Роль мікст-інфекції при патологічних процесах залозистого епітелію статевих органів з атипією клітин неясного генезу у жінок з безплідністю

Abstract

The objective: In purpose to study the biocenosis and infectious agents of the urogenital tract in women with infertility combined with pathological processes of epithelium of the genitals with atypia of cells of unclear genesis. Matirials and methods. 148 women with infertility and pathological processes of epithelium of the genitals with atypia of cells of unclear genesis were examined. The control group included 80 women with infertil. All patients underwent cytological, bacterioscopic, bacteriological examination and polymerase chain reaction to diagnose urogenital tract infections. Results. Dysbiosis of the microflora of the vagina was observed in women with infertility and the presence of pathological processes of the glandular epithelium of the genitals with atypia of cells of unclear genesis. Sexually transmitted infections are reported in 60.1% of patients. In the structure of sexually transmitted infections, prevailed mixed infections (mycoplasmosis associated with ureaplasmosis – 24.3%, and chlamydia with ureaplasmosis – 4.7%) and mono-infections (ureaplasmosis – 10.8%, mycoplasmosis – 13.5%, chlamydia – 4.7%). In 21.3% of cases was detected an association of human papillomavirus with sexually transmitted infections and vaginal dysbiosis. In most cases were observed highly oncogenic types of human papilloma virus, in particular, 18 type and similar types – 19.6%, 16 type and similar types – 8.8% and 45 type and similar types – 15.5%. Conclusion. Due to the prevalence of fungi of the genus Candida, aerobic and anaerobic flora there is a violation of vaginal biocenosis in patients with infertility combined with pathological processes of the glandular epithelium of the genitals with atypia of cells of unclear genesis. Among the sexually transmitted infections are the most common mixed infection of M. genitalium + U. urealyticum and M. hominis + U. urealyticum, as well as mono-infection with urea-micoplasmosis and chlamydia. HPV is 6.2 times more higher than in the comparison group. Highly oncogenic types of HPV were detected in the structure of virus types with a significant difference, in particular, 18 type and similar types, 16 types and similar types. 45 type was determined only in patients with infertility combined with pathological processes of the glandular epithelium of the genitals with atypia of cells of unclear genesis. Key words: pathological processes of the glandular epithelium of the genitals with atypia of cells of unclear genesis (AGC-NOS); infertility; biocenosis of vagina, sexually transmitted infections; human papilloma virus.