Clinical review for general practice

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FULLSCREEN > Archive > 2025 > Vol 6, №2 (2025) > "Renaissance of reproductive losses", or New possibilities for overcoming implantation failures associated with chronic endometritis

"Renaissance of reproductive losses", or New possibilities for overcoming implantation failures associated with chronic endometritis

Mekan R. Orazov , Viktor E. Radzinskii , Lyudmila M. Mikhaleva , Elena S. Silantieva , Evgenii D. Dolgov

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  • Abstract
  • About the Author
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Abstract

Early reproductive losses represent one of the most relevant but unresolved issues of today’s reproductive medicine. To date, it has been proven that embryonic and endometrial factors play equal roles in realization of reproductive failures. Endometrial dysfunction, fibrosis, impaired endometrial receptivity/selectivity are the main causes of the endometrium-associated reproductive losses, which are most common in patients with the morphologically verified chronic endometritis (CE). To date, the world lacks the criteria for CE grading based on its severity. The paper reports new approaches to CE stratification based on severity, as well as options for pathogenetically justified therapy, based on domestic and international data.
Keywords: reproductive losses, implantation failures, endometrial factor, chronic endometritis, physical therapy, antifibrotic therapy, bovhyaluronidase azoximer.

About the Author

Mekan R. Orazov 1 , Viktor E. Radzinskii 1 , Lyudmila M. Mikhaleva 2 , Elena S. Silantieva 3 , Evgenii D. Dolgov 1

1 Patrice Lumumba Peoples' Friendship University of Russia, Moscow, Russia

2 Avtsyn Research Institute of Human Morphology of Petrovsky National Research Centre of Surgery, Moscow, Russia

3 Clinical Hospital "Lapino-1" of the group of companies "Mother and Child", Lapino, Moscow Region, Moscow, Russia

References

1. Предиктивное акушерство. Под ред. В.Е. Радзинского, С.А. Князева, И.Н. Костина. М.: Редакция журнала StatusPraesens, 2021.
Predictive obstetrics. Edited by V.E. Radzinsky, S.A. Knyazev,
I.N. Kostin. Moscow: Editorial Board of the StatusPraesens Journal, 2021 (in Russian).
2. Quenby S et al. Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss. Lancet 2021;397(10285):1658-67.
3. Yang AM, Xu X, Han Y et al. Risk factors for different types of pregnancy losses: analysis of 15,210 pregnancies after embryo transfer. Frontiers Endocrinol 2021;(12):683236.
4. Annual Capri Workshop Group. Early pregnancy loss: the default outcome for fertilized human oocytes. J Assisted Reprod Gen 2020;37(5):1057-63.
5. Morimune A, Kimura F, Nakamura A et al. The effects of chronic endometritis on the pregnancy outcomes. Am J Reprod Immunol 2021;85(3):e13357.
6. Michels TC. Chronic endometritis. Am Fam Physician 1995;52(1):217-22.
7. Wiesenfeld HC, Hillier SL, Meyin LA et al. Subclinical pelvic inflammatory disease and infertility. Obstet Gynecol 2012;120(1):37-43. DOI: 10.1097/AOG.0b013e31825a6bc9
8. Li J et al. Analysis of pregnancy outcomes in patients with recurrent implantation failure complicated with chronic endometritis. Frontiers Cell Dev Biol 2023;(11):1088586.
9. Puente E, Alonso L, Laganà AS et al. Chronic endometritis: old problem, novel insights and future challenges. Int J Fertil Steril 2020;13(4):250.
10. Moreno I, Codoñer FM, Vilella F et al. Evidence that the endometrial microbiota has an effect on implantation success or failure. Am J Obstet Gynecol 2016;215(6):684-703.
11. Petrova MI, Lievens E, Malik S et al. Lactobacillus species as biomarkers and agents that can promote various aspects of vaginal health. Frontiers Physiol 2015;(6):129628.
12. Дикке Г.Б., Остроменский В.В. Нарушение иммунного статуса при хроническом эндометрите и опыт его коррекции посредством локальной цитокинотерапии. Акушерство и гинекология. 2019;(9):139-46. DOI: 10.18565/aig.2019.9.139-146
Dikke G.B., Ostromensky V.V. Immune status impairment in chronic endometritis and experience of its correction by means of local cytokine therapy. Obstetrics and Gynecology. 2019;(9):139-46. DOI: 10.18565/aig.2019.9.139-146 (in Russian).
13. Толибова Г.Х., Траль Т.Г, Клещев М.А. и др. Эндометриальная дисфункция: алгоритм гистологического и иммуногистохимического исследования. Журнал акушерства и женских болезней. 2015;64(4):69-77.
Tolibova G.Kh., Tral T.G., Kleshchev M.A., et al. Endometrial dysfunction: algorithm of histological and immunohistochemical study. Journal of obstetrics and women's diseases. 2015;64(4):69-77 (in Russian).
14. Li Y, Yu S, Huang C et al. Evaluation of peripheral and uterine immune status of chronic endometritis in patients with recurrent reproductive failure. Fertil Steril 2020;113(1):187-196.e1. DOI: 10.1016/j. fertnstert.2019.09.001
15. Mazloomi M et al. Association of Interleukin-33 with Recurrent Pregnancy Loss: A Systematic Review and Meta-Analysis Study. Int J Fertil Steril 2025.
16. McQueen DB, Maniar KP, Hutchinson A et al. Redefining chronic endometritis: the importance of endometrial stromal changes. Fertil Steril 2021;116(3):855-61.
17. Santoro A, Travaglino A, Inzani F et al. The role of plasma cells as a marker of chronic endometritis: a systematic review and meta-analysis. Biomedicines 2023;11(6):1714.
18. Taylor M, Jenkins SM, Pillarisetty LS. Endometritis. [Updated 2023 Oct 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2024.
19. Song D, He Y, Wang Y et al. Impact of antibiotic therapy on the rate of negative test results for chronic endometritis: a prospective randomized control trial. Fertil Steril 2021;115(6):1549-56. DOI: 10.1016/j.fertnstert.2020.12.019
20. Cicinelli E, Resta L, Loizzi V et al. Antibiotic therapy versus no treatment for chronic endometritis: a case-control study. Fertil Steril 2021;115(6):1541-8. DOI: 10.1016/j.fertnstert.2021.01.018
21. Duan H, Li X, Hao Y et al. Risk of spontaneous abortion after antibiotic therapy for chronic endometritis before in vitro fertilization and intracytoplasmic sperm injection stimulation. Fertil Steril 2022;118(2):337-46. DOI: 10.1016/j.fertnstert.2022.04.026
22. Cheng X, Huang Z, Xiao Z, Bai Y. Does antibiotic therapy for chronic endometritis improve clinical outcomes of patients with recurrent implantation failure in subsequent IVF cycles? A systematic review and meta-analysis. J Assist Reprod Genet 2022;39(8):1797-813. DOI: 10.1007/s10815-022-02558-1
23. Kitaya K, Yasuo T. Commonalities and Disparities between Endometriosis and Chronic Endometritis: Therapeutic Potential of Novel Antibiotic Treatment Strategy against Ectopic Endometrium. Int J Mol Sci 2023;24(3):2059.
24. Jafarabadi MN et al. Intravaginal probiotics before embryo transfer do not improve pregnancy rates in recurrent implantation failure cases: An RCT. Int J Reprod BioMed 2024;p.363-74.
25. Abdolmohammadi-Vahid S et al. P-395 Vaginal probiotics and vitamin D, as immunomodulatory approaches in improving the implantation and live birth in repeated implantation failure (RIF) women with imbalanced immune system. Hum Reprod 2024;39(Suppl.1):
С. deae108.750.
26. Оразов М.Р. и др. Повторные неудачи имплантации: этиология и возможности физиотерапии. Трудный пациент. 2020;18(8-9):20-4.
Orazov MR et al. Repeated implantation failures: etiology and possibilities of physiotherapy. Difficult patient. 2020;18(8-9):20-4 (in Russian).
27. Зиновьева О.С. и др. Влияние сочетанной плацентарной терапии и инфракрасного спектра лазера на гемодинамические нарушения в гипопластичном эндометрии. Медицинский альманах. 2018;6(57):94-7. DOI: 10.21145/2499-9954-2018-6-94-97
Zinovieva O.S. et al. Effect of combined placental therapy and infrared laser spectrum on hemodynamic disturbances in hypoplastic endometrium. Medical almanac. 2018; 6 (57): 94-7. DOI: 10.21145/2499-9954-2018-6-94-97 (in Russian).
28. Тапильская Н.И., Савичева А.М., Шалепо К.В., Копылова А.А. Опыт лечения хронического эндометрита. Гинекология. 2020;22(4):68-70.
Tapilskaya N.I., Savicheva A.M., Shalepo K.V., Kopylova A.A. Experience in the treatment of chronic endometritis. Gynecology. 2020;22(4):68-70. DOI: 10.26442/20795696.2020.4.200312 (in Russian).
29. Вартанян Э.В., Девятова Е.А., Цатурова К.А., Аглямова Д.Р. Роль системной терапии при бесплодии и неудачах реализации репродуктивной функции. Акушерство, гинекология и репродукция. 2018;12(1):5-16.
Vartanyan E.V., Devyatova E.A., Tsaturova K.A., Aglyamova D.R. The role of systemic therapy in infertility and failures of reproductive function. Obstetrics, Gynecology and Reproduction. 2018;12(1):5-16 (in Russian).
30. Trizna E et al. Improving the efficacy of antimicrobials against biofilm-embedded bacteria using bovine hyaluronidase azoximer (Longidaza®). Pharmaceutics 2021;13(11):1740.
31. Локшин В.Н., Аскар Е., Рыбина А.Н. и др. Опыт применения бовгиалуронидазы азоксимера в комплексном лечении хронического эндометрита у женщин с повторными неудачами имплантации. Акушерство и гинекология. 2023; DOI: 10.18565/aig.2023.119
Lokshin V.N., Askar E., Rybina A.N., et al. Experience with the use of bovhyaluronidase azoximer in the complex treatment of chronic endometritis in women with repeated implantation failures. Obstetrics and Gynecology. 2023; DOI: 10.18565/aig.2023.119 (in Russian).
32. Оразов М.Р., Радзинский В.Е., Долгов Е.Д. Хронический эндометрит на современном этапе: в фокусе внимания преодоление неудач имплантации. Клинический разбор в общей медицине. 2024;5(3):18-26. DOI: 10.47407/kr2023.5.3.00370
Orazov M.R., Radzinsky V.E., Dolgov E.D. Chronic endometritis at the present stage: in focus on overcoming implantation failures. Clinical review for general practice. 2024;5(3):18-26. DOI: 10.47407/ kr2023.5.3.00370 (in Russian).
33. Краснопольская К.В., Михалева Л.М., Оразов М.Р., Долгов Е.Д. Возможности преодоления неудач имплантации при бесплодии маточного генеза, обусловленных хроническим эндометритом. Гинекология. 2022;24(5):400-7. DOI: 10.26442/20795696.2022.5.201892
Krasnopolskaya K.V., Mikhaleva L.M., Orazov M.R., Dolgov E.D. Possibilities of overcoming implantation failures in infertility of uterine genesis caused by chronic endometritis. Gynecology. 2022;24(5):400-7. DOI: 10.26442/20795696.2022.5.201892 (in Russian).
34. Оразов М.Р., Радзинский В.Е., Долгов Е.Д. Микромир, сыгравший злую шутку: дефектный микробиом и неудачи имплантации на фоне хронического эндометрита. Women’s Clinic. 2024;(2-3):53-60.
Orazov M.R., Radzinsky V.E., Dolgov E.D. Microworld that played a cruel joke: defective microbiome and implantation failures against the background of chronic endometritis. Women’s Clinic. 2024;(2-3):53-60 (in Russian).
35. Женская консультация: руководство. Под ред. В.Е. Радзинского.
4-е изд., перераб. и доп. М.: ГЭОТАР-Медиа, 2021.
Women's consultation: manual. Edited by V.E. Radzinsky. 4th ed., revised and enlarged. Moscow: GEOTAR-Media, 2021 (in Russian).

Портал CON-MED.RU:
https://con-med.ru/magazines/klinicheskiy_razbor_v_obshchey_meditsine/klinicheskiy_razbor_v_obshchey_meditsine-02-2025/renessans_reproduktivnykh_poter_ili_novye_vozmozhnosti_preodoleniya_neudach_implantatsii_assotsiirov/

For citation:Orazov M.R., Radzinskii V.E., Mikhaleva L.M., Silantieva E.S., Dolgov E.D. "Renaissance of reproductive losses", or New possibilities for overcoming implantation failures associated with chronic endometritis. Clinical review for general practice. 2025; 6 (2): 66–72 (In Russ.). DOI: 10.47407/kr2025.6.2.00571


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