Клиническая характеристика пациенток с бесплодием и иммуногистохимическая оценка экспрессии FoxP3 и CD56 в эндометрии

Objective: to evaluate the clinical features of infertile female patients and to determine the immunohistochemical parameters of the endometrium using local immunity markers. Material and methods . The clinical and anamnestic features, FoxP3 and CD56 expression in the endometrium have been studied in infertile patients. Endometrial biopsy was performed depending on the duration of the menstrual cycle on 7-9 days after ovulation using the ProfiCombi aspiration curette (Simurg, Belarus). Results. 55 female patients of the reproductive age altogether were examined. 40 (72.73 %) infertile patients were included in the main group, and the control group consisted of 15 (27.27%) patients with no reproductive malfunction who had undergone preconception checkup. The infertile patients had a high rate of intrauterine manipulation - 22.50 (c 2 = 4.04;p = 0.05), the patients of the comparison group had not undergone these surgical operations. During the immunohistological investigation, chronic endometritis was diagnosed in 37 (92.50 %) infertile patients and in 2 (13.33 %) patients of the control group (c 2 = 33.14; p < 0.001). The expression of CD56 in the endometrium was 15.30 (12.60; 18.60) in the infertile patients and 4.90 (4.00; 5.60) in the patients of the control group (z = 4.96, p < 0.001). FoxP3 expression was 3.00 (2.30; 3.70) in the main group, FoxP3 was not expressed in any patients of the control group (p < 0.001). Conclusion. The prevalence of chronic endometritis in the infertile patients was 7 times (p < 0.001) as high as that in the women in the comparison group. The women of the main group revealed higher values (p < 0.001) of local CD56 and FoxP3 immunity in the endometrium. Evidently, high FoxP3 and CD56 expression in the endometrium of infertile patients causes local disorders of the immune response, which worsens the prognosis of impregnation and carrying of pregnancy. Frequent intrauterine manipulations are a risk factor for chronic endometritis, which should be taken into account during the selection of methods of examination of infertile patients.