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Abstract
sBackground: Implantation failure of in vitro fertilization (IVF) cycles is recognized as one of key problems in contemporary reproductive medicine. Implantation itself is a multifactorial process and one can hardly expect to find a single criterion for the endometrium receptivity. Endometrium biopsy still remains the most applicable technique to diagnose abnormalities causing decrease or complete loss of endometrial receptivity.Materials and methods: We have studied 95 endometrial biopsy samples from 45 patient with I/II stage endometriosis and 40 controls from October 2014 to December 2015. Immunohistochemical analysis of key biological molecules participating in implant window formation (LIF, ER, PR, integrin, TGF-β1 and VEGF) was done to assess their predicting value for endometrial receptivity troubles.Results: The discriminant analysis demonstrated that highest information capacity was characteristic for LIF expression percent area, integrin αVβ3 both percent area and optic density in endometrial stroma and glands and finally TGFβ1 and VEGF-А percent area expression in endometrial stroma. The model test done on a checking group showed 89.1% correct discrimination. Cross-checking in a teaching group showed a bit lower but still high correct answer percentage (88.8%). A decision-making classification tree was worked out.Conclusion: The produced model is sufficient for predicting IVF treatment failure and allows producing reasonable treatment tactics as well as encourages IVF treatment effectiveness improvement in patients with endometriosis.
Highlights
Infertile marriage is a serious medical, social and economic problem
The endometrial receptivity within assisted reproductive technologies (ART) cycles is achieved by estradiol and progesterone affect through interaction with corresponding steroid receptors
leukemia inhibiting factor (LIF) expression could be seen mainly in glandular and luminal epithelium while stromal expression was detected in women with histologically and immunohistochemically confirmed chronic endometrium inflammation, these women were excluded from the study
Summary
Infertile marriage is a serious medical, social and economic problem. According to WHO, it has a 10–15% frequency with no observed tendency decrease. IVF effectiveness optimization is straightforwardly dependent on solving the key reproductive medicine problem: endometrial receptivity period identification for determining endometrium functional ready state for blastocyst implanting [2]. Implantation failure of in vitro fertilization (IVF) cycles is recognized as one of key problems in contemporary reproductive medicine. Endometrium biopsy still remains the most applicable technique to diagnose abnormalities causing decrease or complete loss of endometrial receptivity. Immunohistochemical analysis of key biological molecules participating in implant window formation (LIF, ER, PR, integrin, TGF-b1 and VEGF) was done to assess their predicting value for endometrial receptivity troubles. The model test done on a checking group showed 89.1% correct discrimination. Conclusion: The produced model is sufficient for predicting IVF treatment failure and allows producing reasonable treatment tactics as well as encourages IVF treatment effectiveness improvement in patients with endometriosis
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