P-415 Study of the incidence of herpes viruses in the endometrium of women with evidence of chronic endometritis and reproductive problems

Abstract

Abstract Study question What is the prevalence of herpes viruses in endometrial mucosa in women with chronic endometritis and without bacterial causative agents and reproductive problems. Summary answer In our study in 12.5% were found to be positive for herpes viruses in endometrial sample. What is known already Herpes viruses affect the genital tract and can lead to chronic inflammation of the genital system. They are represented by over 100 different species, 8 of which affect humans. After the initial infection, they usually enter a latent stage as integrated DNA or as an extrachromosomal form. There are various causes that lead to reactivation of herpes viruses in the genital tract, such as decreased immune reactivity, cyclic hormonal changes associated with the menstrual cycle, hypothermia or hyperthermia, infections, invasive gynecological interventions, disturbed psychoemotional status. This can lead to the development of persistent chronic infections in the endometrial lining. Study design, size, duration Prospective cohort study at a Medical Center Institute for Reproductive Medicine, Pleven, Bulgaria. Data collection took place between June 2020 to January 2022. Participants/materials, setting, methods Of all the patients who underwent the Medical Center “Institute of Reproductive Medicine”, we found that in 24 of them (mean age 35.56±3.86 years) there was no evidence of pathogenic microorganisms in the endometrial biopsy. The results of flow cytometric analysis showed a high percentage of CD138+ plasma cells. These were included for further investigation of herpesviruses by Multiplex Real-Time PCR. The endometrial biopsy study was performed mandatorily after negative microbiological result of vaginal swab. Main results and the role of chance The results of this study indicate that 12.5% of women with reproductive problems have herpes virus found in the endometrial mucosa. Demonstration of herpes viruses in endometrial biopsy in women with reproductive problems directs the assisted reproduction specialist to the possible cause of pregnancy loss and helps to prepare and adopt the right strategy for subsequent pregnancies. Endometrial biopsy testing may facilitate the choice of antibacterial or antiviral therapy, which helps to limit the antibiotic effect on the balance of microorganisms forming the genital microbiome. Limitations, reasons for caution The insufficient number of patients. Wider implications of the findings Developing a diagnostic and treatment plan for patients with evidence of chronic endometritis. Trial registration number 1