IMMUNOLOGICAL CHARACTERISTICS OF INTRAUTERINE FLUSHES FROM THE UTERINE CAVITY OF INFERTILE PATIENTS WITH ADENOMYOSIS AND THEIR EFFECT ON THE OUTCOMES OF ART PROGRAMS

Виктория Васильевна Лихачева, Ольга Валентиновна Азарова, Людмила Владимировна Ренге, Екатерина Юрьевна Григорьева, Борис Александрович Лихачев, Борис Исаевич Айзикович
2025 · W7001108652
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In women with grade 1-2 diffuse adenomyosis, intrauterine flushes showed elevated proinflammatory cytokines and α1-antitrypsin levels associated with IVF implantation failures.

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This study investigated immunological predictors of implantation failure in IVF programs among infertile patients with grade 1-2 diffuse adenomyosis. Researchers analyzed intrauterine flushes from 44 affected women and 48 controls, measuring various cytokines and proteins during the luteal phase. The results indicated that patients with adenomyosis exhibited elevated levels of proinflammatory cytokines TNF-α and IL-6, alongside increased α1-antitrypsin and decreased IL-8 compared to healthy controls. Implantation failures were specifically associated with α1-antitrypsin levels exceeding 5200 mcg/l combined with total protein levels below 3.3 g/l. This paper is centrally about adenomyosis — specifically examining its impact on uterine cavity immunology and ART outcomes.

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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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Мать и дитя в Кузбассе (May 2025) IMMUNOLOGICAL CHARACTERISTICS OF INTRAUTERINE FLUSHES FROM THE UTERINE CAVITY OF INFERTILE PATIENTS WITH ADENOMYOSIS AND THEIR EFFECT ON THE OUTCOMES OF ART PROGRAMS 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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