| Endometritis refers to the inflammation of endometrium caused by the invasion of pathogenic bacteria.It is a common disease in women of childbearing age.It can be divided into acute endometritis and chronic endometritis?CE?according to the pathogenesis and development of the disease.Endometrium is the basis for successful implantation of fertilized ovum.CE can affect the receptivity of endometrium to embryos in many ways,leading to infertility or abortion.Studies have shown that 15%of infertile women receiving in vitro fertilization-embryo transplantation?IVF-ET?treatment have CE[1].The diagnosis of endometritis includes ultrasonography,hysteroscopy,cytokine detection and pathogenic microorganism examination.The purpose of this study is to explore the diagnostic value of hysteroscopy and transvaginal ultrasound in CE by transvaginal ultrasonography and hysteroscopy were performed on suspected CE patients.At the same time,the patients diagnosed as CE by pathology and immunohistochemistry were treated with Jinfeng Pill on the basis of traditional western antibiotics.To observe the effect of Jinfeng Pill on IVF-ET pregnancy outcome in patients with CE,in order to provide reference for clinical treatment strategies.Participants were selected from all infertile patients with suspected CE who were under 35 years old and had normal ovarian reserve function from September 2016 to September 2018 in the Reproductive Medical Center of Handan Central Hospital.All these patients needed IVF technology to assist in pregnancy.All these patients were examined by transvaginal ultrasound and hysteroscopy.Both examinations were performed within 3to 7 days after menstruation was cleaned.Patients with irregular vaginal bleeding were examined when the amount of bleeding was less.When patients underwent hysteroscopy,the suspicious endometrial lesions were biopsied and the tissues were examined by pathology and immunohistochemistry.The gold standard for diagnosing CE was the combination of pathological results and immunohistochemistry.Typical plasma cell infiltration appeared in endometrial stroma,and the number of CD138?+?and/or CD38?+?positive plasma cells could be seen at 5 or more times per 400-fold high power microscopy.The positive rates of diagnostic CE in hysteroscopy group and transvaginal ultrasound group were analyzed and compared,and the accuracy of diagnostic CE in each group was evaluated.The patients diagnosed as CE were divided into control group and experimental group according to different treatment method.The control group was given moxifloxacin hydrochloride0.4g/time,once a day for 14 days.On the basis of the control group,the experimental group was given Jinfeng pill 10 pills/time,twice a day,orally for 12 days.After treatment,the patients entered the IVF assisted pregnancy cycle with standard long protocol,and the cleavage embryos were transplanted on the third day after taking the ovum,1-2 cleavage embryos at a time.The endometrial thickness on transplantation day,implantation rate,clinical pregnancy rate,abortion rate and twin rate were compared between the control group and the experimental group.Of all suspected CE patients included in this study,106 were diagnosed as CE,56 in the experimental group and 50 in the control group.The results showed that the positive rate of CE was 15.09%in transvaginal ultrasound group and 89.62%in hysteroscopy group.There was a significant difference between the two groups?x2=118.017,P<0.000?.In the patients diagnosed as CE,the endometrial thickness on transplantation day in the experimental group was?10.45±1.55?mm after treatment,and that in the control group was?9.46±1.42?mm.The difference was statistically significant?t=3.208,P=0.002?.The implantation rate in the experimental group was higher than that in the control group?40.79%vs25.37%?.There was a significant difference between the two groups?x2=4.426,P=0.035?.The pregnancy rate of IVF in the experimental group was also higher than that in the control group?65.00%vs 40.00%?.There was a significant difference between the two groups?x2=4.688,P=0.030?.There was no significant difference between the experimental group and the control group in the rate of good embryo transplantation,the rate of whole embryo freezing,the rate of twins and the rate of abortion.The results confirmed that in the process of clinical diagnosis of CE,the positive rate of CE by transvaginal ultrasonography was low and the rate of missed diagnosis was high.Hysteroscopy was significantly higher than transvaginal ultrasonography in the positive rate of CE.However,there were some missed diagnosis cases if not combined with pathological examination and immunohistochemical diagnosis.Combined with pathological diagnosis and immunohistochemistry,the risk of missed diagnosis could be reduced and the clinical detection rate of CE could be improved.To provide an accurate reference for the formulation of effective clinical treatment programs.Through the comparison between the experimental group and the control group,it is confirmed that Jinfeng pill combined with moxifloxacin hydrochloride can make the endometrial thickness of CE patients significantly thicker on transplantation day than that of moxifloxacin hydrochloride alone,improve the implantation rate and clinical pregnancy rate of IVF assisted pregnancy,improve the pregnancy outcome of IVF assisted pregnancy,and can be popularized and applied in clinic. |
PDF Full Text Request