The problem of infertility affects millions of people around the world. It is becoming more and more difficult for a woman to conceive and bear the desired child
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What are the reasons for this situation and what to do about it – answers these questions obstetrician-gynecologist, doctor of medical sciences, professor, honored doctor of the Russian Federation Yulia Dobrokhotova.
If you carefully read the biblical texts, you can draw interesting observations: barrenness in those Old Testament times, when they walked through the gardens of Eden and ate apples straight from the trees, was extremely rare. Infertility could not threaten half the world’s population, as it is now.
However, when analyzing the present time and our way of life, it can be argued that a huge number of introduced external factors have a negative impact on the systems and tissues of the body, leading them to a painful state in which conception does not occur. Many women live with this and do not feel any painful symptoms, except that the desired pregnancy does not occur from month to month, and if it does, the pregnancy is still interrupted, because the body is not ready to accept and endure, and the woman cannot fulfill their reproductive function – to become a mother.
– Julia Eduardovna, what exactly leads to infertility today?
– Any pathological processes affecting the uterus, such as infectious agents, trauma, adhesions in the uterus, developmental anomalies, endocrine disorders adversely affect the endometrium, and subsequently the ability to conceive and bear a child.
The endometrium is the inner lining of the uterus, where the fertilized egg attaches itself or, in other words, is implanted. It happens that conception has occurred (in any way, both naturally and with the help of assisted reproductive technologies), but due to the fact that a woman has chronic inflammation of the inner lining of the uterus, the so-called chronic endometritis, the embryo cannot attach and All this leads to loss of pregnancy. The inner shell of the uterus is not ready to accept and grow the fetus, just as bad soil cannot give good shoots. As a rule, the cause of the development of such a chronic condition is an infection represented by viruses, bacteria or viral-bacterial associations.
According to a study conducted in St. Petersburg at the Research Institute of Obstetrics, Gynecology and Reproductology. D.R. Ott, it was shown that chronic inflammation of the inner lining of the uterus (chronic endometritis) in primary infertility, when pregnancy did not occur in a woman’s life, was observed in 71.5-88.5% of women and in almost 90% of patients in secondary infertility, when pregnancy was in the life of a woman, and after pregnancy cannot occur. The study, which lasted more than two years, involved 575 women with diagnosed infertility who were preparing for another IVF attempt. This prevalence of the chronic process made me think about many things.
– Recently, there is information that viral diseases of the uterus, in particular the herpes virus, play an important role in infertility? Is it so?
– This is a very serious question. Herpetic infections lead to disruption of embryogenesis. The problem is that 60% of the reproductive population of the Earth (that is, almost every second) are carriers of urogenital herpes, which, alas, is very difficult to diagnose – it is asymptomatic and greatly weakens the woman’s immunity. The highest surge in the incidence of herpes occurs at 20-29 years of age. The second peak is at 35-40. This is the age when couples plan to have children. And just at this moment, great reproductive risks are revealed. Untreated herpes for expectant mothers is intrauterine infections and premature birth with all the ensuing consequences. To date, 7 types of herpes are known, and type 6 herpes is in the endometrium in 40% of women. Only the body itself, which is important to support, can adequately fight it. Which is what we are trying to do.
Obstetrician-gynecologist, Doctor of Medical Sciences, Professor, Honored Doctor of the Russian Federation Yulia Dobrokhotova
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– Probably, not only a woman, if she wants to become a mother, needs to seek medical help, but also a man – a future father?
– Adequate treatment is desirable for both. This will prevent a re-exacerbation of a herpes infection. The influence of the pathogen is leveled, blood flow in the tissues is established and the endometrium comes into order.
By the way, if before the couple had no children for a long time, basically everyone blamed the woman for this. Today it has been officially proven: both partners equally (50 to 50) can be “guilty” of the absence of children. But we are not looking for “guilty” here, this is neither constructive nor ethical. The only important thing is that the problem affects everyone.
– And even IVF is not able to help?
– According to statistics, the success rate of the IVF procedure is 30%. There are also problems with carrying a pregnancy in general, because. there may be premature birth, which is a complication, which leads to the fact that the newborn baby is premature and weak. It is very important on what background the pregnancy occurs. It is the infection, acute at the beginning, and then sluggish, that can be one of the main reasons for subsequent failures.
Chronic inflammation leads to the actual loss of functionality of the inner lining of the uterus (endometrium).
In other words, once fertile soil becomes not fertile, not receptive to crops (the embryo is not able to “attach” to the uterus).
In addition, metabolic processes in the vascular network of the endometrium and uterus are disrupted, which leads to a deterioration in the transport function of nutrients and oxygen.
– Yulia Eduardovna, you conducted your own research, please tell us what was the purpose of the research?
– We evaluated the effect of local immune therapy, in particular the drug “Superlymph” on the endometrium in viral infections. Previous work experience has shown that pregnancy occurred more often in those women who received complex treatment. Our study included women with a diagnosis of “infertility” who were preparing for the IVF procedure. The diagnosis of “chronic endometritis” was in 83 patients. A year later, pregnancy occurred in 42 women (50.6%). 25 women became pregnant on their own, 17 after IVF. We found that after the treatment, the titers of herpes virus type I, II, cytomegalovirus, Epstein-Barr decreased.
The natural complex of natural antimicrobial peptides and cytokines (active molecules that make up the drug) is a universal stimulant of the immune system, has antiviral, antimicrobial, antioxidant, immunomodulatory effects, reduces the development of inflammation, stimulates the healing of wound defects, and also helps to reduce the impact of pathogens, in particular herpes group viruses and bacteria, thereby improving the functionality of the endometrium. Complex regimens for the treatment of infections make it possible to successfully deal with infectious agents – viral and bacterial associations, constant companions of any infectious process. Thus, a comprehensive treatment regimen for chronic endometritis can improve pregnancy rates by 15%.
What advice would you give to a woman who wants to become a mother?
– Be sure to undergo a comprehensive examination, including paying attention to the endometrium. Pipel biopsy and immunohistochemical examination of tissues are modern diagnostic methods. Be sure to be in contact, trust your doctor. The onset of pregnancy is a great joy not only for the patient, but also for the doctor who leads the woman. This is the achievement of all participants in the process to get the coveted result – happiness! Happiness – to be mom, dad, parents! Give new life!!!