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OPTIMIZING PRECONCEPTION PREPARATION FOR WOMEN WITH CHRONIC
HYPOPLASTIC ENDOMETRITIS
Kurbaniyazova Feruza
Samarkand State Medical University
Assistant of the Department of Obstetrics and Gynecology No. 1.
Akhmadova Farkhunda Shukhratovna
Student of Samarkand State Medical University!
https://doi.org/10.5281/zenodo.10829317
Abstract.
This article provides information on optimizing preconception preparation for
women with chronic hypoplastic endometriosis.
Key words:
hypoplastic endometriosis, pathogenetic effect, hormone therapy, IVF program.
ОПТИМИЗАЦИЯ ПОДГОТОВКИ К ЗАЧАТИЮ ЖЕНЩИН С
ХРОНИЧЕСКИМ ГИПОПЛАСТИЧЕСКИМ ЭНДОМЕТРИТОМ
Аннотация.
В статье представлена информация по оптимизации прегравидарной
подготовки женщин с хроническим гипопластическим эндометриозом.
Ключевые слова:
гипопластический эндометриоз, патогенетический эффект,
гормональная терапия, программа ЭКО.
THE GOAL
Using low-frequency ultrasound cavitation of the uterine cavity in combination with cyclic
hormone therapy and improving the results of treatment of women after reproductive defects
caused by "thin" endometrium, based on evidence of its pathogenetic effect.
MATERIALS AND METHODS
We examined 80 women with uterine infertility due to endometrial hypoplasia and its non-
acceptance. Patients were divided into two groups of 40 people. Patients in group 1 underwent
courses of low-frequency ultrasonic cavitation with antiseptic and cytoprotective solutions
together with cyclic hormone therapy. Patients in group 2 received only cyclic hormone therapy.
RESULTS
Complex treatment with the help of cyclic hormone therapy using a course of low-
frequency cavitation with antiseptics and cytoprotectors increases the thickness of the uterine
mucosa and restores its structure, improves hemodynamic indicators of uterine blood flow, and
most importantly, improving the effectiveness of the IVF program.
CONCLUSION
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In patients with hypoplastic endometrium, the complex use of cavitation irrigation of the
uterine cavity led to a statistically significant increase in the level of AMHF, allows to increase
the thickness of the uterine mucosa and restore its structure, and improve the hemodynamic
parameters of uterine blood flow.
Most chronic endometritis occurs latently and does not have clinical manifestations of
infection. In general, 35-40% of patients have no clinical symptoms. The most persistent
manifestation of EC, in 50-85% of cases, includes menstrual dysfunction such as menorrhagia and
metrorrhagia, premenstrual and postmenstrual bleeding. In 30% of cases - reproductive
dysfunction associated with early abortion, as well as infertility and unsuccessful attempts at IVF
(in vitro fertilization). In 80% of cases, patients complain of pain in the lower abdomen with
radiation to the lumbar or sacral spine.
Inflammatory diseases of the pelvic organs lead to immune disorders. In addition to
affecting the general immune system, infectious agents cause serious changes in local immunity,
which is manifested by an increase in the amount of Ig G, M, A, which contributes to embryo
rejection reactions. During CE, the quantitative composition of immunoglobulins M, G, A in
endometrial secretions is 100 times higher than the level of immunoglobulins in healthy women,
which, in turn, requires the use of immunomodulators in the treatment of CE. Histological
examination of endometrial scraping remains the most reliable method for the diagnosis of CE to
date, which is the "gold standard" [2].
There are certain methods of treating CE using drugs (antibacterial drugs [3],
immunomodulators in the form of injections, suppositories, tablets [4]; hormone therapy - cyclic
hormone therapy [5], intrauterine irrigation [6]) and predefined physiotherapeutic methods of
treatment - microwave centimeter range, magnetic field, UHF, pulsed ultrasound, iodine
electrophoresis, etc. [7]. However, with these methods of treatment, there is a high percentage of
complications, as a result of which it is necessary to stop the course of treatment (drug intolerance
- allergic reactions, dysfunction of the gastrointestinal tract).
The use of physiotherapeutic methods can aggravate the chronic process, which requires
the mandatory use of antibacterial agents and possible hospitalization. The duration of the above
course of physiotherapeutic procedures (10-12 days) causes certain discomfort for patients. Also,
certain methods are characterized by low efficiency due to the direct impact on the endometrium
and the impossibility of creating a drug depot in it.
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The closest (prototype) is the treatment of CE using intrauterine irrigation when Poludan
immunomodulator is used as a dialysate solution [8]. However, this method has the following
disadvantages.
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