Repeated Implant Failures. Pathogenesis of Immunological Disorders in Endometrium
https://doi.org/10.31550/1727-2378-2022-21-1-21-26
Abstract
Study Objective: To broaden the understanding of the immunological aspects of implantation incompetence of endometrium in patients with repeated implant failures (RIF) in in vitro fertilisation programs.
Study Design: Open perspective comparative study.
Materials and Methods. 57 women aged 27 to 42 years old (mean age: 36 ± 6.2 years old) with clinically verified RIF. A morphological control group included 30 fertile women with a history of at least 2 deliveries of full-term healthy children and without fertility disorders, who signed a voluntary informed consent to take part in the study. The subject of the study was endometrium biopsy material obtained on day 8–10 of menstruation (middle stage of the proliferation phase).
Study Results. In this study, endometrium biopsy material of patients with RIF demonstrated statistically significant (p < 0.05) changes in the middle stage of the proliferation phase: 1.9- and 1.5-fold increase in CD56+ and CD8+ expression, respectively; 2.2-fold reduction in CD4+ expression, and impaired CD8+/CD4+ ratio (increase in CD8+) vs morphological controls.
Conclusion. Pathogenesis of implantation incompetence in patients with RIF is caused by immunological imbalance in endometrial stroma, the substrate of which is insufficient concentrations of proangiogenic NK-cells, regulatory suppressive Т-helpers, and increased density of the cytotoxic NK- and Т-cells; it forms two primary parts of pathogenesis: reduced immunological tolerance to semiallogenic blastocyte and impaired normal angiogenesis in endometrial stroma of women with RIF.
About the Authors
L. M. Mikhaleva
A.P. Avtsyn Research Institute of Human Morphology
Russian Federation
Russian Federation
3 Tsyurupa Str., Moscow, 117418
M. R. Orazov
Peoples’ Friendship University of Russia (a Federal Government Autonomous Educational Institution of Higher Education)
Russian Federation
Russian Federation
6 Miklouho-Maclay Str., Moscow, 117198
E. S. Silantieva
Mother and Child
Russian Federation
Russian Federation
2 Mozhayskoye Shosse, Moscow, 143081
D. P. Kamilova
Mother and Child
Russian Federation
Russian Federation
2 Mozhayskoye Shosse, Moscow, 143081
K. Yu. Midiber
A.P. Avtsyn Research Institute of Human Morphology ; Peoples’ Friendship University of Russia (a Federal Government Autonomous Educational Institution of Higher Education)
Russian Federation
Russian Federation
3 Tsyurupa Str., Moscow, 117418
6 Miklouho-Maclay Str., Moscow, 117198
R. E. Orekhov
Peoples’ Friendship University of Russia (a Federal Government Autonomous Educational Institution of Higher Education)
Russian Federation
Russian Federation
6 Miklouho-Maclay Str., Moscow, 117198
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Review
For citations:
Mikhaleva L.M., Orazov M.R., Silantieva E.S., Kamilova D.P., Midiber K.Yu., Orekhov R.E. Repeated Implant Failures. Pathogenesis of Immunological Disorders in Endometrium. Title. 2022;21(1):21-26. (In Russ.) https://doi.org/10.31550/1727-2378-2022-21-1-21-26
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