Abstract
Objective. To study the efficacy of different treatment regimens in patients with chronic atrophic endometritis against the background of endometrial hemodynamic dysfunction using intrauterine perfusion of platelet-rich plasma (PRP therapy) or sulodexide, or a combination of PRP therapy and sulodexide. Patients and methods. This study included 116 patients with morphologically confirmed diagnosis of chronic endometritis. Patients were divided into three groups: group 1 (n = 18) received PRP therapy in addition to basic therapy; group 2 (n = 68) received basic therapy and sulodexide; group 3 (n = 3) received PRP therapy combined with sulodexide. All patients underwent Doppler ultrasonography on day 7 (±1) after ovulation and endometrial pipelle biopsy with further histological and immunohistochemical examination (VEGF, TGF-β, CD138) before and after treatment. Results. After treatment, histological examination revealed significant changes in the morphological pattern of the endometrium in all patient groups. However, the best results were observed in group 3: inflammatory infiltrates and stromal fibrosis persisted in 23.3% of patients, stromal sclerosis – in 20% of patients, plasma cells – in 10% of patients. Assessment of changes in TGF-β expression in the endometrial epithelium and stroma revealed its decrease in all groups, but the maximum decrease was noted in group 3. Conclusion. The most effective treatment method for chronic atrophic endometritis is the combined use of PRP therapy and sulodexide. Key words: chronic endometritis, intrauterine hemodynamics, sulodexide, PRP therapy
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