Immunological testing for female infertility: a modern view on the problem-Reference-Cited by-同舟云学术

Immunological testing for female infertility: a modern view on the problem

Published:2024-07-25 Issue:4 Volume:18 Page:547-562
ISSN:2500-3194
Container-title:Obstetrics, Gynecology and Reproduction
language:
Short-container-title:Akušerstvo, ginekologiâ i reprodukciâ

Author:

Konkina A. V.¹^ORCID,Blikyan L. A.¹^ORCID,Aleynikova D. E.²^ORCID,Abubakarov I. R.¹^ORCID,Dzhumanyazova A. S.-M.¹^ORCID,Abramian A. V.¹^ORCID,Gafurova L. G.¹^ORCID,Lobko D. A.¹^ORCID,Pozoyan A. A.¹^ORCID,Thagapsova K. M.¹^ORCID,Golubeva M. S.³^ORCID,Shvanova E. E.⁴^ORCID,Ryzhov E. O.⁵^ORCID

Affiliation:

1. Stavropol State Medical University, Health Ministry of Russian Federation

2. Stavropol Regional Center of Specialized Types of Medical Care No. 1

3. Pavlov First Saint Petersburg State Medical University, Health Ministry of Russian Federation

4. Pavlov Ryazan State Medical University, Health Ministry of Russian Federation

5. Vernadsky Crimean Federal University

Abstract

Introduction. According to various estimates, in Russia 10 to 20 % of people of reproductive age are infertile. Changes in the immune system play a key role in the etiology and treatment of various infertility forms. The active introduction of immunological testing into clinical practice can potentially improve the results of infertility diagnostics and treatment.Aim: to analyze the current literature data on immunological testing in female infertility, as well as to assess its potential role in infertility diagnostics and treatment.Materials and Methods. There was conducted a search for publications in the electronic databases PubMed and eLibrary by using the following keywords and their combinations: "infertility", "immunology", "immune system", "immunological testing", "diagnostics", "treatment". The articles were evaluated in accordance with the PRISMA recommendations. Ultimately, 88 publications were included in the review.Results. Testing for antiphospholipid antibodies (APA) may be useful for women undergoing assisted reproductive technology (ART) therapy, as these antibodies increase the risk of pregnancy complications and thrombotic risks associated with ovarian stimulation, but studies assessing AFA effect on in vitro fertilization (IVF) outcomes have ambiguous results. The presence of antithyroid antibodies (ATA) may be associated with infertility, so their assessment is indeed important to determine treatment tactics. It has been suggested that antinuclear antibodies (ANA) may affect reproductive function by disrupting trophoblast cell development and interfering with RNA transcription, which may lead to lowered reproductive success. Studies have shown that patients with a positive ANA data have a lower incidence of pregnancy and a higher rate of miscarriages after IVF procedure. The human herpes virus type 6 (HHV-6) affects female fertility and is often the cause of spontaneous termination of pregnancy. B-cell lymphoma protein 6 (BCL-6) can serve as an important prognostic biomarker to identify individuals with endometriosis and related reproductive disorders, including idiopathic infertility. Evaluation of endometrial decidualization can be a useful tool to assess readiness for endometrial implantation and provide opportunities for targeted therapeutic interventions. The issue of testing for NK-cells in patients undergoing infertility screening remains controversial due to the difficulties of standardizing testing recommendations.Conclusion. To date, there is a limited number of reliable data on the role of various immunological tests in infertility diagnostics and treatment. With the exception of testing for AFA in patients with RPL, as well as for thyroid-stimulating hormone (TSH) and anti-thyroperoxidase antibodies (TPOAb) in patients undergoing therapy using various types of assisted reproductive technologies, the remaining immunological tests provide scant data to justify their routine use in clinical practice. The major limitations of existing studies are coupled to a small patient sample, as well as heterogeneity of inclusion criteria, patient groups and research methods.

Publisher

IRBIS

Reference88 articles.

1. Korneeva I.E., Nazarenko T.A., Perminova S.G. et al. Medical and social factors of infertility in Russia. [Mediko-social'nye faktory besplodiya v Rossii]. Akusherstvo i ginekologiya. 2023;(3):65-72. (In Russ.). https://doi.org/10.18565/aig.2022.279.

2. Federal State Statistics Service. [Federal'naya sluzhba gosudarstvennoj statistiki]. (In Russ.). Available at: https://rosstat.gov.ru/folder/313/document/94975. [Accessed: 13.04.2024].

3. Savina A.A., Feiginova S.I., Kuraeva V.M., Armashevskaya O.V. The challenge of incomparability of male and female infertility incidence among adult population in the Russian Federation. [Problema nesopostavimosti urovnej zabolevaemosti muzhskim i zhenskim besplodiem vzroslogo naseleniya v Rossijskoj Federacii]. Social'nye aspekty zdorov'ya naseleniya. 2020;(4):7. (In Russ.). https://doi.org/10.21045/2071-5021-2020-66-4-7.

4. Tsakhilova S.G., Kuznetsov V.P., Khmelnitskaya A.V. et al. The influence of the immune status of the mother on fetal development and the health of the newborn (a review). [Vliyanie immunnogo statusa materi na razvitie ploda i zdorov'e novorozhdennogo (obzor literatury)]. Problemy reprodukcii. 2016;22(6):38-43. (In Russ.). https://doi.org/10.17116/repro201622638-43.

5. Practice Committee of the American Society for Reproductive Medicine. Evidence-based treatments for couples with unexplained infertility: a guideline. Fertil Steril. 2020;113(2):305-22. https://doi.org/10.1016/j.fertnstert.2019.10.014.