Use of sodium deoxyribonucleate in complex therapy of chronic endometritis in women with reduced fertility

Abstract

The urgency of the problem of chronic endometritis (CE) is due to the high prevalence of infertility, miscarriage and in vitro fertilization failure (IVF) in patients with this pathology in the absence of a sufficient effect of standard therapy. Successful restoration of the endometrial morphofunctional characteristics requires a decrease in the intensity of the inflammatory response while preserving the reparative potential of the tissue, which can be achieved with the help of immunomodulation. The purpose of this study was to study the effects of the use of sodium deoxyribonucleate (Derinat®) in the complex therapy of CE in women with reduced fertility. The study involved 136 women with verified diagnosis of CE, randomized to the group of research (n = 70) and control group (n = 66). All patients received standard therapy for CE, women in the treatment group additionally received Derinat® (solution for intramuscular administration of 15 mg/ml) according to the scheme: 5 ml (75 mg) once a day after 24-48 hours, 10 injections per course. The effects of therapy were evaluated by the dynamics of clinical symptoms of CE, the results of microbiological and ultrasound studies (US). Results. In the treatment group, there was a significant decrease in the prevalence of clinical symptoms after completion of therapy and a three-month follow-up period compared with the control group (p < 0.05). The frequency of detection of conditionally pathogenic microorganisms after the end of the treatment course decreased in the study group to 26 % and in the control group to 51.5 % (p < 0.05). Comparison of the echographic parameters of the final characteristics showed that in the group treated with Derinat®, the significantly lower percentage of observations preserved the hyperechogenicity of the endometrium and subendometrial layer, the heterogeneity of the structure, the thinning of the endometrium and the dilation of arcuate veins (p < 0.05). Conclusion. The use of Derinat® increases the effectiveness of CE therapy and may be helpful in restoring fertility in these patients.