medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-086medsovet-7455Research ArticleРЕПРОДУКТИВНОЕ ЗДОРОВЬЕ И ВРТREPRODUCTIVE HEALTH AND ARTДискуссионные вопросы лечения хронического эндометритаDiscussion issues in the treatment of chronic endometritishttps://orcid.org/0000-0001-9524-8962ДиккеГ. Б.DikkeG. B.

Дикке Галина Борисовна, д.м.н., доцент, профессор кафедры акушерства и гинекологии с курсом репродуктивной медицины,

190013, Санкт-Петербург, Московский проспект, д. 22

Galina B. Dikke, Dr. Sci. (Med.), Associate Professor, Professor of the Department of Obstetrics and Gynecology with a Course in Reproductive Medicine,

22, Moscow Ave., St Petersburg, 190013

galadikke@yandex.ruАкадемия медицинского образования имени Ф.И. ИноземцеваРоссияАcademy of Medical Education named F.I. InozemtsevRussian Federation202319042023058289Copyright © Дикке Г.Б., 20232023Дикке Г.Б.Dikke G.B.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7455

Распространенность хронического эндометрита (ХЭ) в общей популяции колеблется от 14,1 до 24,4% и в 2–3 раза выше у пациенток с нарушением репродуктивной функции. Лечение ХЭ представляет определенные трудности из-за различных подходов и противоречивых сведений об эффективности используемых методов. По данным исследований частота излечения ХЭ с помощью антибиотиков (АБ) составляет 82,3–87,9% с показателем живорождения – 56–62,4%. В программах ВРТ у пациенток, прошедших курс АБ-терапии, наблюдается увеличение частоты живорождений в 5 раз. Отмечена необходимость достичь консенсуса по диагностическим критериям ХЭ, чтобы исключить влияние гетерогенности исследований на результаты лечения. В последние годы широко обсуждается необходимость восстановления иммунной защиты при ХЭ. Из доступных в РФ иммуномодуляторов средством с доказанной эффективностью является комплекс экзогенных природных цитокинов и хемокинов, использование которого в комбинации с АБ позволяет добиться элиминации возбудителей у 86% пациенток с ХЭ вирусно-бактериальной этиологии (против 56% при лечении только АБ) и достичь наступления беременностей, завершившихся родами, в 60% наблюдений (против 29% соответственно). Иммунная функция может быть улучшена за счет устранения дефицита микронутриентов, в частности витаминно-минерального комплекса Прегнотон, что может способствовать повышению устойчивости к инфекциям, более быстрому выздоровлению и улучшению репродуктивной функции. Лечение ХЭ должно включать АБ-терапию препаратами широкого спектра действия и  противовирусную терапию, направленную на снижение активности вирусов. Комплекс экзогенных природных цитокинов и хемокинов для местного применения способствует увеличению показателей наступления беременности и  живорождений. Биологически активные добавки, в  т. ч. витаминно-минеральный комплекс Прегнотон, могут применяться в качестве дополнительных средств для улучшения функций врожденного и приобретенного иммунитета. 

The prevalence of  chronic endometritis  (CE) in  the general population ranges from 14.1  to 24.4% and is 2–3  times higher in patients with impaired reproductive function. The treatment of CE presents certain difficulties due to different approaches and conflicting information about the effectiveness of the methods used. According to studies, the cure rate of CE with antibiotics (AB) is 82.6–87.9% with a live birth rate of 56–62.4%. In ART programs in patients who have undergone a course of AB-therapy, there is a 5-fold increase in the frequency of live births. The need to reach a consensus on the diagnostic criteria for CE was noted to exclude the influence of study heterogeneity on treatment outcomes. In recent years, the need to restore immune protection in CE has been widely discussed. Of the immunomodulators available in the Russian Federation with proven efficacy is a complex of exogenous natural cytokines and chemokines, the use of which in combination with AB allows to achieve elimination of pathogens in 86% of patients with CE of viral and bacterial aetiology (56% in the treatment of AB alone) and achieve pregnancy, ended in childbirth, in 60% of cases (29% without cytokines). Immune function can be improved by addressing micronutrient deficiencies, in particular the vitamin and mineral complex Pregnoton, which can contribute to increased resistance to infection, faster recovery, and improved reproductive function. Treatment of CE should include broad-spectrum antibiotic therapy and antiviral therapy aimed at reducing the activity of viruses. The complex of exogenous natural cytokines and chemokines for topical application helps to increase the rates of pregnancy and live births. Biologically active supplements, including the Pregnoton vitaminmineral complex, can be used as additional means to improve the functions of innate and acquired immunity. 

бесплодиерецидивирующая неудача имплантациипривычное невынашивание беременностиантибиотикииммуномодуляторыбиологически активные добавкиinfertilityrecurrent implantation failurerecurrent miscarriageantibioticsimmunomodulatorsdietary supplementsReferencesYasuo T., Kitaya K. Challenges in Clinical Diagnosis and Management of Chronic Endometritis. Diagnostics (Basel). 2022;12(11):2711. https://doi.org/10.3390/diagnostics1211271.Yasuo T., Kitaya K. Challenges in Clinical Diagnosis and Management of Chronic Endometritis. Diagnostics (Basel). 2022;12(11):2711. https://doi.org/10.3390/diagnostics1211271.Cicinelli E., Trojano G., Mastromauro M., Vimercati A., Marinaccio M., Mitola P.C. et al. Higher prevalence of chronic endometritis in women with endometriosis: a possible etiopathogenetic link. Fertil Steril. 2017;108(2):289-295.e1. https://doi.org/10.1016/j.fertnstert.2017.05.016.Cicinelli E., Trojano G., Mastromauro M., Vimercati A., Marinaccio M., Mitola P.C. et al. Higher prevalence of chronic endometritis in women with endometriosis: a possible etiopathogenetic link. Fertil Steril. 2017;108(2):289-295.e1. https://doi.org/10.1016/j.fertnstert.2017.05.016.Song D., Feng X., Zhang Q., Xia E., Xiao Y., Xie W., Li T.C. Prevalence and confounders of chronic endometritis in premenopausal women with abnormal bleeding or reproductive failure. Reprod Biomed Online. 2018;36(1):78-83. https://doi.org/10.1016/j.rbmo.2017.09.008.Song D., Feng X., Zhang Q., Xia E., Xiao Y., Xie W., Li T.C. Prevalence and confounders of chronic endometritis in premenopausal women with abnormal bleeding or reproductive failure. Reprod Biomed Online. 2018;36(1):78-83. https://doi.org/10.1016/j.rbmo.2017.09.008.Bouet P.E., El Hachem H., Monceau E., Gariépy G., Kadoch I.J., Sylvestre C. Chronic endometritis in women with recurrent pregnancy loss and recurrent implantation failure: prevalence and role of office hysteroscopy and immunohistochemistry in diagnosis. Fertil Steril. 2016;105(1):106-110. https://doi.org/10.1016/j.fertnstert.2015.09.025.Bouet P.E., El Hachem H., Monceau E., Gariépy G., Kadoch I.J., Sylvestre C. Chronic endometritis in women with recurrent pregnancy loss and recurrent implantation failure: prevalence and role of office hysteroscopy and immunohistochemistry in diagnosis. Fertil Steril. 2016;105(1):106-110. https://doi.org/10.1016/j.fertnstert.2015.09.025.Kimura F., Takebayashi A., Ishida M., Nakamura A., Kitazawa J., Morimune A. et al. Review: Chronic endometritis and its effect on reproduction. J Obstet Gynaecol Res. 2019;45(5):951-960. https://doi.org/10.1111/jog.13937.Kimura F., Takebayashi A., Ishida M., Nakamura A., Kitazawa J., Morimune A. et al. Review: Chronic endometritis and its effect on reproduction. J Obstet Gynaecol Res. 2019;45(5):951-960. https://doi.org/10.1111/jog.13937.Liu Y, Chen X, Huang J, Wang CC, Yu MY, Laird S, Li TC. Comparison of the prevalence of chronic endometritis as determined by means of different diagnostic methods in women with and without reproductive failure. Fertil Steril. 2018;109(5):832-839. https://doi.org/10.1016/j.fertnstert.2018.01.022.Liu Y, Chen X, Huang J, Wang CC, Yu MY, Laird S, Li TC. Comparison of the prevalence of chronic endometritis as determined by means of different diagnostic methods in women with and without reproductive failure. Fertil Steril. 2018;109(5):832-839. https://doi.org/10.1016/j.fertnstert.2018.01.022.Qiao X., Wu L., Liu D., Pei T., Huang W. Existence of chronic endometritis and its influence on pregnancy outcomes in infertile women with minimal/mild endometriosis. Int J Gynaecol Obstet. 2023;160(2):628-634. https://doi.org/10.1002/ijgo.14326.Qiao X., Wu L., Liu D., Pei T., Huang W. Existence of chronic endometritis and its influence on pregnancy outcomes in infertile women with minimal/mild endometriosis. Int J Gynaecol Obstet. 2023;160(2):628-634. https://doi.org/10.1002/ijgo.14326.Hirata K., Kimura F., Nakamura A., Kitazawa J., Morimune A., Hanada T. et аl. Histological diagnostic criterion for chronic endometritis based on the clinical outcome. BMC Womens Health. 2021;21(1):94. https://doi.org/10.1186/s12905-021-01239-y.Hirata K., Kimura F., Nakamura A., Kitazawa J., Morimune A., Hanada T. et аl. Histological diagnostic criterion for chronic endometritis based on the clinical outcome. BMC Womens Health. 2021;21(1):94. https://doi.org/10.1186/s12905-021-01239-y.McQueen D.B., Perfetto C.O., Hazard F.K., Lathi R.B. Pregnancy outcomes in women with chronic endometritis and recurrent pregnancy loss. Fertil Steril. 2015;104(4):927-931. https://doi.org/10.1016/j.fertnstert.2015.06.044.McQueen D.B., Perfetto C.O., Hazard F.K., Lathi R.B. Pregnancy outcomes in women with chronic endometritis and recurrent pregnancy loss. Fertil Steril. 2015;104(4):927-931. https://doi.org/10.1016/j.fertnstert.2015.06.044.Vitagliano A., Laganà A.S., De Ziegler D., Cicinelli R., Santarsiero C.M., Buzzaccarini G. et al. Chronic Endometritis in Infertile Women: Impact of Untreated Disease, Plasma Cell Count and Antibiotic Therapy on IVF Outcome-A Systematic Review and Meta-Analysis. Diagnostics (Basel). 2022;12(9):2250. https://doi.org/10.3390/diagnostics12092250.Vitagliano A., Laganà A.S., De Ziegler D., Cicinelli R., Santarsiero C.M., Buzzaccarini G. et al. Chronic Endometritis in Infertile Women: Impact of Untreated Disease, Plasma Cell Count and Antibiotic Therapy on IVF Outcome-A Systematic Review and Meta-Analysis. Diagnostics (Basel). 2022;12(9):2250. https://doi.org/10.3390/diagnostics12092250.Moreno I., Cicinelli E., Garcia-Grau I., Gonzalez-Monfort M., Bau D., Vilella F. et al. The diagnosis of chronic endometritis in infertile asymptomatic women: A comparative study of histology, microbial cultures, hysteroscopy, and molecular microbiology. Am J Obstet Gynecol. 2018;218(6):602. e1-602.e16. https://doi.org/10.1016/j.ajog.2018.02.012.Moreno I., Cicinelli E., Garcia-Grau I., Gonzalez-Monfort M., Bau D., Vilella F. et al. The diagnosis of chronic endometritis in infertile asymptomatic women: A comparative study of histology, microbial cultures, hysteroscopy, and molecular microbiology. Am J Obstet Gynecol. 2018;218(6):602. e1-602.e16. https://doi.org/10.1016/j.ajog.2018.02.012.Kitaya K., Takeuchi T., Mizuta S., Matsubayashi H., Ishikawa T. Endometritis: new time, new concepts. Fertil Steril. 2018;110(3):344-350. https://doi.org/ 10.1016/j.fertnstert.2018.04.012.Kitaya K., Takeuchi T., Mizuta S., Matsubayashi H., Ishikawa T. Endometritis: new time, new concepts. Fertil Steril. 2018;110(3):344-350. https://doi.org/ 10.1016/j.fertnstert.2018.04.012.Cicinelli E., Vitagliano A., Kumar A., Lasmar R.B., Bettocchi S., Haimovich S. Unified Diagnostic Criteria for Chronic Endometritis at Fluid Hysteroscopy: Proposal and Reliability Evaluation through an International RandomizedControlled Observer Study. Fertil Steril. 2019;112(1):162-173.e2. https://doi.org/10.1016/j.fertnstert.2019.03.004.Cicinelli E., Vitagliano A., Kumar A., Lasmar R.B., Bettocchi S., Haimovich S. Unified Diagnostic Criteria for Chronic Endometritis at Fluid Hysteroscopy: Proposal and Reliability Evaluation through an International RandomizedControlled Observer Study. Fertil Steril. 2019;112(1):162-173.e2. https://doi.org/10.1016/j.fertnstert.2019.03.004.Cicinelli E., Haimovich S., De Ziegler D., Raz N., Ben-Tzur D., Andrisani A. et al. MUM-1 Immunohistochemistry Has High Accuracy and Reliability in the Diagnosis of Chronic Endometritis: A Multi-Centre Comparative Study with CD-138 Immunostaining. J Assist Reprod Genet. 2022;39(1):219-226. https://doi.org/10.1007/s10815-021-02356-1.Cicinelli E., Haimovich S., De Ziegler D., Raz N., Ben-Tzur D., Andrisani A. et al. MUM-1 Immunohistochemistry Has High Accuracy and Reliability in the Diagnosis of Chronic Endometritis: A Multi-Centre Comparative Study with CD-138 Immunostaining. J Assist Reprod Genet. 2022;39(1):219-226. https://doi.org/10.1007/s10815-021-02356-1.Li Y., Xu S., Yu S., Huang C., Lin S., Chen W. et al. Diagnosis of chronic endometritis: How many CD138+ cells/HPF in endometrial stroma affect pregnancy outcome of infertile women? Am J Reprod Immunol. 2021;85(5):e13369. https://doi.org/10.1111/aji.13369.Li Y., Xu S., Yu S., Huang C., Lin S., Chen W. et al. Diagnosis of chronic endometritis: How many CD138+ cells/HPF in endometrial stroma affect pregnancy outcome of infertile women? Am J Reprod Immunol. 2021;85(5):e13369. https://doi.org/10.1111/aji.13369.Zargar M., Ghafourian M., Nikbakht R., Mir H.V., Moradi Choghakabodi P. Evaluating Chronic Endometritis in Women with Recurrent Implantation Failure and Recurrent Pregnancy Loss by Hysteroscopy and Immunohistochemistry. J Minim Invasive Gynecol. 2020;27(1):116-121. https://doi.org/10.1016/j.jmig.2019.02.016.Zargar M., Ghafourian M., Nikbakht R., Mir H.V., Moradi Choghakabodi P. Evaluating Chronic Endometritis in Women with Recurrent Implantation Failure and Recurrent Pregnancy Loss by Hysteroscopy and Immunohistochemistry. J Minim Invasive Gynecol. 2020;27(1):116-121. https://doi.org/10.1016/j.jmig.2019.02.016.Chen Y.Q., Fang R.L., Luo Y.N., Luo C.Q. Analysis of the diagnostic value of CD138 for chronic endometritis, the risk factors for the pathogenesis of chronic endometritis and the effect of chronic endometritis on pregnancy: a cohort study. BMC Womens Health. 2016;16(1):60. https://doi.org/10.1186/s12905-016-0341-3.Chen Y.Q., Fang R.L., Luo Y.N., Luo C.Q. Analysis of the diagnostic value of CD138 for chronic endometritis, the risk factors for the pathogenesis of chronic endometritis and the effect of chronic endometritis on pregnancy: a cohort study. BMC Womens Health. 2016;16(1):60. https://doi.org/10.1186/s12905-016-0341-3.Herlihy N., Titus S., Scott C., Klimczak A., Hanson B., Kim J. et al. Endometrial staining for cd138 as a marker of chronic endometritis does not predict failed implantation. Fertil Steril. 2020;114:209-e210. https://doi.org/10.1016/j.fertnstert.2020.08.593.Herlihy N., Titus S., Scott C., Klimczak A., Hanson B., Kim J. et al. Endometrial staining for cd138 as a marker of chronic endometritis does not predict failed implantation. Fertil Steril. 2020;114:209-e210. https://doi.org/10.1016/j.fertnstert.2020.08.593.Fan X., Li X., Li Y., Liao J., Chen H., Li Y. et al. Endometrial CD138 count appears to be a negative prognostic indicator for patients who have experienced previous embryo transfer failure. Fertil Steril. 2019;112(6):1103-1111. https://doi.org/10.1016/j.fertnstert.2019.08.006.Fan X., Li X., Li Y., Liao J., Chen H., Li Y. et al. Endometrial CD138 count appears to be a negative prognostic indicator for patients who have experienced previous embryo transfer failure. Fertil Steril. 2019;112(6):1103-1111. https://doi.org/10.1016/j.fertnstert.2019.08.006.Gkrozou F., Tsonis O., Dimitriou E., Paschopoulos M. In women with chronic or subclinical endometritis is hysteroscopy suitable for setting the diagnosis? A systematic review. J Obstet Gynaecol Res. 2020;46(9):1639-1650. https://doi.org/10.1111/jog.14360.Gkrozou F., Tsonis O., Dimitriou E., Paschopoulos M. In women with chronic or subclinical endometritis is hysteroscopy suitable for setting the diagnosis? A systematic review. J Obstet Gynaecol Res. 2020;46(9):1639-1650. https://doi.org/10.1111/jog.14360.Liu J., Liu Z.A., Liu Y., Cheng L., Yan L. Impact of antibiotic treatment for chronic endometritis on pregnancy outcomes in women with reproductive failures (RIF and RPL): A systematic review and meta-analysis. Front Med (Lausanne). 2022;9:980511. https://doi.org/10.3389/fmed.2022.980511.Liu J., Liu Z.A., Liu Y., Cheng L., Yan L. Impact of antibiotic treatment for chronic endometritis on pregnancy outcomes in women with reproductive failures (RIF and RPL): A systematic review and meta-analysis. Front Med (Lausanne). 2022;9:980511. https://doi.org/10.3389/fmed.2022.980511.Мальцева Л.И., Шарипова Р.И. Хронический эндометрит - новое время, новые подходы к лечению. Практическая медицина. 2019;(4):15-19. https://doi.org/10.32000/2072-1757-2019-4-15-19.Maltseva L.I. Sharipova R.I. Chronic endometritis - new time, new approaches to treatment. Practical Medicine. 2019;(4):15-19. (In Russ.) https://doi.org/10.32000/2072-1757-2019-4-15-19.Cicinelli E., Matteo M., Trojano G., Mitola P.C., Tinelli R., Vitagliano A. et al. Chronic endometritis in patients with unexplained infertility: Prevalence and effects of antibiotic treatment on spontaneous conception. Am J Reprod Immunol. 2018;79(1). https://doi.org/10.1111/aji.12782.Cicinelli E., Matteo M., Trojano G., Mitola P.C., Tinelli R., Vitagliano A. et al. Chronic endometritis in patients with unexplained infertility: Prevalence and effects of antibiotic treatment on spontaneous conception. Am J Reprod Immunol. 2018;79(1). https://doi.org/10.1111/aji.12782.Molina N.M., Sola-Leyva A., Saez-Lara M.J., Plaza-Diaz J., Tubić-Pavlović A., Romero B. et al. New Opportunities for Endometrial Health by Modifying Uterine Microbial Composition: Present or Future? Biomolecules. 2020;10(4):593. https://doi.org/10.3390/biom10040593.Molina N.M., Sola-Leyva A., Saez-Lara M.J., Plaza-Diaz J., Tubić-Pavlović A., Romero B. et al. New Opportunities for Endometrial Health by Modifying Uterine Microbial Composition: Present or Future? Biomolecules. 2020;10(4):593. https://doi.org/10.3390/biom10040593.Pantos K., Simopoulou M., Maziotis E., Rapani A., Grigoriadis S., Tsioulou P. et al. Introducing intrauterine antibiotic infusion as a novel approach in effectively treating chronic endometritis and restoring reproductive dynamics: a randomized pilot study. Sci Rep. 2021;11(1):15581. https://doi.org/10.1038/s41598-021-95072-w.Pantos K., Simopoulou M., Maziotis E., Rapani A., Grigoriadis S., Tsioulou P. et al. Introducing intrauterine antibiotic infusion as a novel approach in effectively treating chronic endometritis and restoring reproductive dynamics: a randomized pilot study. Sci Rep. 2021;11(1):15581. https://doi.org/10.1038/s41598-021-95072-w.Cicinelli E., Matteo M., Tinelli R., Lepera A., Alfonso R., Indraccolo U. et al. Prevalence of chronic endometritis in repeated unexplained implantation failure and the IVF success rate after antibiotic therapy. Hum Reprod. 2015;30(2):323-330. https://doi.org/10.1093/humrep/deu292.Cicinelli E., Matteo M., Tinelli R., Lepera A., Alfonso R., Indraccolo U. et al. Prevalence of chronic endometritis in repeated unexplained implantation failure and the IVF success rate after antibiotic therapy. Hum Reprod. 2015;30(2):323-330. https://doi.org/10.1093/humrep/deu292.Pirtea P., Cicinelli E., De Nola R., de Ziegler D., Ayoubi J.M. Endometrial causes of recurrent pregnancy losses: endometriosis, adenomyosis, and chronic endometritis. Fertil Steril. 2021;115(3):546-560. https://doi.org/10.1016/j.fertnstert.2020.12.010.Pirtea P., Cicinelli E., De Nola R., de Ziegler D., Ayoubi J.M. Endometrial causes of recurrent pregnancy losses: endometriosis, adenomyosis, and chronic endometritis. Fertil Steril. 2021;115(3):546-560. https://doi.org/10.1016/j.fertnstert.2020.12.010.Kato H., Yamagishi Y., Hagihara M., Hirai J., Asai N., Shibata Y. et al. Systematic review and meta-analysis for impacts of oral antibiotic treatment on pregnancy outcomes in chronic endometritis patients. J Infect Chemother. 2022;28(5):610-615. https://doi.org/10.1016/j.jiac.2022.01.001.Kato H., Yamagishi Y., Hagihara M., Hirai J., Asai N., Shibata Y. et al. Systematic review and meta-analysis for impacts of oral antibiotic treatment on pregnancy outcomes in chronic endometritis patients. J Infect Chemother. 2022;28(5):610-615. https://doi.org/10.1016/j.jiac.2022.01.001.Huang W., Liu B., He Y., Xie Y., Liang T., Bi Y. et al. Variation of diagnostic criteria in women with chronic endometritis and its effect on reproductive outcomes: A systematic review and meta-analysis. J Reprod Immunol. 2020;140:103146. https://doi.org/10.1016/j.jri.2020.103146.Huang W., Liu B., He Y., Xie Y., Liang T., Bi Y. et al. Variation of diagnostic criteria in women with chronic endometritis and its effect on reproductive outcomes: A systematic review and meta-analysis. J Reprod Immunol. 2020;140:103146. https://doi.org/10.1016/j.jri.2020.103146.Singh N., Sethi A. Endometritis - Diagnosis, Treatment and its impact on fertility - A Scoping Review. JBRA Assist Reprod. 2022;26(3):538-546. https://doi.org/10.5935/1518-0557.20220015.Singh N., Sethi A. Endometritis - Diagnosis, Treatment and its impact on fertility - A Scoping Review. JBRA Assist Reprod. 2022;26(3):538-546. https://doi.org/10.5935/1518-0557.20220015.Петров Ю.А., Алехина А.Г., Блесманович А.Е. Актуальные нюансы патогенеза хронического эндометрита. Современные проблемы науки и образования. 2018;(6). Режим доступа: https://science-education.ru/ru/article/view?id=28155.Petrov Yu.A., Alyokhina A.G., Blesmanovich A.E. Current nuances of the pathogenesis of chronic endometritis. Modern Problems of Science and Education. 2018;(6). (In Russ.) Available at: https://science-education.ru/ru/article/view?id=28155.Kushnir V.A., Solouki S., Sarig-Meth T., Vega M.G., Albertini D.F., Darmon S.K. et al. Systemic Inflammation and Autoimmunity in Women with Chronic Endometritis. Am J Reprod Immunol. 2016;75(6):672-677. https://doi.org/10.1111/aji.12508.Kushnir V.A., Solouki S., Sarig-Meth T., Vega M.G., Albertini D.F., Darmon S.K. et al. Systemic Inflammation and Autoimmunity in Women with Chronic Endometritis. Am J Reprod Immunol. 2016;75(6):672-677. https://doi.org/10.1111/aji.12508.Kofod L., Lindhard A., Hviid T.V.F. Implications of uterine NK cells and regulatory T cells in the endometrium of infertile women. Hum Immunol. 2018;79(9):693-701. https://doi.org/10.1016/j.humimm.2018.07.003.Kofod L., Lindhard A., Hviid T.V.F. Implications of uterine NK cells and regulatory T cells in the endometrium of infertile women. Hum Immunol. 2018;79(9):693-701. https://doi.org/10.1016/j.humimm.2018.07.003.Park H.J., Kim Y.S., Yoon T.K., Lee W.S. Chronic endometritis and infertility. Clin Exp Reprod Med. 2016;43(4):185-192. https://doi.org/10.5653/cerm.2016.43.4.185.Park H.J., Kim Y.S., Yoon T.K., Lee W.S. Chronic endometritis and infertility. Clin Exp Reprod Med. 2016;43(4):185-192. https://doi.org/10.5653/cerm.2016.43.4.185.Marci R., Gentili V., Bortolotti D., Lo Monte G., Caselli E., Bolzani S. et al. Presence of HHV-6A in Endometrial Epithelial Cells from Women with Primary Unexplained Infertility. PLoS ONE. 2016;11(7):e0158304. https://doi.org/10.1371/journal.pone.0158304.Marci R., Gentili V., Bortolotti D., Lo Monte G., Caselli E., Bolzani S. et al. Presence of HHV-6A in Endometrial Epithelial Cells from Women with Primary Unexplained Infertility. PLoS ONE. 2016;11(7):e0158304. https://doi.org/10.1371/journal.pone.0158304.Kapranos N.C., Kotronias D.C. Detection of Herpes Simplex Virus in First Trimester Pregnancy Loss Using Molecular Techniques. In Vivo. 2009;23(5):839-842. Available at: https://pubmed.ncbi.nlm.nih.gov/19779121.Kapranos N.C., Kotronias D.C. Detection of Herpes Simplex Virus in First Trimester Pregnancy Loss Using Molecular Techniques. In Vivo. 2009;23(5):839-842. Available at: https://pubmed.ncbi.nlm.nih.gov/19779121.Pereira N., Kucharczyk K.M., Estes J.L., Gerber R.S., Lekovich J.P., Elias R.T., Spandorfer S.D. Human Papillomavirus Infection, Infertility, and Assisted Reproductive Outcomes. J Pathog. 2015;2015:578423. https://doi.org/10.1155/2015/578423.Pereira N., Kucharczyk K.M., Estes J.L., Gerber R.S., Lekovich J.P., Elias R.T., Spandorfer S.D. Human Papillomavirus Infection, Infertility, and Assisted Reproductive Outcomes. J Pathog. 2015;2015:578423. https://doi.org/10.1155/2015/578423.Sherkat R., Meidani M., Zarabian H., Rezaei A., Gholamrezaei A. Seropositivity of cytomegalovirus in patients with recurrent pregnancy loss. J Res Med Sci. 2014;19(Suppl. 1):S22-25. Available at: https://pubmed.ncbi.nlm.nih.gov/25002889.Sherkat R., Meidani M., Zarabian H., Rezaei A., Gholamrezaei A. Seropositivity of cytomegalovirus in patients with recurrent pregnancy loss. J Res Med Sci. 2014;19(Suppl. 1):S22-25. Available at: https://pubmed.ncbi.nlm.nih.gov/25002889.Дикке Г.Б., Остроменский В.В. Нарушение иммунного статуса при хроническом эндометрите и опыт его коррекции посредством локальной цитокинотерапии. Акушерство и гинекология. 2019;(9):139-146. https://doi.org/10.18565/aig.2019.9.139-146.Dikke G.B., Ostromensky V.V. Immune status disorder in chronic endometritis and experience of its correction by means of local cytokine therapy. Akusherstvo i Ginekologiya (Russian Federation). 2019;(9):139-146. (In Russ.) https://doi.org/10.18565/aig.2019.9.139-146.Доброхотова Ю.Э., Ганковская Л.В., Боровкова Е.И., Нугуманова О.Р. Экзогенная цитокинотерапия в лечении пациенток с хроническим эндометритом. Акушерство и гинекология. 2021;(2):119-126. https://doi.org/10.18565/aig.2021.2.119-126.Dobrokhotova Yu.E., Gankovskaya L.V., Borovkova E.I., Nugumanova O.R. Exogenous cytokine therapy in the treatment of patients with chronic endometritis. Akusherstvo i Ginekologiya (Russian Federation). 2021;(2):119-126. (In Russ.) https://doi.org/10.18565/aig.2021.2.119-126.Polanski L.T., Barbosa M.A., Martins W.P., Baumgarten M.N., Campbell B., Brosens J. et al. Interventions to improve reproductive outcomes in women with elevated natural killer cells undergoing assisted reproduction techniques: a systematic review of literature. Hum Reprod. 2014;29(1):65-75. https://doi.org/10.1093/humrep/det414.Polanski L.T., Barbosa M.A., Martins W.P., Baumgarten M.N., Campbell B., Brosens J. et al. Interventions to improve reproductive outcomes in women with elevated natural killer cells undergoing assisted reproduction techniques: a systematic review of literature. Hum Reprod. 2014;29(1):65-75. https://doi.org/10.1093/humrep/det414.Тапильская Н.И., Толибова Г.Х., Савичева А.М., Копылова А.А., Глушаков Р.И., Будиловская О.В. и др. Эффективность локальной цитокинотерапии хронического эндометрита пациенток с бесплодием. Акушерство и гинекология. 2022;(2):91-100. https://doi.org/10.18565/aig.2022.2.91-100.Tapilskaya N.I., Tolibova G.Kh., Savicheva A.M., Kopylova A.A., Glushakov R.I., Budilovskaya O.V. et al. Efficacy of local cytokine therapy for chronic endometritis in infertile patients. Akusherstvo i Ginekologiya (Russian Federation). 2022;(2):91-100. (In Russ.) https://doi.org/10.18565/aig.2022.2.91-100.Доброхотова Ю.Э., Ганковская Л.В., Боровкова Е.И., Зайдиева З.С., Скальная В.С. Модулирование локальной экспрессии факторов врожденного иммунитета у пациенток с хроническим эндометритом и бесплодием. Акушерство и гинекология. 2019;(5):125-132. https://doi.org/10.18565/aig.2019.5.125-132.Dobrokhotova Yu.E., Gankovskaya L.V., Borovkova E.I., Zaidieva Z.S., Skalnaya V.S. Modulation of local expression of innate immunity factors in patients with chronic endometritis and infertility. Akusherstvo i Ginekologiya (Russian Federation). 2019;(5):125-132. (In Russ.) https://doi.org/10.18565/aig.2019.5.125-132.Achilli C., Duran-Retamal M., Saab W., Serhal P., Seshadri S. The role of immunotherapy in in vitro fertilization and recurrent pregnancy loss: a systematic review and meta-analysis. Fertil Steril. 2018;110(6):1089-1100. https://doi.org/10.1016/j.fertnstert.2018.07.004.Achilli C., Duran-Retamal M., Saab W., Serhal P., Seshadri S. The role of immunotherapy in in vitro fertilization and recurrent pregnancy loss: a systematic review and meta-analysis. Fertil Steril. 2018;110(6):1089-1100. https://doi.org/10.1016/j.fertnstert.2018.07.004.Melo P., Thornton T., Coomarasamy A., Granne I. Evidence for the effectiveness of immunologic therapies in women with subfertility and/or undergoing assisted reproduction. Fertil Steril. 2022;117(6):1144-1159. https://doi.org/10.1016/j.fertnstert.2022.04.015.Melo P., Thornton T., Coomarasamy A., Granne I. Evidence for the effectiveness of immunologic therapies in women with subfertility and/or undergoing assisted reproduction. Fertil Steril. 2022;117(6):1144-1159. https://doi.org/10.1016/j.fertnstert.2022.04.015.Liu M., Yuan Y., Qiao Y., Tang Y., Sui X., Yin P., Yang D. The effectiveness of immunomodulatory therapies for patients with repeated implantation failure: a systematic review and network meta-analysis. Sci Rep. 2022;12(1):18434. https://doi.org/10.1038/s41598-022-21014-9.Liu M., Yuan Y., Qiao Y., Tang Y., Sui X., Yin P., Yang D. The effectiveness of immunomodulatory therapies for patients with repeated implantation failure: a systematic review and network meta-analysis. Sci Rep. 2022;12(1):18434. https://doi.org/10.1038/s41598-022-21014-9.Wang C., Guan D., Li R., Bing Z., Yang Y., Yang K. Comparative efficacies of different immunotherapy regimens in recurrent implantation failure: A systematic review and network meta-analysis. J Reprod Immunol. 2021;148:103429. https://doi.org/10.1016/j.jri.2021.103429.Wang C., Guan D., Li R., Bing Z., Yang Y., Yang K. Comparative efficacies of different immunotherapy regimens in recurrent implantation failure: A systematic review and network meta-analysis. J Reprod Immunol. 2021;148:103429. https://doi.org/10.1016/j.jri.2021.103429.Dizzell S., Nazli A., Reid G., Kaushic C. Protective Effect of Probiotic Bacteria and Estrogen in Preventing HIV-1-Mediated Impairment of Epithelial Barrier Integrity in Female Genital Tract. Cells. 2019;8(10):1120. https://doi.org/10.3390/cells8101120.Dizzell S., Nazli A., Reid G., Kaushic C. Protective Effect of Probiotic Bacteria and Estrogen in Preventing HIV-1-Mediated Impairment of Epithelial Barrier Integrity in Female Genital Tract. Cells. 2019;8(10):1120. https://doi.org/10.3390/cells8101120.Громова О.А., Торшин И.Ю. Микронутриенты и репродуктивное здоровье. М.: ГЭОТАР-Медиа; 2019. 220 с.Gromova O.A., Torshin I.Yu. Micronutrients and Reproductive Health. Moscow: GEOTAR-Media; 2019. 220 p. (In Russ.)Romero-Aguirregomezcorta J., Santa A.P., Garcia-Vazquez F.A., Coy P., Matas C. Nitric Oxide Synthase (NOS) Inhibition during Porcine In Vitro Maturation Modifies Oocyte Protein S-Nitrosylation and In Vitro Fertilization. PLoS ONE. 2014;9(12):e115044. https://doi.org/10.1371/journal.pone.0115044.Romero-Aguirregomezcorta J., Santa A.P., Garcia-Vazquez F.A., Coy P., Matas C. Nitric Oxide Synthase (NOS) Inhibition during Porcine In Vitro Maturation Modifies Oocyte Protein S-Nitrosylation and In Vitro Fertilization. PLoS ONE. 2014;9(12):e115044. https://doi.org/10.1371/journal.pone.0115044.Ren W., Yin Y., Liu G., Yu X., Li Y., Yang G. et al. Effect of dietary arginine supplementation on reproductive performance of mice with porcine circovirus type 2 infection. Amino Acids. 2012;42(6):2089-2094. https://doi.org/10.1007/s00726-011-0942-y.Ren W., Yin Y., Liu G., Yu X., Li Y., Yang G. et al. Effect of dietary arginine supplementation on reproductive performance of mice with porcine circovirus type 2 infection. Amino Acids. 2012;42(6):2089-2094. https://doi.org/10.1007/s00726-011-0942-y.So S., Yamaguchi W., Murabayashi N., Miyano N., Tawara F., Kanayama N. Beneficial effect of l-arginine in women using assisted reproductive technologies: a small-scale randomized controlled trial. Nutr Res. 2020;82:67-73. https://doi.org/10.1016/j.nutres.2020.08.008.So S., Yamaguchi W., Murabayashi N., Miyano N., Tawara F., Kanayama N. Beneficial effect of l-arginine in women using assisted reproductive technologies: a small-scale randomized controlled trial. Nutr Res. 2020;82:67-73. https://doi.org/10.1016/j.nutres.2020.08.008.Ghannadi A., Bagherinejad M., Abedi D., Jalali M., Absalan B., Sadeghi N. Antibacterial activity and composition of essential oils from Pelargonium graveolens L’Her and Vitex agnus-castus L. Iran J Microbiol. 2012;4(4):171-176. Available at: https://pubmed.ncbi.nlm.nih.gov/23205247.Ghannadi A., Bagherinejad M., Abedi D., Jalali M., Absalan B., Sadeghi N. Antibacterial activity and composition of essential oils from Pelargonium graveolens L’Her and Vitex agnus-castus L. Iran J Microbiol. 2012;4(4):171-176. Available at: https://pubmed.ncbi.nlm.nih.gov/23205247.Макаров В.Г. Молекулярная биология флавоноидов. СПб.: Лема; 2010. 438 с.Makarov V.G. Molecular biology of flavonoids. St Petersburg: Lema; 2010. 438 p. (In Russ.)Rafieian-Kopaei M., Movahedi M. Systematic Review of Premenstrual, Postmenstrual and Infertility Disorders of Vitex Agnus Castus. Electron Physician. 2017;9(1):3685-3689. https://doi.org/10.19082/3685.Rafieian-Kopaei M., Movahedi M. Systematic Review of Premenstrual, Postmenstrual and Infertility Disorders of Vitex Agnus Castus. Electron Physician. 2017;9(1):3685-3689. https://doi.org/10.19082/3685.Stevens G.A., Beal T., Mbuya M.N.N., Luo H., Neufeld L.M. Micronutrient deficiencies among preschool-aged children and women of reproductive age worldwide: a pooled analysis of individual-level data from populationrepresentative surveys. Lancet Glob Health. 2022;10(11):e1590-e1599. https://doi.org/10.1016/S2214-109X(22)00367-9.Stevens G.A., Beal T., Mbuya M.N.N., Luo H., Neufeld L.M. Micronutrient deficiencies among preschool-aged children and women of reproductive age worldwide: a pooled analysis of individual-level data from populationrepresentative surveys. Lancet Glob Health. 2022;10(11):e1590-e1599. https://doi.org/10.1016/S2214-109X(22)00367-9.Maggini S., Pierre A., Calder P.C. Immune Function and Micronutrient Requirements Change over the Life Course. Nutrients. 2018;10(10):1531. https://doi.org/10.3390/nu10101531.Maggini S., Pierre A., Calder P.C. Immune Function and Micronutrient Requirements Change over the Life Course. Nutrients. 2018;10(10):1531. https://doi.org/10.3390/nu10101531.Gombart A.F., Pierre A., Maggini S. A Review of Micronutrients and the Immune System-Working in Harmony to Reduce the Risk of Infection. Nutrients. 2020;12(1):236. https://doi.org/10.3390/nu12010236.Gombart A.F., Pierre A., Maggini S. A Review of Micronutrients and the Immune System-Working in Harmony to Reduce the Risk of Infection. Nutrients. 2020;12(1):236. https://doi.org/10.3390/nu12010236.Sommer A., Fabri M. Vitamin D regulates cytokine patterns secreted by dendritic cells to promote differentiation of IL-22-producing T cells. PLoS ONE. 2015;10(6):e0130395. https://doi.org/10.1371/journal.pone.0130395.Sommer A., Fabri M. Vitamin D regulates cytokine patterns secreted by dendritic cells to promote differentiation of IL-22-producing T cells. PLoS ONE. 2015;10(6):e0130395. https://doi.org/10.1371/journal.pone.0130395.Lerchbaum E., Rabe T. Vitamin D and female fertility. Curr Opin Obstet Gynecol. 2014;26(3):145-150. https://doi.org/10.1097/GCO.0000000000000065.Lerchbaum E., Rabe T. Vitamin D and female fertility. Curr Opin Obstet Gynecol. 2014;26(3):145-150. https://doi.org/10.1097/GCO.0000000000000065.Rudick B.J., Ingles S.A., Chung K., Stanczyk F.Z., Paulson R.J., Bendikson K.A. Influence of vitamin D levels on in vitro fertilization outcomes in donorrecipient cycles. Fertil Steril. 2014;101(2):447-452. https://doi.org/10.1016/j.fertnstert.2013.10.008.Rudick B.J., Ingles S.A., Chung K., Stanczyk F.Z., Paulson R.J., Bendikson K.A. Influence of vitamin D levels on in vitro fertilization outcomes in donorrecipient cycles. Fertil Steril. 2014;101(2):447-452. https://doi.org/10.1016/j.fertnstert.2013.10.008.Sharif K., Sharif Y., Watad A., Yavne Y., Lichtbroun B., Bragazzi N.L. et al. Vitamin D, autoimmunity and recurrent pregnancy loss: More than an association. Am J Reprod Immunol. 2018;80(3):e12991. https://doi.org/10.1111/aji.12991.Sharif K., Sharif Y., Watad A., Yavne Y., Lichtbroun B., Bragazzi N.L. et al. Vitamin D, autoimmunity and recurrent pregnancy loss: More than an association. Am J Reprod Immunol. 2018;80(3):e12991. https://doi.org/10.1111/aji.12991.Saeed F., Nadeem M., Ahmed R., Nadeem M., Arshad M., Ullah A. Studying the impact of nutritional immunology underlying the modulation of immune responses by nutritional compounds - A review. Food Agric Immunol. 2016;27:205-229. https://doi.org/10.1080/09540105.2015.1079600.Saeed F., Nadeem M., Ahmed R., Nadeem M., Arshad M., Ullah A. Studying the impact of nutritional immunology underlying the modulation of immune responses by nutritional compounds - A review. Food Agric Immunol. 2016;27:205-229. https://doi.org/10.1080/09540105.2015.1079600.Drake V.J. Overview of the Immune System. Available at: http://lpi.oregonstate.edu/mic/health-disease/immunity.Drake V.J. Overview of the Immune System. Available at: http://lpi.oregonstate.edu/mic/health-disease/immunity.Haryanto B., Suksmasari T., Wintergerst E., Maggini S. Multivitamin supplementation supports immune function and ameliorates conditions triggered by reduced air quality. Vitam Miner. 2015;4:1-15. https://www.hilarispublisher.com/abstract/multivitamin-supplementation-supports-immune-functionand-ameliorates-conditions-triggered-by-reduced-air-quality-39795.html.Haryanto B., Suksmasari T., Wintergerst E., Maggini S. Multivitamin supplementation supports immune function and ameliorates conditions triggered by reduced air quality. Vitam Miner. 2015;4:1-15. https://www.hilarispublisher.com/abstract/multivitamin-supplementation-supports-immune-functionand-ameliorates-conditions-triggered-by-reduced-air-quality-39795.html.van de Lagemaat E.E., de Groot L.C.P.G.M., van den Heuvel E.G.H.M. Vitamin B12 in Relation to Oxidative Stress: A Systematic Review. Nutrients. 2019;11(2):482. https://doi.org/10.3390/nu11020482.4van de Lagemaat E.E., de Groot L.C.P.G.M., van den Heuvel E.G.H.M. Vitamin B12 in Relation to Oxidative Stress: A Systematic Review. Nutrients. 2019;11(2):482. https://doi.org/10.3390/nu11020482.4Cirillo M., Fucci R., Rubini S., Coccia M.E., Fatini C. 5-Methyltetrahydrofolate and Vitamin B12 Supplementation Is Associated with Clinical Pregnancy and Live Birth in Women Undergoing Assisted Reproductive Technology. Int J Environ Res Public Health. 2021;18(23):12280. https://doi.org/10.3390/ijerph182312280.Cirillo M., Fucci R., Rubini S., Coccia M.E., Fatini C. 5-Methyltetrahydrofolate and Vitamin B12 Supplementation Is Associated with Clinical Pregnancy and Live Birth in Women Undergoing Assisted Reproductive Technology. Int J Environ Res Public Health. 2021;18(23):12280. https://doi.org/10.3390/ijerph182312280.Amimo J.O., Michael H., Chepngeno J., Raev S.A., Saif L.J., Vlasova A.N. Immune Impairment Associated with Vitamin A Deficiency: Insights from Clinical Studies and Animal Model Research. Nutrients. 2022;14(23):5038. https://doi.org/10.3390/nu14235038.Amimo J.O., Michael H., Chepngeno J., Raev S.A., Saif L.J., Vlasova A.N. Immune Impairment Associated with Vitamin A Deficiency: Insights from Clinical Studies and Animal Model Research. Nutrients. 2022;14(23):5038. https://doi.org/10.3390/nu14235038.Clagett-Dame M., Knutson D. Vitamin A in reproduction and development. Nutrients. 2011;3(4):385-428. https://doi.org/10.3390/nu3040385.Clagett-Dame M., Knutson D. Vitamin A in reproduction and development. Nutrients. 2011;3(4):385-428. https://doi.org/10.3390/nu3040385.Ashraf M., Mustansir F., Baqir S.M., Alam F., Rehman R. Changes in vitamin E levels as a marker of female infertility. J Pak Med Assoc. 2020;70(10):1762-1766. https://doi.org/10.5455/JPMA.40329.Ashraf M., Mustansir F., Baqir S.M., Alam F., Rehman R. Changes in vitamin E levels as a marker of female infertility. J Pak Med Assoc. 2020;70(10):1762-1766. https://doi.org/10.5455/JPMA.40329.Cicek N., Eryilmaz O.G., Sarikaya E., Gulerman C., Genc Y. Vitamin E effect on controlled ovarian stimulation of unexplained infertile women. J Assist Reprod Genet. 2012;29(4):325-328. https://doi.org/10.1007/s10815-012-9714-1.Cicek N., Eryilmaz O.G., Sarikaya E., Gulerman C., Genc Y. Vitamin E effect on controlled ovarian stimulation of unexplained infertile women. J Assist Reprod Genet. 2012;29(4):325-328. https://doi.org/10.1007/s10815-012-9714-1.Hashemi Z., Sharifi N., Khani B., Aghadavod E., Asemi Z. The effects of vitamin E supplementation on endometrial thickness, and gene expression of vascular endothelial growth factor and inflammatory cytokines among women with implantation failure. J Matern Fetal Neonatal Med. 2019;32(1):95-102. https://doi.org/10.1080/14767058.2017.1372413.Hashemi Z., Sharifi N., Khani B., Aghadavod E., Asemi Z. The effects of vitamin E supplementation on endometrial thickness, and gene expression of vascular endothelial growth factor and inflammatory cytokines among women with implantation failure. J Matern Fetal Neonatal Med. 2019;32(1):95-102. https://doi.org/10.1080/14767058.2017.1372413.Crha I., Hrubá D., Ventruba P., Fiala J., Totusek J., Visnová H. Ascorbic acid and infertility treatment. Cent Eur J Public Health. 2003;11(2):63-67. https://pubmed.ncbi.nlm.nih.gov/12884545.Crha I., Hrubá D., Ventruba P., Fiala J., Totusek J., Visnová H. Ascorbic acid and infertility treatment. Cent Eur J Public Health. 2003;11(2):63-67. https://pubmed.ncbi.nlm.nih.gov/12884545.Carr A., Maggini S. Vitamin C and immune function. Nutrients. 2017;9:1211. https://doi.org/10.3390/nu9111211.Carr A., Maggini S. Vitamin C and immune function. Nutrients. 2017;9:1211. https://doi.org/10.3390/nu9111211.Tonai S., Kawabata A., Nakanishi T., Lee J.Y., Okamoto A., Shimada M., Yamashita Y. Iron deficiency induces female infertile in order to failure of follicular development in mice. J Reprod Dev. 2020;66(5):475-483. https://doi.org/10.1262/jrd.2020-074.Tonai S., Kawabata A., Nakanishi T., Lee J.Y., Okamoto A., Shimada M., Yamashita Y. Iron deficiency induces female infertile in order to failure of follicular development in mice. J Reprod Dev. 2020;66(5):475-483. https://doi.org/10.1262/jrd.2020-074.Skalnaya M.G., Tinkov A.A., Lobanova Y.N., Chang J.S., Skalny A.V. Serum levels of copper, iron, and manganese in women with pregnancy, miscarriage, and primary infertility. J Trace Elem Med Biol. 2019;56:124-130. https://doi.org/10.1016/j.jtemb.2019.08.009.Skalnaya M.G., Tinkov A.A., Lobanova Y.N., Chang J.S., Skalny A.V. Serum levels of copper, iron, and manganese in women with pregnancy, miscarriage, and primary infertility. J Trace Elem Med Biol. 2019;56:124-130. https://doi.org/10.1016/j.jtemb.2019.08.009.Lima L.G., Santos A.A.M.D., Gueiber T.D., Gomes R.Z., Martins C.M., Chaikoski A.C. Relation between Selenium and Female Fertility: A Systematic Review. Rev Bras Ginecol Obstet. 2022;44(7):701-709. https://doi.org/ 10.1055/s-0042-1744288.Lima L.G., Santos A.A.M.D., Gueiber T.D., Gomes R.Z., Martins C.M., Chaikoski A.C. Relation between Selenium and Female Fertility: A Systematic Review. Rev Bras Ginecol Obstet. 2022;44(7):701-709. https://doi.org/ 10.1055/s-0042-1744288.Серебренникова К.Г., Кузнецова Е.П., Ванке Е.С., Иванова Т.В., Милославский Ю.В. Прегравидарная подготовка у пациенток с тонким эндометрием в программах вспомогательных репродуктивных технологий. Медицинские новости. 2017;(8):31-34. https://doi.org/10.18565/aig.2017.3.139-46.Serebrennikova K.G., Kuznetsova E.P., Vanke E.S., Ivanova T.V., Kuznetsov Yu.V. Pregravid preparation of patients with thin endometrium in assisted reproductive technology programs. Meditsinskie Novosti. 2017;(8):31-34. (In Russ.) https://doi.org/10.18565/aig.2017.3.139-46.Calella P., Di Dio M., Cerullo G., Di Onofrio V., Gallé F., Liguori G. Antioxidant, immunomodulatory, and anti-inflammatory effects of Spirulina in disease conditions: a systematic review. Int J Food Sci Nutr. 2022;73(8):1047-1056. https://doi.org/10.1080/09637486.2022.2137785.Calella P., Di Dio M., Cerullo G., Di Onofrio V., Gallé F., Liguori G. Antioxidant, immunomodulatory, and anti-inflammatory effects of Spirulina in disease conditions: a systematic review. Int J Food Sci Nutr. 2022;73(8):1047-1056. https://doi.org/10.1080/09637486.2022.2137785.Garner T.B., Hester J.M., Carothers A., Diaz F.J. Role of zinc in female reproduction. Biol Reprod. 2021;104(5):976-994. https://doi.org/10.1093/biolre/ioab023.Garner T.B., Hester J.M., Carothers A., Diaz F.J. Role of zinc in female reproduction. Biol Reprod. 2021;104(5):976-994. https://doi.org/10.1093/biolre/ioab023.Stanhiser J., Jukic A.M.Z., McConnaughey D.R., Steiner A.Z. Omega-3 fatty acid supplementation and fecundability. Hum Reprod. 2022;37(5):1037-1046. https://doi.org/10.1093/humrep/deac027.Stanhiser J., Jukic A.M.Z., McConnaughey D.R., Steiner A.Z. Omega-3 fatty acid supplementation and fecundability. Hum Reprod. 2022;37(5):1037-1046. https://doi.org/10.1093/humrep/deac027.

The authors declare that there are no conflicts of interest present.