THE EFFECT OF CYTOKINE THERAPY ON UTERINE-ENDOMETRIAL BLOOD FLOW AND REPRODUCTIVE FUNCTION IN VARIOUS MORPHOLOGICAL TYPES OF CHRONIC ENDOMETRITIS

Objective: To evaluate the impact of cytokine therapy on utero-endometrial blood flow in different morphological types of chronic endometritis. Materials and methods: We analyzed data from 298 women of reproductive age with a confirmed diagnosis of chronic endometritis (CE). The study group comprised 140 patients in whom standard anti-inflammatory therapy was supplemented with Superlymph. The control group included 158 patients treated with a similar regimen but without cytokine therapy. Doppler parameters of uterine artery blood flow were assessed, including arterial perfusion index (API) and volumetric blood flow indices (VI, FI, and VFI). Results: Following therapy, a significant decrease in vascularization was observed in women with mixed and hyperplastic CE morphotypes, which was attributed to the normalization of venous outflow in the uterine mucosa. However, this pronounced effect was not observed in women with a hypoplastic morphotype. During the first six months after completing complex treatment with exogenous cytokines, clinical pregnancy rates were 38.8% in the study group compared to 27.5% in those receiving only anti-inflammatory therapy (RR=1.412; 95% CI 1.008– 1.997). In the study group, pregnancy occurred 1.9 times more frequently in women with hyperplastic macrotype than in those with hypoplastic macrotype CE. Conclusion: The administration of exogenous cytokines, in conjunction with anti-inflammatory therapy, restores venous outflow in the endometrium for mixed and hyperplastic macrotypes of CE, while enhancing the effectiveness of pathogenetic treatment in the hypoplastic macrotype. This approach increases pregnancy rates by 1.5 times in cases of thin endometrium, by 1.8 times in cases of mixed macrotype, and by 1.3 times in cases of hyperplasia. © 2025 Elsevier B.V., All rights reserved.