INTRACELLULAR PRODUCTION OF CYTOKINES IL-1 AND IL-10 IN PATIENTS WITH THIN ENDOMETRIUM SYNDROME WITH RECURRENT IMPLANTATION FAILURE

Abstract

Evaluation of endometrial cytotoxic lymphocytes using flow cytometry for “thin endome- trium” syndrome in 24 patients with recurrent implantation failure (RIF). The revealed changes in the level of immunocompetent cells indicate that the pathogenesis of recurrent unsuccessful implantation lies in a pronounced decrease in the level of CD8+ cytotoxic / suppressor lymphocytes and CD56 + lymphocytes, as well as a sharp decrease in the intracellular production of cytokines IL-1 and IL-10 by endometrial lymphocytes. Deficiency of signaling molecules and their synthesis of proteins, which oc- curs in the syndrome of “thin endometrium”, is accompanied by disruption of peri-implantation mecha- nisms, including the regulatory action of sex steroid hormones. Prospects for the treatment of failed implantation attempts lie in the selective effect on the endometrium with impaired receptivity. The treatment strategy is to eliminate the microbial-infectious agent with the use of rational antibacterial and immunomodulatory therapy at the first stage, induction of intracellular regeneration: biphasic hor- mone therapy (low doses of estrogen and progesterone). Preference is given to micronized progesterone preparations with bioidentity to endogenous progesterone, higher bioavailability and efficiency in the intravaginal route of administration.