ИММУНОЛОГИЧЕСКИЕ ОСОБЕННОСТИ ВНУТРИМАТОЧНОЙ СРЕДЫ ИНФЕРТИЛЬНЫХ ПАЦИЕНТОК С ДИФФУЗНОЙ ФОРМОЙ АДЕНОМИОЗА 1-2 СТ. И ИХ ВЛИЯНИЕ НА ИСХОДЫ ПРОГРАММ ЭКО
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The study evaluated immunological components of intrauterine flushes collected on days 19–21 prior to IVF in 44 infertile women with diffuse grade 1–2 adenomyosis and compared them with 48 healthy women with male-factor infertility, measuring lactoferrin, α2-macroglobulin, α1-antitrypsin, TNF-α, interferon-γ, IL-6, IL-8, VEGF, and total protein. Women with diffuse grade 1–2 adenomyosis showed increased TNF-α, IL-6, and α1-antitrypsin in the flushes and decreased IL-8 levels. IVF implantation failures were associated with higher α1-antitrypsin values above 5200 mcg/l alongside a concurrent decrease in total protein below 3.3 g/l, with the main limitation being the relatively small sample size and restriction to adenomyosis grade 1–2 diffuse form only. This paper is centrally about adenomyosis — it identifies intrauterine immunological biomarkers linked to implantation failure in IVF for diffuse grade 1–2 adenomyosis.
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Abstract
The purpose of the study – identification of immunological predictors of implantation failures in IVF programs in patients with diffuse grade 1-2 adenomyosis as part of uterine cavity flushes.Materials and methods. 44 infertile patients with grade 1-2 diffuse adenomyosis and 48 healthy women with male-related infertility were examined. All patients underwent immunological studies of the composition of intrauterine flushes on days 19-21 in the menstrual cycle preceding the IVF program: lactoferrin (LF), α2-macroglobulin (α2-MG), α1-antitrypsin (α1-AT), tumor necrosis factor-α (TNF-α), interferon-γ (INF-γ), interleukin-6 (IL-6), interleukin-8 (IL-8), vascular endothelial growth factor (VEGF) by enzyme immunoassay and total protein (OB) by pyrogallol method, followed by an assessment of the effect of these indicators on the effectiveness of treatment.Statistical processing of the obtained data was performed in the R statistical environment (v.3.6, GNU GPL2 license). The results were considered statistically significant at p < 0.05.Results. In infertile women with a diffuse form of grade 1-2 adenomyosis, increased levels of proinflammatory cytokines TNF-α, IL-6 and the α-1-AT protease inhibitor were found in intrauterine flushes, as well as decreased levels of IL-8 and B. Implantation failures in IVF programs were associated with increased α-1-AT values above 5200 mcg/l with simultaneous a decrease in the level of less than 3.3 g/l.
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Abstract
The purpose of the study – identification of immunological predictors of implantation failures in IVF programs in patients with diffuse grade 1-2 adenomyosis as part of uterine cavity flushes.
Materials
and methods. 44 infertile patients with grade 1-2 diffuse adenomyosis and 48 healthy women with male-related infertility were examined. All patients underwent immunological studies of the composition of intrauterine flushes on days 19-21 in the menstrual cycle preceding the IVF program: lactoferrin (LF), α2-macroglobulin (α2-MG), α1-antitrypsin (α1-AT), tumor necrosis factor-α (TNF-α), interferon-γ (INF-γ), interleukin-6 (IL-6), interleukin-8 (IL-8), vascular endothelial growth factor (VEGF) by enzyme immunoassay and total protein (OB) by pyrogallol method, followed by an assessment of the effect of these indicators on the effectiveness of treatment.
Statistical processing of the obtained data was performed in the R statistical environment (v.3.6, GNU GPL2 license). The results were considered statistically significant at p < 0.05.
Results. In infertile women with a diffuse form of grade 1-2 adenomyosis, increased levels of proinflammatory cytokines TNF-α, IL-6 and the α-1-AT protease inhibitor were found in intrauterine flushes, as well as decreased levels of IL-8 and B. Implantation failures in IVF programs were associated with increased α-1-AT values above 5200 mcg/l with simultaneous a decrease in the level of less than 3.3 g/l.
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References
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