Results of the treatment in selected infertile patients with high density of endometrial NK cells CD56+ and CD16+ Second part

Česká verzia

Authors: Z. Ulčová-Gallová ^1,2; M. Pešek ³; M. Haschová ⁴; P. Chaloupka ³; P. Mukenšnabl ⁵; J. Cibulka ¹; P. Lošan ¹; K. Bibková ¹; Z. Mičanová ¹
Authors place of work: Genetika-Plzeň, s. r. o., ředitel MUDr. P. Lošan ¹; Gynekologicko-porodnická klinika LF UK a FN, Plzeň, přednosta doc. MUDr . Z. Novotný, CSc. ²; Mulačova nemocnice, gynekologicko-porodnické oddělení, Plzeň, přednosta MUDr. Z. Knaizl ³; MN Privamed a. s., OKB, přednosta Ing. Z. Jeřábek ⁴; Šiklův ústav patologie LF UK a FN, Plzeň, přednosta prof. MUDr. M. Michal ⁵
Published in the journal: Ceska Gynekol 2018; 83(2): 115-118

Summary

Introduction:
This statements follows the first part of our publication entitled Screening of endometrial NK cells in selected infertile patients (First part – Methods and current results), where we dealt with methodology and endometrial findings of the natural killer cells CD16+ and CD56+. These cells are among the most important in preimplantaion, and in implantation period, in early pregnancy too, but can also negatively influence above mentioned processes.

Objective:
We focused on the immunomodulatory treatment with intramuscular immunoglobulins in 21 infertile patients with a high density of endometrial NK cells CD16+ and CD56+.

Design:
Original work-prospective study.

Setting:
Genetics-Pilsen.

Methods:
From the originally investigated 57 women aged 25–41 (average 34) years with their history of 3–9 abortions, we target on a high selective subgroup of 21 infertile patients with pathological density of endometrial NK cells CD56+ and CD16+.

Results:
Twelve patients underwent immunomodulatory treatment with intramuscular immunoglobulin in time of positive HCG and went on the therapeutic scheme, nine infertile women continued with IVF-ET but did not achieve HCG positivity despite of initial treatment with immunoglobulins. Of the 12 treated patients, seven of them gave a birth to healthy babies, as to the next five pregnancies - one was extrauterine pregnancy, one genetically defective fetus, three pregnancies go on successfully.

Nine women from the IVF program did not get pregnat.

Conclusion:
Immunomodulatory treatment with immunoglobulins also influences endometrial NK cells CD56+ and CD16+ associating with an overproduction of embryocytoxic cytokines. Treatment of our patients with the pathological endometrial density of NK cells must be solved strictly individually.

Keywords:
treatment, immunoglobulins, infertility, natural killer cells, endometrium

Zdroje

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