Modern options of pre-conception preparation in patients with infertility due to chronic endometritis, cervicitis and concomitant urological pathology: a clinical analysis

Аim. To study the interdisciplinary approach to verifying the diagnosis and conducting pre-conception preparation in patients with inflammatory infertility. Design. Prospective comparative study. Materials and methods. A prospective observation of two patients suffering from infertility caused by a combination of several nosological forms of infectious pathology (endometritis, cervicitis, lower urinary tract infection) was conducted. The examination included the use of bacterioscopic, bacteriological studies (aspiration biopsy of the endometrium), the method of polymerase chain reaction in real time (Femoflor 16 and Femoflor Screen); ultrasound examination of the pelvic organs; morphological study using the immunohistochemical method. A comparative analysis of the effectiveness of examination and pre-gravid preparation was conducted. Results. To fully verify the diagnosis and identify the cause of infertility, it was necessary to conduct examination and treatment of patients by a urologist, followed by pre-gravid preparation, which included three stages: antimicrobial, hormonal therapy; plasma therapy, physiotherapy; assisted reproductive technologies. After each stage, an examination was performed to assess the effectiveness of treatment. The duration of the total course of treatment was 4.5 months. An adequate approach to pre-gravid preparation allowed each patient to carry a pregnancy to term, which ended in timely delivery. Conclusion. The presented clinical analysis of the interdisciplinary approach to the management of patients with infertility shows that when verifying the diagnosis, it is necessary to take into account all nosological forms that are the causes of infertility of inflammatory genesis. The choice of effective therapy prescribed in accordance with the results of the comprehensive examination allows for the rehabilitation of the identified dysfunction of the reproductive system and the restoration of fertility in patients with infertility. Keywords: chronic endometritis, infertility, inflammatory diseases of the pelvic organs, chronic cystitis, chronic pyelonephritis, cervicitis, PRP therapy, combined broad-spectrum antibiotics, assisted reproductive technologies, pre-conception preparation.