Current approaches to diagnosing and treating endometrial receptor apparatus disorders in patients with recurrent implantation failures


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Abstract

The given review analyzes the data available in the literature on the main etiological factors and pathogenetic mechanisms of endometrial susceptibility disorders in patients with recurrent implantation failures in assisted reproductive technology programs. The paper includes the publications available in the Pubmed database (https://pubmed.ncbi.nlm.nih.gov/) on this topic. It gives information on modern molecular genetic methods for determining the personalized window of implantation and for correcting the timing of embryo transfer, for identifying the pathogenic microorganisms that cause chronic endometritis, and for analyzing the species and quantitative composition of the endometrial microbiota. It summarizes the results of the most effective methods of immunotherapy, which are aimed at improving the receptive properties of the endometrium, by using platelet-rich plasma, mononuclear cells, granulocyte-stimulating factor, growth hormone, and the drugs dexamethasone and letrozole. The paper reflects the expediency of etiotropic antibacterial therapy in patients with chronic endometritis and recurrent implantation failures at the stage of preparation for assisted reproductive technology programs. It shows an association between endometrial scratching and improved reproductive outcomes in patients with recurrent implantation failures. Special attention in overcoming infertility is paid to the possibilities of cell therapy using mesenchymal stem cells in women with Asherman’s syndrome and endometrial hypoplasia. Conclusion. Patients with multiple implantation failures in assisted reproductive technology programs require the in-depth diagnosis of the endometrial receptor apparatus and the application of personalized approach to preparing the endometrium.

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About the authors

Maya M. Maslova

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: mayay2012@mail.ru
MD, PhD, Department of Obstetrics, Gynecology, Perinatology and Reproductology

Stanislav V. Pavlovich

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University); Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: s_pavlovich@oparina4.ru
MD, Academic Secretary

Veronika Yu. Smolnikova

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: veronika.smolnikova@mail.ru
MD, PhD, leading researcher, Department of assistive reproductive technology in the treatment of infertility; Professor of the Department of Obstetrics, Gynecology, Perinatology and Reproductology

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