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Abstract
Adenomyosis is a benign neoplastic process of the uterus, one of the forms of endometrioid disease. The negative impact of this pathology on the outcome of ART programs is associated with impaired implantation and loss of pregnancy in the early stages.
We studied the levels of regulatory transport proteins (α2-MG, α1-AT, LF and ALB) and cytokines (IL-8, IL-6, TNF-α, INF-γ) in the blood serum of infertile patients with grade 1-2 adenomyosis and their influence on the outcomes of IVF programs.The study included 97 women. The main group consisted of 60 infertile patients with grade 1-2 adenomyosis, the comparison group consisted of 37 healthy women with male factor infertility.The embryos were cultured in one-step Irvine medium. The quality of embryos was assessed according to international standards (scale Gardner D.K. et al., 2001). Selective transfer of no more than 2 good quality embryos was performed on the 5th day of development. The effectiveness of IVF programs was assessed by the incidence of clinical pregnancy (CNB) according to ultrasound data on days 21-23 after embryo transfer.The study showed that the immunological profile of some factors of innate immunity: pro-inflammatory cytokines (TNF-α, IL-6, chemokine IL-8 and IFN-γ) and immunoregulatory proteins (a2-MG and a1-AT and Lf) in the blood serum of women with adenomyosis, entering the IVF program, has significant differences from the indicators of healthy women. In particular, they have decreased levels of a2-MG and a1-AT and increased concentrations of the cytokines TNF-α, IL-6, chemokine IL-8, and lactoferrin. Changes in indicators in response to CVD also differed in patients with adenomyosis and healthy women.Keywords
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Aksenenko AA, Gus AI, Mishieva NG. Adenomyosis and infertility. Obstetrics and Gynecology. 2021; 4; 41-47. Russian (Аксененко А.А., Гус А.И., Мишиева Н.Г. Аденомиоз и бесплодие //Акушерство и гинекология. 2021. № 4. С. 41-47.) DOI: https://dx.doi.org/10.18565/aig.2021.4.41-47
Clinical guidelines. Endometriosis ICD 10: N80. Feb 2020. Russian (Клинические рекомендации. Эндометриоз. МКБ 10: N80. 2020 г.)
Buggio L, Monti E, Gattei U, Dridi D, Vercellini P. Adenomyosis: fertility and obstetric outcome. A comprehensive literature review. Minerva Ginecol. 2018; 70(3): 295-302. https://dx.doi.org/10.23736/S0026-4784.17.04163-6
Adamyan LV, Andreeva EN, Apolikhina IA, Balan VE, Bezhenar VF, Gevorkyan MA, et al. Concomitant benign tumors and hyperplastic processes of the uterus (fibroids, adenomyosis, endometrial hyperplasia): a tutorial. M., 2015. 104 p. Russian (Адамян Л.В., Андреева Е.Н., Аполихина И.А., Балан В.Е., Беженарь В.Ф., Геворкян М.А. и др. Сочетанные доброкачественные опухоли и гиперпластические процессы матки (миома, аденомиоз, гиперплазия эндометрия): уч. пособие. М., 2015. 104 с.)
Vercellini P, Consonni D, Dridi D, Bracco B, Frattaruolo MP, Somigliana E. Uterine adenomyosis and in vitro fertilization outcome: a systematic review and meta_analysis. Hum Reprod. 2014; 29(5): 964-977. doi: 10.1093/humrep/deu041
Yazbeck C, Falcone S, Ballout A, Gauche-Cazalis C, Epelboin S, Patrat C et al. An update on adenomyosis and implantation. Gynecol Obstet Fertil. 2015; 43(10): 665-669. doi: 10.1016/j.gyobfe.2015.09.001
Benaglia L, Cardellicchio L, Leonardi M, Faulisi S, Vercellini P, Paffoni A, et al. Asymptomatic adenomyosis and embryo implantation in IVF cycles. Reprod Biomed Online. 2014; 29(5): 606-611. doi: 10.1016/j.rbmo.2014.07.021
Brosens I, Pijnenborg R, Benagiano G. Defective myometrial spiral artery remodeling as a cause of major obstetrical syndromes in endometriosis and adenomyosis. Placenta. 2013; 34(2): 100-105. https://dx.doi.org/10.1016/j.placenta.2012.11.017
Vercellini P, Vigano P, Somigliana E. Adenomyosis: epidemiological factors. Best Pract Res Clin Obstet Gynaecol. 2006; 20: 465-477. doi: 10.1016/j.bpobgyn.2006.01.017
Younes G, Tulandi T. Effects of adenomyosis on in vitro fertilization treatment outcomes: a meta-analysis. Fertil. Steril. 2017; 108(3): 483-490. https://dx.doi.org/10.1016/j.fertnstert.2017.06.025
Brosens I, Derwig I, Brosens J, Fusi L, Benagiano G, Pijnenborg R. The enigmatic uterine junctional zone: the missing link between reproductive disorders and major obstetrical disorders? Hum Reprod. 2010; 25(3): 569-574. doi: 10.1093/humrep/dep474
Tremellen KP, Russell P. The distribution of immune cells and macrophages in the endometrium of women with recurrent reproductive failure. II: adenomyosisand macrophages. J Reprod Immunol. 2012; 93(1): 58-63. doi: 10.1016/j.jri.2011.12.00
Yang JH, Wu MY, Chen MJ et al. Increased matrix metalloproteinase-2 and tissue inhibitor of metalloproteinase-1 secretion but unaffected invasiveness of endometrial stromal cells in adenomyosis. Fertil. Steril. 2009; 91(5): 2193-2198
Likhacheva VV, Bazhenova LG, Zorina RM, Markdorf AG, Chirikova TS, Shramko SV, Filimonov SN. Regulatory and transport proteins of blood serum and follicular fluid in prediction of efficiency of the programs of in vitro fertilization in women with adenomyosis. Medicine in Kuzbass. 2017; 16(3): 64-69. Russian (Лихачева В.В., Баженова Л.Г, Зорина Р.М., Маркдорф А.Г., Чирикова Т.С., Шрамко С.В., Филимонов С.Н. Регуляторно-транспортные белки сыворотки крови и фолликулярной жидкости в прогнозе результативности программ экстракорпорального оплодотворения у женщин с аденомиозом //Медицина в Кузбассе. 2017. Т. 16, № 3. С. 64-69)
Singh M, Chaudhry P, Asselin E. Bridging endometrial receptivity and implantation: network of hormones, cytokines, and growth factors. J Endocrinol. 2011; 210(1): 5-14
Zhihong N, Yun F, Pinggui Z, Sulian Z, Zhang A. Cytokine profiling in the eutopic endometrium of adenomyosis during the implantation window after ovarian stimulation. Reprod Sci. 2016; 23(1): 124-133. doi: 10.1177/1933719115597761
Actor JK, Hwang SA, Kruzel ML. Lactoferrin as a natural immune modulator. Curr Pharm Des. 2009; 15(17): 1956-1973. doi: 10.2174/138161209788453202
Siqueiros-Cendon T, Arevalo-Gallegos S, Iglesias-Figueroa BF, Garcia-Montoya IA, Salazar-Martinez J, Rascon-Cruz Q. Immunomodulatory effects oflactoferrin. Acta Pharmacol Sin. 2014; 35(5): 557-566. doi: 10.1038/aps.2013.200
Zorin NA, Levchenko VG, Zorina RM, Zorina VN. A role of macroglobulins in reproductive function (Literature review). Obstetrics and Gynecology. 2005; 4: 7-8. Russian (Зорин Н.А., Левченко В.Г., Зорина Р.М., Зорина В.Н. Роль макроглобулинов в репродуктивной функции (Обзор литературы) //Акушерство и гинекология. 2005. № 4. С. 7-8)
Prasnikar E, Kunej T, Knez J, Repnik K, Potocnik U, Kovacic B. Determining the molecular background of endometrial receptivity in adenomyosis. Biomolecules. 2020; 10(9): 1311. https://dx.doi.org/10.3390/biom10091311
Nazarenko TA. Stimulation of ovarian function. M.: MEDpress, 2015. 272 p. Russian (Назаренко Т.А. Стимуляция функции яичников. M.: МЕДпресс, 2015. 272 с.)
