Endometrial polyps: new strategies for effective treatment

Abstract

The work is devoted to the issue of effectiveness improvement in treatment of endometrial polyps (EP) in women of reproductive age.Study objective: to evaluate the clinical efficacy of the Allokin-alpha in combination with dydrogesterone for the treatment of EP in women of reproductive age.Study design: the study involved 70 patients aged 18–35 years: 34 patients with EP (group I), 30 patients with EP and chronic endometritis (CE) (group II) and 30 patients of the control group (group III). Subgroup Ia (n = 15) received dydrogesterone for the treatment, Ib (n = 19) – dydrogesterone and Allokin-alpha, IIa (n = 17) – dydrogesterone and antibiotic, IIb (n = 19) – dydrogesterone, antibiotic and Allokin-alpha.Study methods: group I and II were diagnosed by hysteroscopy with histological confirmation, endometrial samples from healthy women were obtained by aspiration biopsy. Bacteriological examination of the endometrium was performed by PCR and by cultivating aerobic and anaerobic microorganisms on special growth media. The endometrial sections were immunostained with monoclonal antibodies against the specific markers of plasmacytes (CD138), NK cells (CD56, CD16), cellular marker for proliferation (Ki-67).Study results: Endometrial samples of women with EP (isolated or in conjunction with CE) were characterized by significantly higher detection of Candida spp. – 21% (p = 0,012), and Herpes viruses type 1, 2, and 6 – 17% (p = 0,016). Compared with the normal endometrium, isolated EP contained a lower density of CD56 and CD16, EP in conjunction with CE had a higher density of CD138 along with a lower density of CD16.Dydrogesterone therapy in combination with Allokin-alpha was effective in correcting local immune disorders in the endometrium, normalizing proliferative processes and eliminating infectious agents in the uterine cavity.