[Diagnostics of genital herpesvirus infection in women with tubal-peritoneal infertility].

AIM: Optimization of diagnostics of genital herpesvirus infection (herpes simplex virus types 1 and 2, cytomegalovirus [CMV]) in women with tubal-peritoneal infertility on the basis of detection of viral material in various parts of genital system using polymerase chain reaction (PCR) and revealing pathogenetically significant systemic abnormalitites of cytokine- and nitroxidergic regulation. MATERIALS AND METHODS: Sixty-three women with tubal-peritoneal infertility were included in the study. Immunoenzyme assay, PCR, and modified Griess method were used. RESULTS: In cervical canal herpesvirus infection was detected together with other agents in 30.1% of cases. In upper parts of reproductive system monoinfection with herpesvirus was detected in 74.63% of cases (herpes virus types 1 and 2--in 46.03%, CMV--in 28.6% of women). Increased levels of stable end metabolites of nitric oxide and cytokines were noted in sera of tested women. CONCLUSION: Inflammatory changes in reproductive organs in women with tubal-peritoneal infertility are determined by chronic herpesvirus infection. This leads to Th1 polarization of immune response and developing of immune-mediated inflammation.

[Microflora of reproductive system in women with tubal-peritoneal sterility].

AIM: To study the composition of microflora of lower and upper parts of reproductive system in women with tubal-peritoneal sterility. MATERIALS AND METHODS: One hundred and forty-five women with tubal-peritoneal sterilitywere examined. Laparoscopy with biopsy of ovaries and endometrium with evaluation of specimens by histology and PCR was performed in all patients. Cervical material, endometrial and ovarian biopsy specimens, and peritoneal fluid were tested by PCR on the presence of genetic material of sexually-transmitted microorganisms. Cervical material was tested for human papillomaviruses (types 16 and 18). RESULTS: Bacteria were isolated from cervical canal specimens in 40% of women. Chlamydia, Ureaplasma, herpes virus type 1 and 2, cytomegalovirus were detected in specimens of cervical canal, endometrium, ovaries and peritoneal fluid in 80%, 38,6%, 34,3%, and 38,46% of women, respectively. CONCLUSION: In cases of tubal-peritoneal sterility female reproductive system is infected with different pathogenic microorganisms. Growth of microorganisms was detected in 40% of cervical mucosa samples. Intracellular pathogens persist in upper and lower parts of female reproductive system. It was noted that Herpes simplex infection predominated in ovaries.