The treatment of female infertility remains an urgent public health problem in the Russian Federation due to its high frequency and increase by a third over the past 10 years.
PURPOSE
To determine the prevalence of female infertility and its main causes in the Tyumen region and to provide a comparative assessment of the effectiveness of various methods of treating patients with chronic endometritis (CE) and reproductive dysfunction used in the Tyumen perinatal center.
MATERIAL
Information about the prevalence of infertility and its causes was obtained by applying to the Perinatal Center (Tyumen). Data on treatment methods and their effectiveness are analyzed based on annual reports for 2018—2022.
RESULTS
The frequency of female infertility in the Tyumen region in 2022 was 1608.4 per 100 thousand women of childbearing age, which is 2 times higher than in the Russian Federation and has increased by 18.6% since 2018. In the age structure of infertility, the main share is made up of women from 30 to 39 years old (68.9%). Among the causes, the first place in frequency is occupied by infertility of uterine origin (56.9%), the second — associated with the absence of ovulation (20.7%), the third — tubal origin (9.4%). In dynamics over 5 years, the proportion of uterine infertility increased by 25.8% due to CE. Among the total number of women with impaired reproductive function, including infertility and recurrent miscarriage, the proportion of CE as the main and concomitant disease was 60.8%. Complex treatment of infertility using physiotherapy methods is not effective enough with a live birth rate of 6.9 to 15.4% with significant time costs for treatment (3 courses lasting 10—12 days). The use of an immunomodulating agent in complex therapy containing a complex of natural antimicrobial peptides and cytokines (Superlymph) allows to achieve results in a shorter time (treatment duration 20 days, one course) with the onset of pregnancy within 6 months after treatment in 44.9% of patients and live birth rate of 37.3%, which is comparable to the IVF success rate (average 30.7% for 2018—2021). In addition, the use of Superlymph in women in preparation for IVF made it possible to increase the effectiveness of ART programs from 37.0% in 2019 to 43.6% in 2022 (+16.6%) in terms of pregnancy and from 31.0 to 37.4% respectively (+5.5%) in terms of live birth.
CONCLUSION
The prevalence of female infertility in the Tyumen region is 2 times higher compared to the Russian Federation, mainly in women aged 30 to 39 years (68.9%) and the prevalence of CE in the structure of its causes (60.8%). Among the methods used to treat infertility caused by CE, the most effective is a complex that includes Superlymph.
