Unit:
Κατεύθυνση Αναπαραγωγική-Αναγεννητική ΙατρικήLibrary of the School of Health Sciences
Author:
Mitrousi Aikaterini
Supervisors info:
Δρακάκης Πέτρος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Στεφανίδης Κωνσταντίνος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μαυρογιάννη Δέσποινα, Ε.ΔΙ.Π., Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Ανίχνευση μολυσματικών παραγόντων στο ενδομήτριο γυναικών με υπογονιμότητα και μελέτη του οφέλους μετά από στοχευμένη αντιβιοτική αγωγή
Translated title:
Detection of infectious factors in the endometrium of infertile women and study of the benefit after targeted antibiotic treatment
Summary:
INTRODUCTION: In recent years there has been a significant scientific interest in the exclusion of infectious agents in the endometrium of infertile women. The endometrium, being inextricably linked to implantation, has been systematically investigated for polyps, fibroids and adhesions, considering the above as the only factors preventing the implantation of a fetus. It has been observed, however, that micro-organisms succeed in penetrating the uterus creating chronic endometritis and thus, an inhospitable environment for the fetus, which often fail to be detected by cultures of vaginal and cervical fluid. The purpose of the current research study was to investigate the presence or not of infectious agents in the endometrium of infertile women and to record the births of live neonates after targeted antibiotic treatment.
MATERIALS AND METHODS: The study involved 45 women, aged from 27 to 49 years old, who came to a gynecological clinic in order to investigate infertility. Endometrial tissue was obtained in all women with a disposable endometrial pipelle after the end of menstruation, which was later subjected to histological examination and culture. Some of the participants underwent diagnostic hysteroscopy, vaginal fluid culture, and sperm culture of the partner. Targeted antibiotic treatment, either monotherapy or combined, was given to all women with positive endometrial tissue culture and to some with suspected endometritis.
RESULTS: Of the 45 women, 21 (46.7%) were found to have positive endometrial tissue culture and received antibiotic treatment. Of the remaining 24 with negative culture, 15 were treated with antibiotics for suspected hidden microbial infection. Seven births (7) of live neonates were recorded from a total of 36 women treated with antibiotics. The 3 newborns belonged to women with automatic conception (15) and the 4 newborns to women with in vitro fertilization (17). No live births were observed in the remaining women (4) who had underwent insemination. Statistical analysis showed no statistically significant correlation between antibiotic treatment and live birth (p=0.732).
CONCLUSIONS: A large percentage of infertile women may possibly have endometrial infection and may achieve childbirth after antibiotic treatment. Because infertility is multifactorial, it is likely that some women eliminated the endometrial microbial agent but did not acquire an offspring due to another unexplained or undiagnosed infertility factor. More studies are needed, with a larger sample of patients and a smaller diversity of cases to demonstrate the potential benefit of antibiotic treatment to infertile women with microbial agent in the endometrium.
Main subject category:
Health Sciences
Keywords:
Chronic endometritis, Endometrium, Infertility, Endometrial tissue culture, Repeated implantation failures
Number of references:
127
