Modern assessment of the endometrium (Literature review)

Abstract

The article reviews the literature on various aspects of diagnosis, evaluation and treatment of pathological conditions of the endometrium. From a clinical point of view, the significance of such indicators as the thickness of the endometrium, the endometrial pattern, the volume and features of endometrium vascularization, the assessment of the microbial environment of the endometrium, and molecular studies of its receptivity are described. In particular, the impact of the endometrial microbiota on reproductive outcomes in patients starting infertility treatment was considered. Considerations regarding the analysis of endometrial receptivity to implantation, data on the personalized implantation window are given. Complex methods for assessing the state of the endometrium are considered: ERA (Endometrial Receptivity Assay), EMMA (Endometrial Microbiome Metagenomic Analysis), ALICE (Analysis of Infectious Chronic Endometritis). The article summarizes the results of the most effective diagnostic methods and the modern approach to the treatment of endometrial susceptibility. Over the past decade, studies have identified a potential link between poor reproductive outcomes and chronic endometritis. The review presents data on chronic endometritis and highlights recent advances in the study of this gynecological disease. Considerations on the feasibility of antibiotic therapy in chronic endometritis are presented.The studies were analyzed, which demonstrated the clinical value of evaluating the morphological markers of endometrial receptivity, pinopodia. From a clinical point of view, the importance of chronic endometritis as the cause of the formation of “thin” endometrium in infertility is presented. In particular, the effectiveness of hysteroscopy in chronic endometritis has been demonstrated to optimize the chances of successful embryo implantation. Data from foreign and domestic articles published over the past 10 years in the Scopus, Web of Science, MedLine, Cochrane Library, Embase, Global Health, Pubmed databases are included in the review.