Immunological disorders in patients with mammary gland pathology in infertility associated with anovulation

Abstract

The objective: to study the state of the immune system in women with pathology of the mammary glands and infertility, and on the background of menstrual cycle disorders.Materials and methods. The research was performed in two stages. The first (1) stage included examination of women with infertility associated with anovulation who had breast pathology. These patients were divided into three groups: 1.1 group – 44 patients with diffuse fibrocystic breast disease (FBD), 1.2 group – 4 patients with fibroadenoma of the mammary glands, 1.3 group (control one) – 37 patients without pathological changes in the mammary glands.During the second (2) stage of the study, 110 women were examined: 2.1 group – 52 patients with regular menstruations and luteal phase insufficiency (LPI) and 2.2 group – 58 patients with anovulatory cycles.During two research stages, the immune status (CD3, CD4, CD8, immunoregulatory index (CD4/CD8), CD72, CD16, circulating immune complexes) and cytokine profile (IL-1, IL-2, IL-6, TNF-α, INF) in venous blood were determined. Differences were considered statistically significant at p<0.05.Results. A significant increase in the CD8 index was found in the group of patients with normal mammary glands (34.7±6.9 pg/ml; p<0.05) and with a diffuse form of FBD (35.13±6.9 pg/ml; p<0.05) versus its normal level in the group of patients with fibroadenoma (26.5±15.9 pg/ml; p>0.05).During the analysis of the CD16 level, it was determined its significantly increased to 18.8±3.1 pg/ml (р<0.05) in patients with LPI and regular menstrual cycle and to 26.3±4.8 pg/ml (р< 0.05) – in patients with anovulation without LPI, the difference between the groups was significant. The level of CD16 was significantly higher in anovulatory menstrual cycle disorder without LPI compared to patients with menstrual cycle disorder and LPI.The concentration of TNF-α in patients with a regular menstrual cycle (998.1±166.3 pg/ml; p<0.05) and with an anovulatory cycle without LPI (1029.3±187.1 pg/ml; p<0.05) was significantly higher compared to normal values (778.5±64.0 pg/ml). The level of IL-2 was significantly lower than normal indices. Thus, in the group of women with LPI, this indicator was 17.13±2.85 pg/ml (р<0.05), and by anovulation without LPI – 16.84±3.07 pg/ml (р<0.05) versus normal parameter 22.29±0.81 pg/ml.Conclusions. In patients with diseases of the mammary glands and infertility associated with anovulation without LPI, a significant decrease in the activity of T2-helpers (IL-2) and an increase in the activity of T1-helpers (TNF-α) were determined in cases of anovulation without LPI compared with cases of luteal phase insufficiency.