Importanţa endometritei cronice şi a disbiozei în eşecul de implantare în ciclurile de FIV

Abstract

Recurrent implantation failures have multiple causes. Microorganisms frequently invade the uterine cavity, and consecutive endometrial infection or inflammation can play a role in implantation failure during assisted human reproduction techniques. Pathological microorganisms and inflammatory mediators in the host can cause a cascade of events, leading to the implantation failure or expulsion of the embryo. This review addresses an important factor related to implantation failure, dysbiosis and chronic endometritis. Prolonged menstrual bleeding, previous abortions, uterine curettage, tubal pathology or a history of vaginal bacterial infections are common risk factors for endometritis. Chronic endometritis is often asymptomatic, but it plays an important role in implantation failures. The embryo implantation rates were significantly higher in patients receiving combined antibiotic therapy for chronic endometritis. It is therefore important that, in the case of infertile couples, this potential cause be sought and treated, because, if left untreated, it has the potential to determine recurrent implant failure. Oral antibiotic therapy, associated with oral and vaginal probiotics, plays an important role in regulating endometrial microbiome.