Gryshchenko M. Pathogenesis of infertility caused by chronic inflammatory pelvic disease and applications to improvement of assisted reproductive technology.

The purpose of this study was to investigate the possibility of improving assisted reproductive technology results in women with infertility caused by chronic inflammatory pelvic disease. Pathogenesis of the inflammation was experimentally studied on 144 laboratory animals, and a clinical study was conducted on 239 females who previously suffered inflammatory diseases of small pelvis, focusing on clinical, anamnestic, immunologic and embryological characteristics of assisted reproduction methods. The study identified novel pathogenic mechanisms of reproductive disorders in patients with infertility caused by chronic inflammatory pelvic disease. The newly obtained data on the pathogenesis of impaired fertility following inflammatory diseases of the pelvic organs allowed to extend the existing diagnostic criteria and therapeutic options, and to identify new approaches to improve the effectiveness of assisted reproductive technology in this patient group. We developed and introduced into gynecological practice an algorithm of predicting the effectiveness of reproductive function restoration in women with infertility caused by chronic inflammatory pelvic disease. The forecasting system includes clinical, anamnestic, immunologic and embryologic criteria. As a part of the assisted reproductive technology program for patients with the consequences of chronic inflammation in the reproductive organs and poor prognosis of treatment, we developed a novel effective method of immunotropic therapy utilizing placental cryoextract. This therapy significantly improves the effectiveness of assisted reproductive technology in patients with infertility caused by chronic inflammatory pelvic disease.