CLINICAL MANIFESTATIONS OF HPV INFECTIONS IN WOMEN WITH SECONDARY INFERTILITY

Аннотация

This article analyzes the main factors of female infertility, including tubal-peritoneal, endocrine, immunological, infertility caused by genital diseases, and idiopathic infertility. The etiological aspects are considered, including the influence of infectious agents on female fertility. Particular attention is paid to the role of sexually transmitted infections - the human papillomavirus, in the development of infertility. Data from numerous studies on the prevalence of HPV and its impact on women's reproductive health are presented. The article emphasizes the importance of a comprehensive approach to the diagnosis and treatment of female infertility to improve treatment outcomes and increase the chances of successful conception. Keywords Secondary infertility, papillomavirus infection, condyloma acuminata, diagnosis of "thin" endometrium 1. Introduction In the field of reproductive health today, infertility occupies a special place. According to modern sources, 8 to 12% of married couples have infertile marriages, in which the woman's share is about 50-80% [3,6,10,29,38]. There are five main groups of factors of female infertility: Tubal-peritoneal Endocrine Infertility caused by genital diseases and anatomical abnormalities Immunological Idiopathic (infertility of unknown origin) Analyzing these factors, it should be recognized that infectious agents can become a predictor of female infertility in all five groups. Undoubtedly, infection affects the condition of the fallopian tubes and endometrium, but the inflammatory autoimmune process contributes to the disruption of the structure and function of the ovaries. And finally, the disruption of the vaginal microbiota in connection with the presence of microorganisms with impaired immunoreactivity contributes to the development of antisperm antibodies and impaired sperm motility [7, 8, 9, 11, 12,14, 23, 24, 31,34]. In this regard, the 203 ACADEMIC RESEARCH IN MODERN SCIENCE International scientific-online conference problem of sexually transmitted infections (chlamydia, ureaplasmosis, mycoplasmosis, gonorrhea), as predictors of infertility, has already been sufficiently studied. However, the etiological role of viral sexually transmitted infections (STIs) in fertility impairment, including human papillomavirus infection, has not yet been studied. The frequency of human papillomavirus infections (HPV) in the world, according to various researchers, has increased more than 10 times over the past decade [2,4,5, 16,20, 21, 22, 27,35, 36]. Almost all of the reports cited are based on the detection and treatment of oncogenic HPV strains. However, in practice, clinical manifestations of the human papillomavirus in the form of condyloma acuminata are increasingly encountered, which is the main reason for women to seek medical attention, in whom, upon closer examination, other infections are also detected [17,19, 37, 40]. This state of affairs even led to the need to publish clinical guidelines for the management of women with condyloma acuminata [32]. Although most researchers agree that human papillomavirus infection itself does not lead to infertility in women, but can be the cause of male infertility in her partner [5,18,25, 26, 30, 39]. the frequent referral of infertile patients with manifestations of condyloma acuminata served as the reason for conducting this study. Objective of the study: To study the condition of the endometrium in infertile patients with condyloma acuminata. Materials and methods: Using ultrasound, the condition of the endometrium was studied in 78 patients with secondary infertility who applied to the private medical clinic MCHJ "Mama i Ya" in 2022-2023 (main group). The control group consisted of 50 patients with secondary infertility without condyloma acuminata. The inclusion criteria for the study were: age not older than 35 years; absence of developmental anomalies of the pelvic organs; history of pregnancy; absence of pregnancy for 12 months without the use of contraceptives; signed informed consent to participate in the study; condyloma acuminata detected during genital examination. Exclusion criteria: age over 35 years; absence of condyloma; congenital malformations of the pelvic organs; somatic diseases that are contraindications for pregnancy and childbirth; patient's refusal to participate in the study; alcohol abuse, drug or drug addiction; male infertility. 204 ACADEMIC RESEARCH IN MODERN SCIENCE International scientific-online conference Standard clinical and gynecological research methods were used. In the middle of the menstrual cycle, an ultrasound examination of the pelvic organs with Dopplerography was performed on a Sonoscape 3D/4D device. The obtained results were subjected to statistical processing using methods presented in the Statistica 6.0 program. To assess the differences between groups according to quantitatively measured indicators, the parametric Student's t-test was used. To compare the control and main gro