Structural and functional features of endometrium in patients undergoing in - vitro fertilization

Abstract

A complex of diagnostic and therapeutic measures had been established in order to overcome many different causes of female infertility and restore women’s reproductive health.The aim of research is to determine value of immunohistochemical method in determination of disregenerative condition of endometrium in patients undergoing in - vitro fertilization (IVF) program. Materials and methods. The research included 62 patients treated according to IVF program in Clinic of FSBI HPE KSMU NOH Russia, Krasnodar city, in 2017 year. Data of history of disease, laboratory diagnostics, hormonal monitoring at 2-3 day of menstrual cycle and dynamic ultrasound investigation were processed. To evaluate urogenital microbiocenosis real - time PCR was used with “Femoflor-16” kit. Pipelle - biopsy of endometrium was taken at 22-24 day of menstrual cycle. Results. After certain investigation patients were divided into three groups. First group consisted of 18 (29.03%) women with primary infertility, second group - 17 (27.42%) patients with secondary infertility, third group - 27 (43.55%) women with recurrent pregnancy loss. Absence of secretory transformation had been revealed in 27.7% women with primary infertility. In patients with secondary infertility and recurrent pregnancy loss proliferative disorders were less frequent, in11.8 and 7.4% respectively. Immunohistochemistry showed that recurrent pregnancy loss was not associated with impairment of both estrogen and progesterone receptors expression, unlike patients with primary and secondary infertility. In patients with recurrent pregnancy loss increased by 2.9 times collagen growth in endometrial stroma was detected. Conclusion. Addition of immunohistochemistry to routine histological investigation allows detection of impaired cyclic endometrial transformations during window of transformation which prevents successful implantation of blastocyst and pregnancy progression.