DETERMINATION OF IL-1β mRNA EXPRESSION LEVELS PRIOR TO TREATMENT DEPENDING ON INFERTILITY TYPE IN WOMEN WITH ENDOMETRIOSIS PREPARING FOR ASSISTED REPRODUCTIVE TECHNOLOGIES

Introduction. Endometriosis is one of the most urgent problems in modern gynecology. Since this disease is observed in almost every third woman and there is a tendency toward an increase in the frequency of cases, endometriosis remains a subject of special interest not only for scientists but also for practicing physicians. According to statistics, endometriosis affects more than 10% of women of reproductive age, which accounts for approximately 176 million women worldwide. Endometriosis is a common gynecological disease. About 10% to 15% of women of childbearing age have endometriosis, and about 30% of infertile women are affected by this disease. Many recent studies have suggested that immune factors play important roles in its pathogenesis. Hypothyroidism, susceptibility to vaginal candidiasis, autoimmune diseases, fibromyalgia, chronic fatigue syndrome, headaches, arthralgias and myalgias, asthma, and allergies are more common comorbidities in women with endometriosis than in women without it.The pathogenesis and mechanisms leading to the development of infertility continue to be studied worldwide. The same pathogenetic mechanisms that lead to the development of infertility in endometriosis may also be the reason for unsuccessful attempts in IVF programs.Treatment of endometriosis-associated infertility is a serious problem because currently existing methods, which are based on surgical removal of endometriosis foci followed by the administration of hormonal drugs, do not always demonstrate sufficient effectiveness. The success of the most effective approach — surgical treatment — to a certain extent depends on the form and stage of the disease, the degree of infiltration of ectopic tissue into the underlying peritoneum, and the cicatricial-dystrophic changes that accompany this disease during its development.However, the immunopathogenetic mechanisms of endometriosis development, the ways of drug influence on the clinical manifestations of endometriosis-associated infertility, and the improvement of the effectiveness of IVF methods through pathogenetically justified and optimized preparation are still insufficiently studied.The possibility that effector pathways of inflammasome activation may be involved in the pathogenesis of endometriosis is being discussed. Inflammation may lead to progressive tissue destruction, which initiates the development of a chronic disease. IL-1β is a key cytokine involved in the regulation of adhesion and proliferation of endometrial cells.Some authors present the results of a study on the influence of lactobacilli on the morphology of endometriosis foci in an experimental model of endometriosis. It was established that after treatment with lactobacilli, a complex of changes is observed in the tissue of endometriosis foci, indicating the development of significant pathological processes and their destruction.Endometriosis often leads to infertility, which is the main complaint in women of reproductive age (35–50%). Despite significant achievements, many problems still remain open today, and, what is also very important, the difficulty of detecting this pathology in the early stages, when treatment can help the most.Objective. To investigate the relationship between the level of IL-1β mRNA gene expression and the type of infertility and to study the levels of IL-1β mRNA gene expression in women with endometriosis-associated infertility. Materials and methods. For the analysis of IL-1β mRNA gene expression and determination of relative normalized IL-1β mRNA expression, the real-time reverse transcription polymerase chain reaction method (RT-PCR) was used. The object of molecular genetic studies using RT-PCR was a fraction of mononuclear cells isolated from whole blood of patients with endometriosis. In this study, we conducted a retrospective analysis of the case histories of 30 infertile women undergoing assisted reproductive technologies. The main group consisted of 20 women diagnosed with endometriosis who underwent assisted reproductive technologies. In addition to the standard preparation for assisted reproductive technologies, women in the main group received a probiotic containing Lactobacillus 10¹⁰ manufactured by Unic Biotech Ltd, India. They took one tablet twice a day for one month as part of the general treatment before undergoing assisted reproductive technologies. We determined the level of IL-1β expression before and after this stage of preparation. The control group consisted of 10 women who had tubal infertility due to a previous inflammatory disease but, according to the results of a comprehensive clinical and laboratory examination, were considered healthy. These women aged 21 to 42 years (mean age 29.75 years) did not undergo the proposed preparation for ART with the inclusion of a probiotic. This study was conducted at Bukovinian State Medical University and the “Medical Center of Infertility Treatment” clinic. Results and discussion. In the main group, the level of IL-1β mRNA gene expression before preparation was 26.7877 ± 0.01, which was significantly higher than the level after preparation (0.1610 ± 0.01*).Analyzed results showed that the mean level of IL-1β mRNA in women with endometriosis-associated infertility of the 1st degree was 8.53 c.u., while the mean level of IL-1β mRNA in women with endometriosis-associated infertility of the 2nd degree was 1.0 c.u.In the main group, the level of IL-1β mRNA gene expression before preparation was 26.7877 ± 0.01, which was significantly higher than the level after preparation (0.1610 ± 0.01*). Analyzed results showed that a normal level of IL-1β mRNA in women with endometriosis was observed in 25% of patients, a high level in 70% of patients, and a low level in only 5% of patients, while the level of IL-1β mRNA in women of the control group was normal in 100% of patients. Conclusions. The inclusion of probiotics in a comprehensive regimen of preparation for assisted reproductive technologies leads to a noticeable improvement in the patient’s well-being.