Pathology of the endometrium in women with chronic hepatitis C and HIV infection as a cause of unsuccessful in vitro fertilization attempts

Abstract

Aim: The purpose of the study is to detect endometrial pathology in individuals with blood-borne infections (hepatitis C virus [HCV] and HIV) and to assess the impact of quality of the endometrium on the efficiency of assisted reproductive technologies (ART).

Materials and methods of research: The study involved 56 women of reproductive age, 33 women with HCV, 22 with HIV infection (stages 3 and 4A) and 1 patient with co-infection of HCV and HIV, which was excluded from the further study. Ultrasound investigation of the small pelvic organs, hysteroscopy with biopsy of the mucosa of the uterine cavity, histological examination of the endometrium, determination of HCV RNA and HIV RNA in serum and endometrial tissue by PCR method were conducted.

Results: Ultrasound and histological studies of the endometrium revealed a high incidence of development of hyperplastic and inflammatory processes of the endometrium in women with HCV (86% and 100%) and HIV (51% and 99%). When molecular biological examination of endometrial tissue of these patients was performed with the use of a set of reagents “AmpliSens HCV/HBV/HIV-FL” produced by Federal Budgetary Institution of Science (FBUN) Central Research Institute of Epidemiology of Rospotrebnadzor of Russia, HCV was detected in 16.7% and HIV in 14.3% of cases. In 5% of patients with HCV infection and 7% with HIV, pathogens were detected in the endometrium under the non-detectable viral load in the blood plasma. Lower effectiveness of IVF in women with HIV and HCV is defined compared to the women without blood-borne infections.

Conclusion: Detected HIV and HCV replications in the endometrium is the likely cause of hyperplastic and inflammatory processes of the endometrium leading to reduced efficiency of the ART programs in patients with chronic hepatitis C and HIV.