018. http://www.medlit.ru/journalsview/clinicalmedicine/view/journal/2016/issue-1/69-sovremennoe-sostoyanie-problemy-realizacii-fertil-noy-funkcii-zhenschin-pozdnego-reproduktivnogo-vozrasta
[4]
Register ART RAHR. Report for 2016. SP-b; 2017. (in Russ.). Accessed July 08. 2018. http://www.rahr.ru/d_registr_otchet/registr_BRT_RARCH16.pdf
[5]
Valdes CT. Schutt A. Simon C. Implantation failure of endometrial origin: it is not pathology. but our failure to synchronize the developing embryo with a receptive endometrium. Fertil Steril. 2017 Jul; 108(1):15-18. https://doi.org/10.1016/j.fertnstert.2017.05.033
[6]
Boyarskij K. YU. Gajdukov S. N. Pal'chenko N. A. Modern view on the problem of receptivity and thin endometrium in ART programs. Literature review. [Problemy reprodukcii]. 2013; 4:3-7. (in Russ.). Accessed July 08. 2018. https://www.mediasphera.ru/issues/problemy-reproduktsii/2013/4/031025-72172013411
[7]
Uterine Endometrial Function. Editor of H. Kanzaki. Osaka: Springer; 2017.
[8]
Molecular mechanisms of the reproductive system diseases. Editor of M. A. Pal'cev. SPb.: Eko-vektor; 2017. (in Russ.).
[9]
Pregravid preparation: the clinical protocol. Editor of V.E. Radzinskij. М.: Status Praesens; 2016: 23-25. (in Russ.). Accessed July 08. 2018. https://praesens.ru/pregravidarnaya-podgotovka-klinicheskiy-protokol-mezhdistsiplinarnoy-assotsiatsii-spetsialistov-repr
[10]
Krylova YU. M. Kvetnoj I. M. Ajlamazyan Eh.K. Receptivity of the endometrium: molecular mechanisms of regulation of implantation. [Zhurnal akusherstva i zhenskih boleznej]. 2013; 2: 63-74. https://doi.org/10.17816/JOWD663135-142
[11]
Li Z. L. Ueki K. Kumagai K. Regulation of bcl-2 transcription by estrogen receptor-alpha and C-Jun in human endometrium. Med. Mol. Morphol. 2014; 47(1): 43-53. https://doi.10.1007/s00795-013-0043-y
[12]
Ogata T. Ito K. Shindo T. Hatanaka K. Eguchi K. Kurosawa R. Kagaya Y. Monma Y. Ichijo S. Taki H. Kanai H. Shimokawa H. Low-intensity pulsed ultrasound enhances angiogenesis and ameliorates contractile dysfunction of pressure-overloaded heart in mice. PLoS One. 2017; 12(9):e0185555. https://doi.org/10.1371/journal.pone.0185555
[13]
Wu S. Xu X. Sun J. Zhang Y. Shi J. Xu T. Low-Intensity Pulsed Ultrasound Accelerates Traumatic Vertebral Fracture Healing by Coupling Proliferation of Type H Microvessels. J Ultrasound Med. 2018 Jan 24. https://doi.org/10.1002/jum.14525
[14]
Bogdanova AM. Glukhov E.Yu. Dicke G.B. Application of low-frequency ultrasound in the complex treatment of the hypoplastic variant of chronic endometritis. Obstetrics and gynecology. 2017; 2: 90-6. https://dx.doi.org/10.18565/aig.2017.2.90-6
[15]
Altland O.D. Dalecki D. Suchkova V.N. Low-intensity ultrasound increases endothelial cell nitric oxide syntase activity and nitric oxide synthesis. J. Thromb. Haemost. 2004; 2:637–643. https://doi.org/10.1111/j.1538-7836.2004.00655.x
[16]
Hanawa K. Ito K. Aizawa K. Low-intensity pulsed ultrasound induces angiogenesis and ameliorates left ventricular dysfunction in a porcine model of chronic myocardial ischemia. PLoS One. 2014; (9):8:104-863. https://doi.org/10.1371/journal.pone.0104863. eCollection 2014.
[17]
Shindo T. Ito K. Ogata T. Low-Intensity Pulsed Ultrasound Enhances Angiogenesis and Ameliorates Left Ventricular Dysfunction in a Mouse Model of Acute Myocardial Infarction. Arterioscler. Thromb. Vasc. Biol. 2016; (36):6:1220-1229. https://doi.org/10.1161/ATVBAHA.115.306477
[18]
Huang J. I. A. Shi Y. O. Li R. L. Angiogenesis effect of therapeutic ultrasound on HUVECs through activation of the PI3K-Akt-eNOS signal pathway. Am. J. Transl. Res. 2015; (7):6:1106-1115. Accessed July 08. 2018. http://www.ajtr.org/files/ajtr0004723.pdf
[19]
Cleicher N. Vidali A. Barad D.H. Successful treatment of unreceptive thin endometrium. Fertill Sterill. 2011; (95):6:2123-2137. https://doi.org/10.1093/humrep/des370
[20]
Jerman L. F. Hey-Cunningham A. The role of the lymphatic system in endometriosis: a comprehensive review of the literature. J. Biol. Reprod. 2015; (92):3:64-66. https://doi.org/10.1095/biolreprod.114.124313
[21]
Koukourakis M. I. Giatromanolaki A. Sivridis E. LYVE-1 immunohistochemical assessment of lymphangiogenesis in endometrial and lung cancer. J. Clin. Pathol. 2015; (58):2:202-206. https://doi.org/10.1136/jcp.2004.019174
[22]
Uterine Endometrial Function / Editor of H. Kanzaki. Osaka: Springer. 2017; 155 р. Accessed July 08. 2018. https://www.springer.com/gp/book/9784431559702
[23]
Simón C. Giudice LC. The Endometrial Factor: A Reproductive Precision Medicine Approach. CRC Press. Apr 27. 2017. Accessed July 08. 2018. https://www.crcpress.com/The-Essential-Endometrium-Handbook-Current-Applications-in-Clinical-Medicine/Simon-Giudice/p/book/9781498740395
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