Evaluation of the effectiveness of cytotherapy in women with early pregnancy loss
- 作者: Shengeliia M.O.1, Bespalova O.N.1, Zhernakova T.S.1, Kornyushina E.A.1, Pachuliia O.V.1, Semenov V.A.1
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隶属关系:
- The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott
- 期: 卷 73, 编号 6 (2024)
- 页面: 182-193
- 栏目: Original study articles
- ##submission.dateSubmitted##: 31.03.2024
- ##submission.dateAccepted##: 06.09.2024
- ##submission.datePublished##: 06.12.2024
- URL: https://journals.eco-vector.com/jowd/article/view/629708
- DOI: https://doi.org/10.17816/JOWD629708
- ID: 629708
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Background: Cytotherapy, or alloimmunization, with partner lymphocytes is a method of active immunocorrection through artificial immunization with allogeneic paternal or donor leukocytes or their fragments before and in the early stages of pregnancy, as an effective method for correcting immunoregulation, which will increase the effectiveness of assisted reproductive technologies protocols and the number of successful pregnancies ending in live birth in couples with recurrent pregnancy loss.
Aim: The aim of this study was to evaluate the clinical and laboratory effectiveness of cytotherapy in married couples with a history of reproductive disorders.
Materials and methods: The study included 77 married couples with recurrent miscarriage, primary infertility, and repeated implantation failure during in vitro fertilization. Inclusion criteria were age 20–44 years, 2 implantation failures during in vitro fertilization and more and/or 2 spontaneous abortions before 20 weeks of gestation and more, normal karyotypes of the abortus and partners, HLA (human leukocyte antigen, major histocompatibility complex) class II gene typing at three loci (DQA1, DQB1, DRB1) in the married couple. All women received cytotherapy as monotherapy before a planned pregnancy. To study the immune status, the patients’ blood was examined and the natural killer (NK) cell (CD3−CD16+CD56+) and natural T-killer (NKT) cell (CD3+CD16+CD56+) counts, as well as NK cell activity, were determined by spontaneous or activated expression of CD107a.
Results: Of the 77 women included in the study, 32 individuals did not have 12 months to register their pregnancy, therefore, of the remaining 48 married couples, 32 (66.7%) ones had pregnancy registered within 12 months after immunization. Among patients with recurrent miscarriage, pregnancy occurred in 87.0% of cases, in which in 45.2% of cases it ended in the birth of a healthy full-term newborn, and in 29% of cases, pregnancy is currently developing. Among patients with primary infertility and repeated implantation failure during in vitro fertilization, pregnancy occurred in 35.3% of cases. When comparing the functional activities of NK cells in peripheral blood before and two weeks after the second cytotherapy, we found a decrease in the total NK cell count by 5.1% (p = 0.015).
Conclusions: Cytotherapy is an effective therapy in patients with recurrent early miscarriage and leads to pregnancy in 87% of cases and its prolongation after 13 weeks in 74% of cases. The effect of the procedure is justified by its immunoregulatory functions, which is manifested by a decrease in the total NK cell count.
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作者简介
Margarita Shengeliia
The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott
编辑信件的主要联系方式.
Email: bakleicheva@gmail.com
ORCID iD: 0000-0002-0103-8583
SPIN 代码: 7831-2698
MD, Cand. Sci. (Medicine)
俄罗斯联邦, Saint PetersburgOlesya Bespalova
The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott
Email: shiggerra@mail.ru
ORCID iD: 0000-0002-6542-5953
SPIN 代码: 4732-8089
MD, Dr. Sci. (Medicine)
俄罗斯联邦, Saint PetersburgTatiana Zhernakova
The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott
Email: tatazhernakova@gmail.com
ORCID iD: 0000-0002-5131-4363
SPIN 代码: 3913-7697
MD
俄罗斯联邦, Saint PetersburgEkaterina Kornyushina
The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott
Email: hapacheva@yandex.ru
ORCID iD: 0009-0003-5918-2697
SPIN 代码: 5844-1975
MD, Cand. Sci. (Medicine)
俄罗斯联邦, Saint PetersburgOlga Pachuliia
The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott
Email: for.olga.kosyakova@gmail.com
ORCID iD: 0000-0003-4116-0222
SPIN 代码: 1204-3160
Scopus 作者 ID: 57299197900
MD, Cand. Sci. (Medicine)
俄罗斯联邦, Saint PetersburgVyacheslav Semenov
The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott
Email: semenov.v.a@gmail.com
ORCID iD: 0009-0001-1777-9650
俄罗斯联邦, Saint Petersburg
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