HORMONEMEDIATED REGULATION OF CYTOKINES IN PATIENTS WITH ADENOMYOSIS AND UNSUCCESSFUL IVF ATTEMPTS

Aim. The study was to evaluate the effect of cytokine dysfunctions on the endometrial implantation potential in patients with adenomyosis and unsuccessful IVF attempts and the possibility of hormone-mediated regulation of the cytokine balance at the pre-gravitational stage.

Materials and methods. The study included 90 patients with infertility, an unsuccessful attempt of IVF in the history and diffuse adenomyosis of 1 or 2 degrees. Patients were randomized into two groups: the 1st group consisted of 44 patients (group 1) − no pre-education training was conducted. The second group − 46 patients − pregravid preparation of dienogest (2 mg daily for 3 months before the IVF cycle). Control group (group 3) − 30 healthy fertile women. To assess the implantation potential of the endometrium, initially, and after pre-gravity training, the concentration of LIF, IL1в, IL-6, IL-10, RAIL in cervical mucus was determined.

Results. Analysis of the indices in patients with adenomyosis showed a decrease in their implantation potential of the endometrium. It has been revealed that hormone-modulating therapy with dienogest partially neutralizes cytokine regulation defects and leads to a certain increase in the effectiveness of IVF programs.

Conclusion. Shows expediency of including dienogest in the pregravide preparation plan for patients with adenomyosis, but for full immunocorrection in pregravidual training in women with adenomyosis 1 and 2 The degree of additional directional immunotropic therapy is probably necessary.