Influence of immunomodulatory therapy on reproductive function in female patients with infertility caused by chronic endometritis

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Abstract

The complex of antimicrobial peptides and cytokines has a positive effect on immunity, progesterone receptor expression, and angiogenesis; it also improves the rates of pregnancy and live birth in patients with infertility and chronic endometritis (CE). The question of the optimal number of treatment courses to achieve the greatest effect remains unresolved.

Objective: To compare the effectiveness of complex treatment in the preconception period of patients with infertility caused by CE in achieving spontaneous pregnancy and live birth with the use of the Superlymph drug in one and two courses.

Materials and methods: The patients of group I (n=303) received 25 IU of the Superlymph drug in one course (for 20 days), the patients of group II (n=303) received the drug in two courses with a break of 1–1.5 months; in addition, all patients received one course of antibacterial therapy and progestogen cyclically. Clinical and laboratory studies were used.

Results: During six months after treatment, pregnancy rates were 52.2% and 63.4% in groups I and II, respectively, p=0.05, with a maximum difference in the first month after the end of treatment of 15.5% vs. 31.4%, respectively, p<0.001 (OR=2.02, 95% CI 1.48–2.75), that is, it was 2-fold higher in group II compared to group I. The live birth rate was 43.2 and 57.8%, p=0.05, with a maximum difference in pregnancy in the first month after the end of treatment of 11.9% versus 28.1%, respectively, p<0.001 (OR=2.36, 95% CI 1.65–3.37). The risk of miscarriage and premature birth was two times lower with two courses of the Superlymph drug.

Conclusion: The treatment of CE using the Superlymph drug in the preconception period by two courses of 20 days with a break of 1–1.5 months increases the chances of spontaneous pregnancy by 22%, live births by 34% and helps to reduce the risk of miscarriage and preterm birth by two times compared to one course.

About the authors

Anton A. Sukhanov

Perinatal Medical Center; Tyumen State Medical University, Ministry of Health of Russia

Author for correspondence.
Email: such-anton@yandex.ru
ORCID iD: 0000-0001-9092-9136

PhD, Head of the Department of Family Planning and Reproduction; Associate Professor, Department of Obstetrics and Gynecology

Russian Federation, Tyumen; Tyumen

Galina B. Dikke

F.I. Inozemtsev Academy of Medical Education

Email: galadikke@yandex.ru
ORCID iD: 0000-0001-9524-8962

Dr. Med. Sci., Professor, Department of Obstetrics and Gynecology with a Course of Reproductive Medicine

Russian Federation, Saint Petersburg

Irina I. Kukarskaya

Perinatal Medical Center; Tyumen State Medical University, Ministry of Health of Russia

Email: kukarskay@mail.ru
ORCID iD: 0000-0002-8275-3553

Dr. Med. Sci., Professor, Department of Obstetrics, Gynecology and Resuscitation with the Course of Clinical Laboratory Diagnostics, Institute of Continuous Professional Development; Chief Physician; Chief Specialist in Obstetrics and Gynecology, Department of Health of the Tyumen Region

Russian Federation, Tyumen; Tyumen

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