Иммунологические аспекты бесплодия при хроническом эндометрите

Abstract

Over the past decades, chronic endometritis (CE) has been the focus of scientists and infertility specialists due to its potential association with reproductive disorders. The pathogenesis of CE is conventionally associated with the impairment of endometrial commensal microbiota and pathogenic microflora entering the uterus through the cervical canal. A necessary prerequisite for preserving female reproductive health is the balance between the microbiota and local immunity of the endometrium. To date, no unified concept of the immunopathogenesis of infertility associated with CE has been established, which precludes the ability to fully resolve reproductive disorders arising from this condition. An analysis of current published data on the association between CE and infertility and reproductive losses illustrates the necessity to expand the ideas about the role of immune disorders in the pathogenesis of CE and the possibility of optimizing diagnostic tools for CE using local and systemic immunity indicators. In light of the aforementioned considerations, the aim of this paper is to provide a comprehensive review of recent published data on the local immunity of the endometrium in both healthy and chronically inflamed states, as well as to elucidate the immunological mechanisms underlying infertility associated with CE. KEYWORDS: endometrium, local immunity, systemic immunity, chronic endometritis, infertility, reproductive losses. FOR CITATION: Kolesnikova N.V., Filippov E.F. Immunologic aspects of infertility in chronic endometritis. Russian Medical Inquiry. 2024;8(3):155–162 (in Russ.). DOI: 10.32364/2587-6821-2024-8-3-6.