Eco after endometritis treatment. Are chronic endometritis and IVF compatible? Treatment of chronic endometritis before IVF
My young neighbor suffers from chronic endometritis. She applied for help to various centers, underwent many examinations. I wondered why the doctor allowed her to the protocol, whether IVF and chronic endometritis are compatible. Let's take a closer look.
Chronic endometritis is a pathological process that is provoked by pathogens (bacteria and viruses). These negative changes cause a violation of natural growth, as well as rejection of endometrial tissue.
Such problems cause the following conditions:
- uterine bleeding;
- infertility;
- irregular menstruation;
- inability to bear fruit.
The causes of negative processes are such factors:
- long-term operation of the intrauterine device;
- promiscuity;
- abortions;
- infectious processes in the genitals;
- systemic diseases.
Chronic endometritis is classified as follows:
- A non-specific species that occurs against the background of vaginal dysbacteriosis, internal uterine spiral, abortion.
- A specific type provoked by tuberculosis, herpes or thrush.
Often, the development of the disease is influenced by the general condition of the body, in particular, poor immunity, the result of gynecological pathologies.
Treatment of chronic endometritis before IVF
The health course for this condition is based on activities whose task is to regulate the menstrual cycle, as well as increase the reaction of endometrial susceptibility. Treatment is carried out through the following actions and means:
- taking antibiotics and drugs with an antiviral effect;
- vitamin complexes that enhance the body's defense mechanisms;
- hormonal agents;
- massage;
- physiological procedures.
- recreational activities in sanatoriums;
- proper nutrition;
- activity.
If the therapy was ineffective, the patient is prescribed cleaning (curettage) followed by a renewal of the therapeutic course. The duration of therapy is determined individually for each patient. Treatment may take several weeks to months.
Modern treatment options are based on the use of special intrauterine injections. The drug is injected into the area of inflammation. Such activities help to quickly restore damaged tissue. Before planning an IVF procedure, the patient is prescribed medications that stimulate the production and development of several eggs at the same time.
The IVF procedure begins with the release of mature biological materials (eggs with spermatozoa). These substances are placed in a special environment so that fertilization occurs in a separate container.
After successful cell division, which occurs on days 5-7, several embryos are placed in the patient's uterus. In the future, the woman is placed in a hospital and the process of implantation of the embryo is observed.
Patient reviews
Before the procedure
- Tanya, Moscow: I have endometritis, but I still went to the doctor for IVF. The doctor was very competent, I was satisfied with the result of the healing. The therapy took a couple of cycles, after which I was allowed to prepare for the protocol.
- Katyusha, Rostov-on-Don: found chronic endometritis. Treatment was carried out for 3 cycles. It's all behind. The specialist said that you can go to IVF. I hope everything works out.
After
- Oksana, 54 years old, Tambov: My daughter has chronic endometritis, for this reason she could not get pregnant. After the wellness course, the disease went away, but it was not possible to get pregnant. Daughter decided on IVF. Finally, I have a grandson.
- Elena, 32 years old, Moscow: I could not get pregnant for a long time, there were reasons for that - polyps in the uterus, endometriosis with endometritis (chronic). When they cleaned it, I was soon able to get pregnant, however, thanks to IVF.
When is IVF allowed?
Before planning IVF, it is necessary to completely get rid of the pathological process. Successful therapy will restore the endometrium, establish the menstrual cycle, and the mucosa will become normal, updated in a timely manner.
Before planning a pregnancy, no matter what (natural or IVF), you need to consult a gynecologist.
Preparatory stage
IVF is preceded by some kind of comprehensive examination that determines the presence of diseases, existing contraindications. The procedure is not carried out in such cases:
- hypoplasia of the uterine endometrium;
- the presence of polyps.
While preparing for future events, it is necessary to stay in nature more often, not to worry, and eat right.
How to really increase the chances of a favorable conception
The fulfillment of the above conditions increases the chance of conception. Also, the future dad should prepare for the IVF procedure. A man undergoes a complete examination of his health, then he is cured of diseases that interfere with fertilization.
A few months before IVF, a man should refuse to visit the bath, sauna, and not take alcohol. These activities will help reduce the negative impact of external factors on spermatozoa.
Is it possible to get pregnant
Pathology is a significant obstacle to conception. This is due to the fact that pathological disorders of the endometrium cause the production of lymphocytes in the basal layer, so the substances do not have the power to implant an already fertilized egg inside the uterine mucosa, and the embryo is rejected.
All this becomes a provocateur of infertility, miscarriage or missed pregnancy. To avoid such negativity, treatment is required.
How to prepare
Preparing for IVF, future parents must strictly follow all the doctor's instructions. If necessary:
- to carry out antibiotic therapy;
- improve blood quality;
- normalize the hormonal background and the menstrual cycle.
Be sure to adjust proper diet and more rest.
Management of pregnancy
After the embryo is fixed in the uterine cavity, the pregnant woman should take a number of medications:
- folic acid with iodine;
- improving blood circulation;
- medicines that block uterine muscle contraction to avoid spontaneous abortion.
Examination before artificial insemination
To identify chronic endometritis, the following measures are used during diagnosis:
- hysteroscopy;
- endometrial histology;
- laboratory tests of blood, substances from the cavity of the female genital organs.
If a woman is found to be infertile, a hormonal analysis is prescribed.
Will it work the first time
The IVF procedure does not always give a 100% result. It is important not to lose heart, but to try to get pregnant again. Such therapy has helped many couples to enjoy the happiness of motherhood.
in vitro fertilization
The main objective of this technique is to prepare for the procedure, to establish the reproductive system. Against the background of successful therapy, the endometrium in the uterus is restored, its necessary thickness is achieved, the ability to fully function. It will take several months to achieve this - you should be ready for this.
3 weeks before IVF, the patient takes medication that promotes multiple ovulation. After that, sperm and eggs are taken from future parents. This is followed by the procedure of growing the embryo and planting it in the mother's body. During the first month, the gynecologist monitors the state of fetal development.
Unsuccessful IVF
Sometimes IVF is unsuccessful. The reasons for this phenomenon are not fully understood, but if specialists observe a similar reaction due to a hormonal failure, they perform hormonal stimulation before trying again, and then support progesterone with the necessary medications.
Price
IVF price ranges from 82 to 135 thousand rubles in different regions.
Contraindications to IVF from the side of the uterus
Absolute contraindications for IVF are:
- congenital anomalies of the uterus;
- inflammatory reactions;
- mental disorders;
- oncology;
- benign uterine tumors.
Some of the contraindications are temporary, as they can be eliminated. Those contraindications that cannot be corrected make the IVF procedure prohibited.
Before in vitro fertilization, the woman's genitals must be examined. Many patients write on the forums: chronic endometritis and IVF are incompatible. If the endometrium is infected, it is useless to implant the embryo into the uterine cavity. First you need to undergo treatment with antimicrobial and anti-inflammatory drugs, try to cure infertility, restore reproductive functions.
With progressive chronic endometritis, the walls of the uterus become thinner. This phenomenon leads to infertility. The key features of the course of uterine inflammation are as follows:
- disorder of proliferative processes that cause thinning of the endometrium;
- a decrease in receptors for reproductive hormones, remaining without a normal response to the natural endocrine action;
- hormonal imbalance caused by a deficiency of the hormone of the 2nd cycle - progesterone;
- violation of blood flow in the uterine cavity with vascular sclerosis;
- disorder of local immunity.
Before in vitro fertilization, all the doctor's recommendations for a diagnostic examination are charmingly fulfilled. Diagnosis allows timely detection of intrauterine diseases, in which it is impractical to perform the procedure of artificial insemination.
Contraindications for in vitro fertilization
The fertilization procedure is postponed and treatment is started if certain intrauterine diseases are detected:
- acute endometritis;
- subacute form of inflammation in the mucous layer;
- diffuse chronic endometritis;
- focal endomyometritis;
- hypoplasia of the mucous layer;
- polyps in the uterine cavity.
You can often hear from women: she treated chronic endometritis before IVF. And indeed it is. If endometritis is detected, the doctor prescribes treatment before IVF. He draws up a therapy regimen so that reproductive functions are restored to normal. It makes sense to do replanting when optimal conditions for the development of the embryo are created in the uterine cavity.
Treatment of endometritis
Methods of how to treat chronic endometritis before IVF are selected by the attending physician. The choice of methods is influenced by the symptoms of the disease. Carry out drug therapy or perform an operation in which pathological formations in the uterine cavity are removed.
Expert opinion After the diagnosis of chronic endometritis before IVF, complex treatment is used in several stages. Therapy can last several months. Entry into the protocol scheme is possible after confirmation of recovery. There are different treatment regimens for chronic endometritis before IVF, the drugs may be different. But the directions in therapy are repeated.
Treatment regimens for endometritis before IVF include:
- carrying out antibacterial treatment, the preparations for which are selected depending on the results of the analyzes (pathogenic microflora);
- taking anti-inflammatory drugs that suppress the course of infection;
- the use of funds to strengthen the immune system that fights harmful microorganisms;
- implementation of preventive measures aimed at stopping post-inflammatory disorders (sclerosis and tissue fibrosis - the main factors leading to infertility);
- the use of drugs that eliminate hormonal dysfunction of the ovaries, capable of restoring monthly ovulation.
After the diagnosis of chronic endometritis before IVF, complex treatment is used in several stages. Therapy can last several months.
Early detection of the disease and an adequate treatment regimen for chronic endometritis before IVF, implementation of all recommendations - perfect way preparation for artificial insemination, the successful implementation of the procedure.
Dr. Artut Visot notes that women with more severe endometriosis are forced to resort to IVF to conceive. The more severe the endometriosis, the less likely it is to get pregnant, even using IVF. Patients with time intervals after endometriosis surgery of 7 to 12 months and 13 to 25 months achieved more favorable IVF outcomes. In the 7 to 12 month group, the pregnancy rate was 50%, while in the 13 to 25 month group it was 52.4%. By comparison, the pregnancy rate in the 25-month-old group was only 32.5%, which is the same as the 0 to 3-month group, the author notes.
Pregnancy support tactics
After the treatment of endometritis, IVF, which ended in pregnancy, it is necessary to strictly follow the medical recommendations. Conception is just the first fragile step towards the birth of a baby.
The IVF scheme after endometritis includes:
A qualified doctor in the treatment of infertile spouses takes into account the inflammatory process that occurs with chronic endometritis. With adequate therapy, strict adherence to the appointments of the attending physician, the pregnancy proceeds well, the patients bear the fetus, give birth to healthy children.
The chances of a successful IVF attempt after successful treatment increase. With the normalization of the state of the endometrium, the pregnancy rate is 66%.
After numerous examinations and the inability to conceive, you decide to use in vitro fertilization. You choose a clinic, and there they again appoint an examination, according to the results of which a diagnosis of chronic endometritis is established. What to do in this situation? Is IVF still possible? Let's try to understand this delicate problem and find answers to frequently asked questions.
The inflammatory process that captures the mucous membrane of the uterus (endometrium) is called endometritis. Like any inflammatory disease, endometritis can be acute or chronic.
In the acute course of the disease, the lesion affects only the upper functional layer of the endometrium, therefore, if there are no associated complications, it is much easier to cure it than a chronic process. The occurrence of inflammation of the mucous layer will inevitably spread to the muscle layer, so chronic endomyometritis will become a more accurate diagnosis.
The causes of the inflammatory process of the endometrium are microorganisms. These can be staphylococci, E. coli, streptococci, chlamydia, yeast-like fungi (causative agents of thrush), as well as pathogens of sexually transmitted diseases, in particular, gonococci, Trichomonas, etc.
When they enter the uterine cavity, they cause an acute inflammatory process, if it is not treated, it will appear chronic illness. AT last years the presence of several types of pathogens is noted, and in very rare cases, the pathogenic organism cannot be identified at all.
Microorganisms can enter the uterine cavity in several ways:
- Ascending way. That is, there is an inflammatory process in the vagina caused by one of the types of pathogens. Gradually, the infection enters the cervix, overcoming the barrier of cervical mucus, and inseminates the uterine cavity.
- Inflammation of the mucous layer develops. Non-compliance with personal hygiene and sexual relations during menstruation can contribute to this.
- Due to mechanical damage to the mucous layer of the uterus. This can happen during childbirth (long labor, after water breaks, etc.), abortion and / or diagnostic curettage, as well as the remains of the fetal egg or part of the placenta.
- Installing an intrauterine device more than five years ago significantly increases the risk of developing endometritis.
- Infection in the uterine cavity can also penetrate from the fallopian tubes. This happens in the case of the development of chronic inflammatory processes affecting the appendages.
The following factors contribute to the development of chronic endometritis:
- Ignoring the symptoms of acute endometritis, or an acute process that has not been fully treated.
- Decreased immunity.
- Promiscuous sexual relations.
- Frequent abortions.
- Long-term use of intrauterine contraceptives, improperly selected contraceptives.
- Sexually transmitted diseases;
- Inflammatory processes of the fallopian tubes, lack of personal hygiene.
signs
The manifestations of acute endometritis are very bright, so it is very difficult to ignore them. A sharp rise in temperature to high levels (39-40 ° C), chills, weakness, headaches appear (symptoms of intoxication). Complaints of very severe pain in the lower abdomen, which are given to the sacrum. Allocations, during this period, are abundant, purulent, with a pronounced bad smell. If endometritis developed after childbirth, severe bleeding is possible.
Chronic endometritis is characterized by asymptomatic or erased manifestations of the disease. There may be complaints about a slight increase in temperature (36.9-37.7 ° C). The main complaints will be on violations of the menstrual cycle (irregular cycle, menstruation for more than 7 days, intermenstrual spotting, etc.) and pain in the abdomen.
Some women complain of pain in the back, lower back. Pain can be nagging in nature, give to the sacrum or tailbone and can be perceived by a woman as a symptom of fatigue and overwork. Moreover, any chronic inflammatory processes are characterized by the presence of weakness, lethargy and high fatigue.
There is a high probability of pain during sexual relations, a feeling of discomfort. There may be discharge from the genital organs of a greenish or brown color, with an unpleasant odor (putrefactive). Approximately 58% of women diagnosed with chronic endometritis have problems with the possibility of conceiving and carrying a pregnancy, infertility.
Treatment
The main methods of diagnosing this disease are ultrasound examination of the uterus and appendages, hysteroscopy. According to the indications, a biopsy is performed. To identify pathogens and determine the degree of purity, a swab is taken from the vagina and cervical canal.
Additionally, bacteriological culture is carried out to identify the pathogen and its degree of sensitivity to antibiotics. If required, tests for the detection of sexually transmitted diseases are carried out. Be sure to donate blood and urine.
Treatment of chronic endometritis before IVF is carried out only by a doctor! Prescribe antibiotics based on bacteriological culture, Metronidazole, antifungal drugs, vitamins and non-steroidal anti-inflammatory drugs.
Outside the exacerbation of the chronic process, physiotherapy is prescribed. To restore the regularity of the menstrual cycle, prescribe oral contraceptives for a period of 3 to 6 months. With proper treatment and proper medication, pregnancy occurs in 91% of women.
ECO
The presence of chronic endometritis and the in vitro fertilization procedure are incompatible. Since it is contraindicated to transplant a fertilized egg into the uterine cavity in the presence of inflammatory processes.
Why does the inflammatory process of the endometrium interfere with the onset of pregnancy? The fact is that the main function of the inner uterine layer is to create a place for fixing the fetal egg and creating favorable conditions for carrying a pregnancy.
The endometrium cyclically grows and is rejected (if pregnancy does not occur), with the development of the inflammatory process, this cycle is disrupted. The endometrium is unable to create not only a layer of sufficient thickness to secure the fertilized egg, but also optimal conditions in the uterine cavity. As a result, a miscarriage may occur upon the onset of conception. This situation can occur repeatedly, a diagnosis of habitual miscarriage will appear.
Before the IVF procedure, it is mandatory to undergo an examination for both spouses. This will help to timely detect the presence of inflammatory diseases of the uterine cavity and conduct a full treatment.
Direct contraindications for the IVF procedure:
- Acute and subacute endometritis.
- The presence of diffuse chronic endometritis and focal inflammation of the endometrium.
- Hypoplasia of the endometrium, polyps that have arisen against the background of a chronic inflammatory process or due to hormonal imbalance.
If these pathologies are identified, an individual treatment is prescribed based on the results of the examination. The goal of treatment is to restore the proper functioning of the reproductive system.
Treatment of endometritis before IVF does not differ from that during conventional therapy. Antibacterial drugs are prescribed according to sensitivity, antifungal agents. Be sure to use means to increase immunity (Interferon, Likopid) and vitamins of group B, C, E. To restore the menstrual cycle and increase the thickness of the endometrium, Duphaston is prescribed, less often Utrozhestan.
Approximate terms of treatment of chronic endometritis are from 3 weeks to one month. This is followed by a period of rehabilitation therapy for 3-4 months. During this time, the menstrual cycle normalizes, normal growth of the endometrium is restored. After all, you can prepare for IVF.
Before the procedure, a set of examinations is again prescribed:
- Blood test to determine the level of sex hormones.
- General and detailed (blood test with formula) blood tests.
- A smear from the vagina and cervical canal to determine the microflora.
- Ultrasound examination to determine the condition of the mucous layer of the uterus, the body of the uterus and appendages.
- Perhaps the appointment of a second biopsy.
In addition, an examination by a therapist and other specialists is necessary (which is also carried out when pregnancy occurs naturally).
Women are advised to avoid bad habits(smoking, alcohol), establish a diet (adhere to balanced nutrition, with plenty of vegetables, lean meats, fish, etc.). Be sure to normalize the daily routine and lifestyle: sleep for at least 8 hours, walks, stay on fresh air. It is recommended to avoid stressful situations whenever possible.
If all indicators are good, then the doctor prescribes the IVF procedure. And this is only the first step to the long-awaited motherhood. We need to take responsibility for this situation. Strict adherence to medical recommendations is the key to a successful outcome and the onset of long-awaited motherhood.
The usual scheme for managing a pregnancy that has come through IVF includes:
- Preparations of iodine, folic acid.
- Drugs that improve uterine blood flow.
- Means that help to bear the fetus and maintain hormonal balance.
- Medicines selected individually for symptomatic treatment.
After in vitro fertilization, the woman stays in the clinic for 14 days under the constant supervision of doctors. Then she is sent home. 30 days after the procedure, an examination is prescribed for the development of pregnancy. If everything goes well, then some of the drugs are canceled. However, you should not relax, as timely visits to consultations and strict adherence to all doctor's recommendations are necessary. But the opportunity to cuddle a child is worth it.
So, the conclusion: even in the presence of chronic endometritis, there are great chances of becoming a mother. The main thing is not to despair, but to try to follow all the prescriptions and recommendations of doctors. And then everything will work out! Be healthy!
Article last updated 07.12.2019
When a woman fails to get pregnant on her own for a long time, doctors recommend paying attention to IVF. The method of in vitro fertilization is recognized as the most effective and safe. To eliminate the risks, complications, and disruptions of a potential pregnancy, the patient must undergo a thorough medical examination before the procedure. Any inflammation in the uterus is a threat. Chronic endometritis and IVF are closely related. Scientists have proven that more than 60% of women with ineffective artificial insemination had CE, which was not treated.
Endometritis is an inflammation of the inner layer of the uterus. The danger of the disease lies in the fact that the pathology can develop for a long time without making itself felt.
Signs and symptoms may appear too late when the disease has become chronic form. CE in most cases develops against the background of factors such as:
- frequent abortions, curettage;
- the use of an intrauterine device for a long time;
- urinary tract infections;
- promiscuous sexual relations;
- inflammatory processes of the genital organs.
IVF in chronic endometritis may be unsuccessful due to the fact that inflammation provokes various pathological processes and disrupts blood circulation. Also, the consequence of the disease is reduced immunity, hormonal imbalance, infertility. It is important for a woman of reproductive age to closely monitor her health, monitor well-being. If you experience the slightest discomfort, you should seek the advice of a gynecologist.
The attending physician will be able to make an accurate diagnosis and determine the correct treatment regimen for the following signs:
- violation of the menstrual cycle;
- clots, heavy bleeding during menstruation;
- pulling pains in the lower abdomen;
- purulent or bloody discharge between periods;
- discomfort during sexual intercourse.
The main diagnostic methods are ultrasound, MRI, clinical tests blood. The doctor will also take biological material for histological examination and biopsy.
Preparatory stage and procedure
Treatment of chronic endometritis before IVF is a complex of measures. At the first stage, a woman is prescribed hormonal and anti-inflammatory drugs, as well as antibiotics.
At the second stage, therapy is introduced:
- vitamins;
- medicines that increase immunity;
- preparations for the normalization of microflora;
- physiotherapy.
If conservative methods were ineffective, cleaning or scraping is possible before IVF. After that, a second course of treatment is prescribed. The duration of therapy, the drugs used are set individually. General term treatment can range from 3 months to a year.
AT modern clinics where innovative treatment methods are used, intrauterine injections are used. Such injections help repair damaged tissues and prepare the uterus to receive a fertilized egg. Doctors recommend walking more, avoiding stress, eating right, visiting a sanatorium. It is equally important to prepare the man whose biomaterial will be used.
A few weeks before IVF, a woman should start drinking drugs that stimulate the development of not one, but several eggs at once. The in vitro fertilization procedure itself begins with the collection of the egg and sperm, which are processed and stored in a special solution. In a separate test tube, the cells are fertilized, after which doctors observe their division for 5-7 days. Several prepared embryos are placed in the uterus. This is followed by 2 weeks of hospitalization or close medical supervision.
Chronic endometritis as a cause of IVF failure
A.A. FEOKTISTOV, PhD, Reproductologist, IVF Department, Mother and Child Clinic A little about physiology In the work of every doctor involved in assisted reproductive technologies, there are times when you have to explain to a patient or a married couple the reason for IVF failures. One of the most common reasons for an unsuccessful program is the condition of the endometrium - the inner lining of the uterus, where the embryo is transferred, its further development, and. In our article we will talk about chronic endometritis.
A.A. FEOKTISTOV, Ph.D., "Mother and Child"