Abstract
Aim: to evaluate the efficacy concerning the combined use of a complex including antimicrobial peptides and cytokines and a natural direct oral anticoagulant in female patients with endometriosis-associated infertility in the setting of thin endometrium Patients and Methods: the article presents a conducted comparative study. The main group (n=25) included therapeutic and restorative measures using a drug containing the complex of antimicrobial peptides and cytokines (vaginal suppositories 25U vaginally and rectally, alternating, for 40 days) in combination with natural direct oral anticoagulant (2 capsules per os, 3 times daily, for 20 days). Before the therapy initiation and 3 menstrual cycles after the treatment, biomarker levels in menstruation (proinflammatory cytokine IL-6), endometrial thickness (endometrial echo parameter) were measured in the main group, where its echostructure, hysteroscopy and optical spectroscopy data were also evaluated. The follow-up was lasting for 6 months after the treatment. The analysis and comparison of reproductive outcomes were conducted in the main group receiving the studied drugs and in the retrospective comparison group (n=56), which received traditional cyclic hormone therapy and a course of systemic magnet therapy Results: after the treatment course in the main group, there was a tendency to the IL-6 increase in menstrualtion, an increase in endometrial thickness (endometrial echo) to optimal values, as well as an increase in the parameters of endometrial oxygen consumption and its proliferative ability according to optical spectroscopy. In the main group who received the studied drugs, pregnancy occurred in 44±7.9% of cases, whereas in the comparison group — in 38±5.9% (p=0.2). Conclusion: the article has shown the combined use efficacy of drugs with antimicrobial peptides, cytokines and the natural direct oral anticoagulant in the treatment of endometriosis-associated infertility in the setting of thin endometrium. An increase in the IL-6 level in menstruation of the main group may indicate an inflammatory response activation from the endometrium ("cure through exacerbation"). It is necessary to continue research with a larger sample of patients and an assessment of additional parameters (microcirculation, tissue sensitivity) that characterize other links in the pathogenesis of endometriosis KEYWORDS: thin endometrium, endometriosis-associated infertility, menstruation biomarkers, diagnostic ultrasound, optical spectroscopy, complex of antimicrobial peptides and cytokines, natural direct oral anticoagulants. FOR CITATION: Motovilova T.M., Simakova V.Yu., Kachalina T.S., Borovkova L.V., Ponomareva I.V., Martiantseva I.V., Kruglova I.A., Lazukin V.F., Bogomolova M.D., Kazarinova D.A. The effectiveness of combination therapy with a complex of antimicrobial peptides and cytokines and a natural direct-acting anticoagulant in patients with endometrial infertility: first results of a comparative study. Russian Journal of Woman and Child Health. 2024;7(2):155–162 (in Russ.). DOI: 10.32364/2618-8430-2024-7-2-11.
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