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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">uzspbgmu</journal-id><journal-title-group><journal-title xml:lang="ru">Учёные записки Первого Санкт-Петербургского государственного медицинского университета имени академика И. П. Павлова</journal-title><trans-title-group xml:lang="en"><trans-title>The Scientific Notes of the Pavlov University</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1607-4181</issn><issn pub-type="epub">2541-8807</issn><publisher><publisher-name>Academician I.P. Pavlov First St. Petersburg State Medical University</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.24884/1607-4181-2025-32-2-18-25</article-id><article-id custom-type="elpub" pub-id-type="custom">uzspbgmu-1206</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ И ЛЕКЦИИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS AND LECTURES</subject></subj-group></article-categories><title-group><article-title>Хронический эндометрит и фертильность</article-title><trans-title-group xml:lang="en"><trans-title>Chronic endometritis and fertility</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7807-4929</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Беженарь</surname><given-names>В. Ф.</given-names></name><name name-style="western" xml:lang="en"><surname>Bezhenar</surname><given-names>V. F.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Беженарь Виталий Федорович, доктор медицинских наук, профессор, зав. кафедрой акушерства, гинекологии и неонатологии/кафедрой акушерства, гинекологии и репродуктологии, руководитель клиники акушерства и гинекологии</p><p>197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8 </p></bio><bio xml:lang="en"><p>Bezhenar Vitaly F., Dr. of Sci. (Med.), Professor, Head of the Department of Obstetrics, Gynecology and Neonatology/Department of Obstetrics, Gynecology and Reproductology, Head of the Clinic of Obstetrics and Gynecology</p><p>6-8, L’va Tolstogo str., Saint Petersburg,  197022 </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6032-1936</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Линде</surname><given-names>В. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Linde</surname><given-names>V. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Линде Виктор Анатольевич, доктор медицинских наук, профессор, профессор кафедры акушерства, гинекологии и репродуктологии</p><p>197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8 </p></bio><bio xml:lang="en"><p>Linde Viktor A., Dr. of Sci. (Med.), Professor, Professor of the Department of Obstetrics, Gynecology and Reproductology</p><p>6-8, L’va Tolstogo str., Saint Petersburg,  197022 </p></bio><email xlink:type="simple">vik-linde@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4407-1543</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Молчанов</surname><given-names>О. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Molchanov</surname><given-names>O. L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Молчанов Олег Леонидович, доктор медицинских наук, профессор, профессор кафедры акушерства, гинекологии и репродуктологии</p><p>197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8 </p></bio><bio xml:lang="en"><p>Molchanov Oleg L., Dr. of Sci. (Med.), Professor, Professor of the Department of Obstetrics, Gynecology and Reproductology</p><p>6-8, L’va Tolstogo str., Saint Petersburg,  197022 </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2868-7997</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Аракелян</surname><given-names>Б. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Arakelyan</surname><given-names>B. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Аракелян Бюзанд Вазгенович, доктор медицинских наук, доцент, профессор кафедры акушерства, гинекологии и неонатологии, заместитель руководителя клиники акушерства и гинекологии</p><p>197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8 </p></bio><bio xml:lang="en"><p>Arakelyan Byuzand V., Dr. of Sci. (Med.), Associate Professor, Professor of the Department of Obstetrics, Gynecology and Neonatology, Deputy Head of the Clinic of Obstetrics and Gynecology</p><p>6-8, L’va Tolstogo str., Saint Petersburg,  197022 </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6058-8801</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Татарова</surname><given-names>Н. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Tatarova</surname><given-names>N. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Татарова Нина Александровна, доктор медицинских наук, профессор, профессор кафедры акушерства, гинекологии и репродуктологии</p><p>197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8 </p></bio><bio xml:lang="en"><p>Tatarova Nina A., Dr. of Sci. (Med.), Professor, Professor of the Department of Obstetrics, Gynecology and Reproductology</p><p>6-8, L’va Tolstogo str., Saint Petersburg,  197022 </p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Первый Санкт-Петербургский государственный медицинский университет имени академика И. П. Павлова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Pavlov University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>16</day><month>09</month><year>2025</year></pub-date><volume>32</volume><issue>2</issue><fpage>18</fpage><lpage>25</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Беженарь В.Ф., Линде В.А., Молчанов О.Л., Аракелян Б.В., Татарова Н.А., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Беженарь В.Ф., Линде В.А., Молчанов О.Л., Аракелян Б.В., Татарова Н.А.</copyright-holder><copyright-holder xml:lang="en">Bezhenar V.F., Linde V.A., Molchanov O.L., Arakelyan B.V., Tatarova N.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.sci-notes.ru/jour/article/view/1206">https://www.sci-notes.ru/jour/article/view/1206</self-uri><abstract><p>Обзор выполнен на основании баз данных https://cyberleninka.ru/, PubMed, MedArt и ЦНМБ. В последние десятилетия при неясных причинах бесплодия или невынашивания беременности, особенно при неудачах в программах экстракорпорального оплодотворения или при повторных выкидышах раннего срока беременности, большое значение придают хроническому эндометриту. При этом сама нозологическая форма «хронический эндометрит» не до конца ясна.Патогенетически отчетливо отслеживаются два варианта развития хронического эндометрита – собственно инфекционно-воспалительный процесс и аутоиммунная патология, при которой роль триггера, запустившего процесс, нивелируется. Иммунологические изменения, с которыми связывают процессы, влияющие на исход имплантации, определяющий нарушение фертильности, неспецифичны и не могут рассматриваться как диагностические критерии хронического эндометрита. Исключение составляет, с оговорками, инфильтрация CD138 (+) плазмоцитами стромы эндометрия. Нарушение рецепции эндометрия, выявляемое при хроническом эндометрите, представляется неспецифической результирующей большого количества разнородных патологических состояний.При доказанном инфекционно-воспалительном пути развития хронического эндометрита оправдана этиотропная терапия, направленная на элиминацию инфекционного агента. В остальных случаях необходим поиск причин возникновения и/или поддержания вторичного аутоиммунного процесса.Цель обзора – облегчение врачам поиска наиболее эффективных путей преодоления бесплодия и невынашивания беременности, ассоциированных с хроническим эндометритом.</p></abstract><trans-abstract xml:lang="en"><p>This review was based on the databases https://cyberleninka.ru/, PubMed, MedArt, and CSML. In recent decades, chronic endometritis has received increasing attention as a potential factor in unexplained infertility or recurrent pregnancy loss, especially in cases of unsuccessful in vitro fertilization programs or repeated early miscarriages. At the same time, the nosological entity of «chronic endometritis» remains insufficiently defined.From a pathogenetic perspective, two variants of chronic endometritis development are identified: an infectious-inflammatory process and an autoimmune pathology, in which the initial triggering factor that started the process is leveled. Immunologic changes associated with processes that affect the outcome of implantation, determining fertility impairment, are nonspecific and cannot be considered as diagnostic criteria for chronic endometritis. The exception is, with reservations, infiltration of CD138 (+) plasmacytes by endometrial stroma. The endometrial receptor disorder detected in chronic endometritis appears to be a nonspecific result of a large number of heterogeneous pathologic conditions.If the infectious-inflammatory pathway of chronic endometritis development is proven, etiotropic therapy aimed at elimination of the infectious agent is justified. In other cases, it is necessary to identify the causes and/or maintenance of secondary autoimmune process.The objective of the review was to facilitate the physicians’ search for the most effective ways to overcome infertility and pregnancy failure associated with chronic endometritis.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>хронический эндометрит</kwd><kwd>бесплодие</kwd><kwd>плазмоциты CD138</kwd><kwd>окно имплантации</kwd><kwd>рецепторность эндометрия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>chronic endometritis</kwd><kwd>infertility</kwd><kwd>CD138 plasmacytes</kwd><kwd>implantation window</kwd><kwd>endometrial receptivity</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Серебренникова К. Г., Арутюнян Н. А., Алехин А. И. 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