ENDOMETRIAL RECEPTIVITY IN WOMEN WITH EARLY MISCARRIAGES IN ANAMNESIS

Problem statement: Reduced endometrial receptivity may be the cause of early pregnancy loss.Objective. To study the receptivity characteristics of the endometrium in women with early miscarriages in the anamnesis. Methods. Ultrasound, hormonal examinations, morphological examination of endometrial biopsy specimens were performed.Participant(s). 48 women 23-40 years old (mean age 30.3±0.4) were examined: 33 women with early miscarriages in anamnesis (of these 39% (n=13) with recurrent miscarriage); 15 healthy fertile women. All women had a normal level of thyreoid hormones, prolactin, androgens in the blood.Result(s). Healthy women and 36% patients with anamnesis of miscarriage (n=12) had a normoreceptor endometrial response with normal endometrial secretory transformation; H-score of estrogen (ER) and progesterone (PR) receptors in the endometrium were comparable (p>0.01), respectively: ER in the glands – 72,2±13,6 and 116,7±11,7; in the stroma – 88,9±12,9 and 145,0±20,1; PR in the glands – 34,4±11,2 and 59,2±17,2; in the stroma – 210,0±17,0 and 260,8±8,0. In 64% women with anamnesis of miscarriage (n=21) morphological characteristics of insufficient secretory phase of the endometrial cycle were revealed. H-score indicators in these women significantly differed from healthy women (p<0.01): ER in the glands – 201,9±19,4; in the stroma u2212 159,0±21,5; PR in the glands u2212 228,6±15,5; in the stroma u2212 256,7±7,8. All women had an ovulatory menstrual cycle (m.c.). The E2, P content in the blood (6-8 days after ovulation), M-echo thickness (12-14 days m.c.) did not differ in the groups.Conclusion(s). Almost two thirds of the women with anamnesis of miscarriage in the observed cohort had a decreased endometrial receptivity status.