MORPHOLOGICAL AND MOLECULAR CRITERIA OF THE ENDOMETRIAL RECIPTIVITY VIOLATION IN PATIENTS WITH INFERTILITY ASSOCIATED WITH CHRONIC ENDOMETRITIS

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

The goal is to study the morphological and molecular features of endometrial receptivity in reproductive-age women with chronic endometritis and infertility and unsuccessful attempts in vitro fertilization (IVF) in anamnesis. Material and methods. The study included 120 reproductive-age women with morphologically verified chronic endometritis: the first group included 64 patients with infertility and unsuccessful IVF attempts in history; in the 2nd group there were 56 women without violation of the fertility; the control group consisted of 30 healthy reproductive-age women, in whom samples of the endometrium were taken in the II phase of the menstrual cycle. A comparative analysis of the morphological and molecular criteria of endometrial receptivity in all study groups was carried out. Results. In patients of the 1st group there was a significant twofold prevalence rate of the average duration of chronic endometritis since the moment of its morphological verification, which led to a critical decrease in the receptivity of the endometrium and the development of infertility has been established in 5.50 ± 0.06 years (p < 0.001). In the first group of patients following morphological features of chronic endometritis were established: the presence of classical signs of inflammation in the mucous membrane of the uterus with an autoimmune component revealed in 90.6% of observations: high expression of CD16, CD20, CD56 and low HLA-DRII (p < 0.001). Morphological criteria of endometrial receptivity disorders in patients with infertility on the background of chronic endometritis were such as the delay in the maturation of the endometrium from the day of the menstrual cycle and a decrease in the number of mature pinopodia in the apical part of the superficial epitheliocytes. Molecular criteria of the infertility in the endometrial receptivity violation include the significant decrease in the expression of steroid ER and PR receptors in glands and stroma, LIF in glands and in the surface of the pinopodia, CLDN4 - in the apical part of the superficial epithelial cells and in the base of the pinopodia (p < 0.001). Conclusion. Chronic endometritis, associated with the infertility, in 90.6% of cases has an autoimmune genesis and is characterized by a long (more than 5 years) course with the development of morphological and molecular criteria of endometrial receptivity disorders.

Full Text

Restricted Access

About the authors

Tatyana A. Demura

I.M. Sechenov First Moscow State Medical University; Centre for Strategic Planning and Management of Biomedical Health Risks

Email: demura-t@yandex.ru
MD, PhD, DSci., professor of the Department of Pathological Anatomy of A.I. Strukov Medical Faculty of the I.M. Sechenov First Moscow State Medical University, Moscow, 119991, Russian Federation Moscow, 119991, Russian Federation; Moscow, 119121, Russian Federation

E. A Kogan

I.M. Sechenov First Moscow State Medical University

Moscow, 119991, Russian Federation

Yu. M Kossovich

I.M. Sechenov First Moscow State Medical University

Moscow, 119991, Russian Federation

A. L Unanyan

I.M. Sechenov First Moscow State Medical University

Moscow, 119991, Russian Federation

References

  1. Кулаков В.И., Лопатина Т.В. Репродуктивное здоровье населения России. В кн.: Бесплодный брак: Руководство для врачей. М.: ГЭОТАР-Медиа; 2006: 10-8.
  2. Сухих Г.Т., Шуршалина А.В. Хронический эндометрит: Руководство. М.: ГЭОТАР-Медиа; 2010.
  3. Коган Е.А., Колотовкина А.В., Файзуллина Н.М., Калинина Е.А. Морфологические и молекулярно-биологические особенности эндометрия в период «окна имплантации» у пациенток с бесплодием, сочетающимся с наружным генитальным эндометриозом 1-2-й стадии. Акушерство и гинекология. 2013; 9: 35-40.
  4. Шуршалина А.В., Демура Т.А. Морфофункциональные перестройки эндометрия в «окно имплантации». Акушерство и гинекология. 2011; 7/2: 9-13.
  5. Бессмертная B.C., Самойлов М.В. , Серебренникова К.Г., Бабиченко И.И. Морфологические и иммуногистохимические особенности эндометрия женщин с первичным и вторичным бесплодием. Архив патологии. 2008; 70 4: 31-4.
  6. Самойлов М.В., Бессмертная В.С., Серебренникова К.Г., Мишнев О.Д. Эндометриальное «окно имплантации» при бесплодии. Архив патологии. 2011; 3: 13-8.
  7. Dimitriadis E., Sharkey A.M., Lee Tan Y. et al. Immunolocalisation of phosphorylated STAT3, interleukin 11 and leukaemia inhibitory factor in endometrium of women with unexplained infertility during the implantation window. Reproduct. Biol. Endocrinol. 2007; 5: 44-51.
  8. Serafini P.C., Silva I.D.C.G., Smith G.D., Motta E.L.A., Rocha A.M., Baracat E.C. Endometrial claudin-4 and leukemia inhibitory factor are associated with assisted reproduction outcome. Reproduct. Biol. Endocrinol. 2009; 7: 30.
  9. Achache H., Revel A. Endometrial receptivity markers, the journey to successful embryo implantation. Hum. Reprod. Update. 2006; 12 (6): 731-46.
  10. Fukuda M.N., Sugihara K. An integrated view of L-selectin and trophinin function in human embryo implantation. J. Obstet. Gynaecol. Res. 2008; 34 (2): 129-36.
  11. Jee Byung Chul, Chang Suk Suh, Ki Chul Kim et al. Expression of vascular endothelial growth factor-A and its receptor-1 in a luteal endometrium in patients with repeated in vitro fertilization failure. Fertil. Steril. 2009; 91 (2): 528-34.
  12. Ruiz-Alonso M., Blesa D., Simon C. The genomics of the human endometrium. Biochim. Biophys. Acta. 2012; 1822: 1931-42.
  13. Левиашвили М.М., Демура Т.А., Мишиева Н.Г., Файзуллина Н.М., Назаренко Т.А., Коган Е.А. Оценка рецептивности эндометрия у пациенток с безуспешными программами экстракорпорального оплодотворения в анамнезе. Акушерство и гинекология. 2012; 4/1: 65-9.
  14. Дюжева Е.В., Калинина Е.А., Кузьмичев Л.Н., Коган Е.А. Иммуногистохимическое исследование эндометрия в программах ВРТ. Вестник Российского университета дружбы народов. Серия: Медицина. 2009; 6: 98-104.
  15. Hou J., Gomes A.S., Paul D.L., Goodenough D.A. Study of claudin function by RNA interference. J. Biol. Chem. 2006; 281: 3617-23

Statistics

Views

Abstract: 170

PDF (Russian): 1

Article Metrics

Metrics Loading ...

Refbacks

  • There are currently no refbacks.

Copyright (c) 2018 Eco-Vector



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies