MORPHOLOGICAL CHANGES OF THE ENDOMETRIUM IN PATIENTS WITH CHRONIC ENDOMETRITIS AFTER PRP THERAPY
DOI:
https://doi.org/10.11603/24116-4944.2026.1.16377Keywords:
chronic endometritis, PRP therapy, endometrium, infertility, hysteroscopy, immunohistochemistry, morphologyAbstract
The aim of the study – to assess the dynamics of morphological changes of the endometrium in patients with chronic endometritis before and after the use of PRP therapy.
Materials and Methods. The prospective study included 200 women with infertility (mean age (32.5±1.2) years) who were treated with assisted reproductive technologies. All patients underwent office hysteroscopy with endometrial biopsy in the middle proliferative phase of the menstrual cycle. Morphological assessment was performed using standard histological staining with Hematoxylin and Eosin. Chronic endometritis was diagnosed in 93 patients. After PRP therapy, repeated hysteroscopy with biopsy was performed. Changes were assessed on a semi-quantitative scale (0–3) using the following criteria: edema, glandular structure, stromal cellularity, inflammatory infiltration, vascular changes, and other morphological features.
Results and Discussion. The study confirmed the leading role of morphological diagnostics of the endometrium as a key method for verifying chronic endometritis and objective monitoring of treatment effectiveness, which allows assessing not only the presence of inflammation, but also its stage, activity, and depth of structural changes; the most informative markers were lymphocytic infiltration, stroma condition, degree of fibrotic and vascular changes, and synchrony of endometrial maturation. It was found that antibacterial therapy provides only partial regression of inflammation without full restoration of tissue architectonics, while the addition of PRP therapy significantly improves regeneration, microcirculation, and structural organization of the endometrium, reducing the severity of pathological changes by almost half.
Conclusions. The most pronounced restorative effect is achieved when using a combined approach with the inclusion of antiviral therapy, which provides almost complete normalization of the morphofunctional state of the endometrium, emphasizing the importance of a comprehensive impact on all links of pathogenesis and its significance for increasing the effectiveness of subsequent reproductive interventions.
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