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

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.