RU2424519C2 - Method of inflammatory process detection in cervical canal of uterus in sterile women - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: cervical mucus is examined. The mucus is sampled at an internal orifice of uterus at 4 cm from an external orifice of uterus. The sampling procedure is followed with microscopy of the sampled materials, and if observing the leukocytes count exceeding 30 in a microscopic field with magnification 10/40, the presence of protozoa and the other microscopic factors, an inflammatory process is detected in a cervical canal of uterus in sterile women.

EFFECT: higher accuracy of endocervicitis detection.

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Description

The invention relates to medicine and can be used to detect an inflammatory process in the cervical canal of the cervix (endocervicitis) in women with infertility, when all classical methods do not give a definite answer.

Recent decades have been characterized by significant advances in the diagnosis and treatment of various forms of infertility. Suffice it to say that while at the beginning of the 20th century there were practically no scientifically based methods of treating infertility, at the end of the same century the problem of diagnosing and treating infertility can be considered fundamentally solved. Nevertheless, it is known that if the frequency of infertile marriages reaches or exceeds 15%, then the problem of infertility in this case becomes of national importance. According to some researchers, the frequency of fruitless marriages in our country is 12-15% and has a tendency to increase. Medical and sociological studies have shown that in the vast majority of women, infertility leads to mental, social discomfort, reduces social adaptation, professional activity, and increases the number of divorces.

One of the causes of female infertility is the so-called cervical factor. Cervical (cervical) factor, according to various authors, is from 5 to 15% of all causes of infertility in women. The cervical canal and mucus filling its lumen are a significant obstacle to sperm into the uterine cavity. Therefore, it is obvious that one of the important roles in the formation of cervical infertility is played by changes in the qualitative and quantitative composition of cervical mucus that occur in the presence of inflammatory processes.

Known generally accepted method of collection and study of cervical mucus in women with infertility. In the periovulatory period, cervical mucus is aspirated with a tuberculin syringe, a mucus syringe or a polyethylene tube from the cervical canal at a distance of 1 cm from the external pharynx (WHO Guidelines for the Laboratory Study of Human Ejaculate and the Interaction of Sperm and Cervical Mucus, 4th ed., 2001 .) - PROTOTYPE.

Its disadvantage is the lack of information.

An object of the invention is to increase the information content of this method for identifying endocervicitis and its causes in women with infertility, followed by the possibility of specific drug treatment.

To solve the problem is proposed.

A method for identifying an inflammatory process in the cervical canal of the cervix in women with infertility, based on the study of cervical mucus, characterized in that the mucus is taken from the internal pharynx of the cervix, at a distance of about 4 cm from the external pharynx; capture of cervical mucus and superficial cells of the mucous membrane of the cervical canal is performed by anatomical tweezers; After taking the material, microscopy of the samples taken is immediately performed, and if there are more than 30 leukocytes in the field of view of the microscope with an increase of 10/40 and other microscopic signs of endocervicitis, further thorough microscopy of the cervical mucus is carried out to detect the simplest microorganisms. When they are detected, they conclude that their causal relationship with endocervicitis is possible; protozoan microorganisms are not trichomonads and represent another variety of protozoa, and their final identification is now being carried out.

Identification of endocervicitis by this method is as follows.

Douching should not be performed for 24 hours before the study, and the use of intravaginal therapy should be ruled out.

The cervical mucus is taken and examined during the periovulatory period (approximately 12-14 days of the menstrual cycle). Manipulation is performed when a woman is lying in a gynecological chair.

The cervix is exposed using a gynecological mirror, the vulva, vagina and vaginal part of the cervix are examined.

The tip of a long anatomical tweezers with closed branches is inserted into the external pharynx of the cervix and immersed to a depth of 3-4 cm, that is, in the upper third of the endortsevix. Further, the branches open and close again, capturing the cervical mucus of the upper third of the endocervix together with the epithelial cells of the mucous membrane of the cervical canal. The tweezers are removed. The duration of the cervical mucus collection procedure is from 2 to 5 minutes. The captured material is placed on a glass slide and covered with a coverslip and transported to the laboratory. In order to prevent the material from drying out, it is necessary to microscope cervical mucus in the range from 1 to 30 minutes after its collection.

The native drug delivered to the laboratory is examined under a light microscope at a magnification of 10/40. Microscopes over 20 fields of view. The study time can reach 20-30 minutes.

The simplest microorganisms discovered by us have an oval shape, several cilia are located at one end. The cytoplasm contains several vacuoles. The simplest microorganisms produce oscillatory movements in one place. The number of protozoa in the drug can vary from 1 to 10-20. The background of the drug is red blood cells, inflammatory infiltrate (white blood cells more than 30 in the field of view, lymphocytes, cell detritus). The epithelium is represented by layers, groups and scattered cells of the cylindrical epithelium. Microflora is mixed.

Clinical examples.

Patient K., 29 years old. She complained about the absence of pregnancy in marriage for 5 years. When examined in the analysis of cervical mucus: the mucus is thick, the viscosity is high, the white blood cells are completely in sight, the microflora is mixed, the simplest microorganisms were found. Complex treatment was carried out using naxoggine, vaginal tampons with metronidazole, Osarbon suppositories. In the next periovulatory period, a control analysis of cervical mucus was performed - the simplest microorganisms were not detected, white blood cells were single in the field of view, the viscosity of cervical mucus was normalized.

Patient L., 24 years old. She was examined for the absence of pregnancy in marriage for 2 years. When examined in the analysis of cervical mucus: the mucus is thick, the viscosity is high, leukocytes are 20-30 in the field of view, in clusters up to 60 in the field of view, the microflora is mixed, the simplest microorganisms were found. Complex treatment was carried out using naxoggine, vaginal tampons with metronidazole, Osarbon suppositories. In the next periovulatory period, a control analysis of cervical mucus was carried out - the simplest microorganisms were not detected, leukocytes 4-6 in the field of view, the viscosity of the cervical mucus returned to normal.

Patient D., 32 years old. She was examined for the absence of pregnancy in marriage for 6 years. At the initial examination in the analysis of cervical mucus: thick mucus, high viscosity, leukocytes 50-70 in the field of view, mixed microflora, simple microorganisms were found. Complex treatment was carried out using naxoggine, vaginal tampons with metronidazole, Osarbon suppositories. In the next periovulatory period, a control analysis of cervical mucus was performed - the simplest microorganisms were not detected, leukocytes 1-3 in the field of view, the viscosity of cervical mucus returned to normal.

Thus, the invention allows to detect endocervicitis if it is impossible to do this by other (standard) methods and to reveal a clear correlation of the inflammatory process with the presence of simple microorganisms in cervical mucus.

Claims (3)

1. A method for identifying an inflammatory process in the cervical canal of the cervix - endocervicitis - in women with infertility, based on the study of cervical mucus, characterized in that the mucus is taken from the internal pharynx of the cervix at a distance of about 4 cm from the external pharynx. 2. The method according to claim 1, characterized in that the capture of cervical mucus and surface cells of the mucous membrane of the cervical canal is performed by anatomical tweezers; After taking the material, microscopy of the samples taken is immediately performed, and if the number of leukocytes is more than 30 in the field of view of the microscope with an increase of 10/40 and other microscopic signs of endocervicitis, further thorough microscopy of the cervical mucus is carried out to detect the simplest microorganisms and, if detected, conclude that their causal relationship with endocervicitis. 3. The method according to claim 1, characterized in that the protozoa are not trichomonads and are another variety of protozoa.