Morphological features of erdometrium for women with reproductive losses on a background chronic endometritis

Abstract

The objective. Analysis to investigate the morphological features of endometrium in patients without aphids with chronic endometritis. Materials and methods. Conducted a prospective investigation in women with a history of chronic endometritis and infertility. The main group - 100 women of reproductive age with chronic endometritis, the control group - 40 women of reproductive age, with supra-temporal menstruation, with a medical history of history of pregnancy and childbirth. To study the morphological characteristics of endometrium in patients with chronic endometritis, an assessment of the results of endometrial biopsy, viconanization on the 5th-7th day of the menstrual cycle was carried out using an additional aspiration curette Pipelle de Cornier (France). Statistically significant differences were taken as p<0.05. Results. Pathomorphological examination of the endometrium revealed characteristic signs of chronic inflammation - the presence of a large number of plasma cells in the stroma of the endometrium, lymphoid infiltrates near blood vessels and the mouth of glands, unevenly expressed fibrosis of the stroma, sclerotic changes in the walls of spiral arteries. All examinees had two or more morphological signs of chronic endometritis. The most common morphological sign of chronic endometritis in the main group was inflammatory infiltrates, consisting mainly of lymphoid elements, which occurred in 94.0%, respectively, and were absent in patients of the control group (p<0.001). Focal fibrosis of the endometrial stroma covered large areas in the vast majority of women in the main group and accounted for 93.0% (р<0,01). In the stroma of the endometrium, the appearance of capillary-type vessels was noted, the intensity of their development had a strong correlation with the degree of severity of inflammatory changes (r=0.69: p<0.05). Conclusions. A morphological study of the endometrium in patients with infertility, against the background of chronic endometritis, shows that inflammatory changes in the tissues have clear morphological criteria, which are most pronounced on the 5-7th day of the menstrual cycle - the presence of plasma cells, stroma fibrosis, and sclerosis of the vessel walls