Changes in the immune system in pregnant women, after pregravid preparation before the DRT program, with a history of sexually transmitted infections
Keywords:sexually transmitted infections, pregravid preparation, immune homeostasis
The objective: to analyze the dynamics of laboratory indicators of the functioning of the immune system in pregnant women with a history of sexually transmitted infections (STIs) before and after pre-gravid preparation before cycles of assisted reproductive technologies (ART).
Materials and methods. An analysis of the functioning of the immune system was carried out in 247 women with infertility who had a history of STIs and planned to participate in the DRT program: 115 women underwent our proposed pre-gravid training, of which 56 women in the DRT program ended in pregnancy, who entered the 1st group and received the proposed we take medical and preventive measures; 132 women underwent standard pre-gravid training, of which 55 women in the DRT program ended in pregnancy, who were included in the II group and received generally accepted medical and preventive measures.
An in-depth immunological examination included: the absolute number of blood leukocytes and lymphocytes, as well as their subpopulations: CD3+ CD4+ helpers; CD3+ CD8+ cytotoxic T cells; activated CD3+DR+ T-lymphocytes; B-lymphocytes CD19+; (natural killers) of CD16+, CD56+, CD50+ cells.
Statistical processing of research results was carried out using standard programs «Microsoft Excel 5.0» and «Statistica 8.0».
Results. During immunological control before the start of preparation for DRT, immune maladaptation was observed in both study groups and there were no reliable changes in immunological indicators. During pregnancy, in the group of patients who received our proposed pre-gravid preparation, a probable decrease (p<0.05) of the immunoregulatory coefficient from 2.17 to 1.87 was observed, as a result of adequate correction of derived immunological disorders, compared to pregnant women of the II group (2,20–2.19). As a result of the pregravid preparation offered by us, in 84,3% of the patients of the I group, stimulation of the cellular link of immunity was observed, the phagocytic activity of neutrophils and the number of B-lymphocytes increased, the number of M-immunoglobulins decreased by 267.3±14.2 mg% versus 257.7±12, 7 mg%, p<0.05
Conclusions. The development and implementation of effective pre-gravid preparation before DRT cycles in women with a history of STIs and medical correction during pregnancy contributes to increasing the adaptive compensatory-adaptive potential in the immune homeostasis of the mother and perinatal protection of the fetus.