Uterine natural killer cells during the implantation window period in women veterans experienced by injury with unrealished reproductive function

Abstract

Annotation. Against the background of stress and post-traumatic stress disorder (PTSD) in women, changes in the hormonal background improve – the levels of stress hormones and the morphofunctional endometrium, which in their change negatively affect the reproductive health of women in Ukraine. The purpose of this study was to increase the efficiency of diagnosis and treatment of pathology and implantation capacity of the endometrium in women of reproductive age who took part in hostilities and suffered a concussion. Uterine natural killer cells were studied during the implantation window in 487 women of reproductive age who participated in combat operations and suffered concussions, who underwent hysteroscopy with endometrial sampling for histological examination and scanning electron microscopy on the 21st day of menstruation cycle (MC). Of these women, 246 patients – the comparison group – of reproductive age with a history of trauma without post-concussive syndrome and 211 in the main group, women of reproductive age who have consequences of concussion in the form of post-concussive syndrome. 30 conditionally healthy civilian women of reproductive age served as controls. The average age of the examined was 37.08±4.23 years. The period of stay in the combat zone is 60.26±42.21 months, the time since receiving a traumatic brain injury (concussion) is 18.8±9.2 months. Instrumental examination of women included hysteroscopy. The spectrum of MNC cells (CD16+ and CD56+) in the stroma of the endometrium on the 21st day of MC was determined. Microscopy of the preparations and all morphometric studies were performed on an Olympus AX70 Provis microscope (Olympus, Japan) using the image analysis program Analysis 3.2 Pro (Soft Imaging, Germany) according to the recommendations of the software manufacturer. The obtained results were processed using the Statistica 6.0 and Biostat software packages and methods of analytical statistics. It is established that in women military servicemen, participants in combat operations who suffered a concussion, the content of CD56+ and CD16+ cells in the stroma of the endometrium in women with post-concussion syndrome is greater than that in patients without post-concussion syndrome: in the endometrium, which corresponds to the proliferation phase, it is 1.45 (p<0.0001) and 1.64 times (p<0.0001), in the endometrium, which corresponds to the early secretion phase, 1.93 (p<0.0001) and 2.22 (p<0,0001), in the endometrium, which corresponds to the middle phase of secretion, – in 1.61 (p<0.0001) and in 3.42 (p<0.0001), in chronic endometritis – in 1.92 (p<0 .0001) and 1.94 (p<0.0001), with SAHE – in 1.79 (p<0.0001) and 1.51 (p<0.0001), with endometrial polyps – in 1, 60 (p<0.0001) and at 1.56 (p<0.0001). This study proves the need to improve the efficiency of diagnosis and treatment of endometrial pathology in women of reproductive age who participated in hostilities and suffered concussions.