[The preconceptional preparation of the patients presenting with chronic endometritis: the evaluation of the effectiveness of phyto- and physiotherapy]. / Pregravidarnaia podgotovka patsientok s khronicheskim éndometritom: otsenka éffektivnosti fito- i fizioterapii.

BACKGROUND: The necessity of the comparative studies with special reference to the preconceptional preparation of the patients presenting with chronic endometritis is self-evident bearing in mind the lack of common approaches to the preconceptional preparation of the patients with this condition. AIMS: The objective of the present study was the evaluation of the effectiveness of preconceptional with the use phyto- and/or physiotherapies for the treatment of the patients suffering from chronic endometritis. MATERIAL AND METHODS: This prospective study included 309 patients from the couples in the infertile marriage attributable to chronic endometritis. All the patients were divided into three group depending on the choice of the preconceptional preparation modality. Those comprising the first group (n=148) received 2.5 mg in days the aqueous extract of one-sided-wintergreen (Orthilia secunda) at a daily dose of 2.5 mg during three months. The patients of the second group (n=101) were given the combined physiotherapeutic treatment. The patients of the third group (n=60) refused any preconceptional preparation; therefore an expectant strategy was chosen to manage them. Part of patients of the first and second groups (n=30) underwent the immunohistochemical investigation aimed at evaluation of the methods employed in this study to the solution of the infertility problem. The data obtained were treated with the use of the Statistica 11.0 software package. RESULT: The preconceptional preparation of the patients suffering infertility associated with chronic endometritis with the use of the aqueous extract of one-sided-wintergreen in the combination with physiotherapeutic treatment resulted in the development of pregnancy in 72.9% and 81.2% of the participants in the study respectively and its completion with labors in 95.3% and 90.1% of the women respectively. The results of the immunohistochemical study involving the patients treated with the aqueous extract of one-sided-wintergreen alone gave evidence of the reduced frequency of frequency of leukocytic infiltration and leukocytic activity in dynamics of an experiment (CD 20+, CD138+, CD 56+, CD 16+, HLA-DRII+); simultaneously, an augmentation of the reception of endometrium to sex steroids. CONCLUSION: The preconceptional preparation of infertile women with the application of the aqueous extracts of one-sided-wintergreen can be recommended for the patients with chronic endometritis, especially in the presence of contraindications for physiotherapy. Phytotherapy made use of in the present study restored reception of endometrium to estrogens and alleviated the autoimmune manifestations of local immunity.