Dependence of the Effectiveness of Infertility Treatment in Women with Endometriosis on the State of Immunogenetic Regulation
Aim of the study: to optimize the approaches to comprehensive treatment of infertility in women with endometriosis by development of model for predicting the efficiency of therapy on the basis of analysis of dynamics of immune indexes changes. Materials and methods. The article presents the results of studying the impact of immune factors on the effectiveness of infertility treatment using standard approaches and assisted reproductive technologies in 65 women with endometriosis associated with infertility. Results. The clinical efficiency of the treatment in women with infertility and endometriosis mostly depends on the degree of changes in the expression of messenger ribonucleic acid (mRNA) of T-box-expressed-in-T-cells (T-bet), trans-acting T-cell-specific transcription factor 3 (GATA-3), forkhead box P3 (Foxp3), Toll-lire receptors (TLR) 2, TLR4, levels of interleukin (IL) 2 and IL-4. Effectiveness of conservative approaches is inversely proportional to the degree of changes in the expression of TLR2 and Foxp3 in the endometrial tissue and level of IL-2 in the blood serum (informativeness — 2.66, 1.81, 1.33, respectively), and effectiveness of the use of assisted reproductive technologies — inversely proportional to the degree of changes in the expression of T-bet/of GATA-3, GATA-3 in the endometrial tissue and level of IL-4 in the blood serum (informativeness — 2.23, 2.12, 1.26, respectively). These results give an opportunity to personify the approaches and to increase the efficiency of treatment for infertility in patients with endometriosis. Conclusions. In order to optimize the treatment of infertility in women with endometriosis, it is expedient to apply the developed model for predicting treatment outcomes taking into account the influence of immune factors. In women with a sum of more than 5.56 points, according to the results of prognostication, conservative treatment of infertility is optimal, and women with a sum less than 5.56 points should be sent for treatment with the use of assisted reproductive technologies.
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