#192 : Comparison of Cytokine Profiles and Th1/Th2 Ratios in the Peri-Implantation Endometrium in Recurrent Reproductive Failure Women with and Without Chronic Endometritis

Abstract

Background and Aims: Aberrant local endometrial microenvironment in chronic endometritis (CE) may be involved in reduced endometrial receptivity and recurrent reproductive failure. Previous studies have observed some discrepancies between different types of cytokines, without showing the predominance of a specific immune response between women with miscarriage and normal pregnancy. However, exactly how CE alters the endometrial function and interferes with the process of implantation is still uncertain. Method: It was an observational retrospective study. A total of 39 women with unexplained recurrent miscarriage (RM) participated in this study. Endometrial specimens were obtained precisely 7 days after luteinization hormone surge and chronic endometritis was diagnosed by plasma cell density. In total, 24 different cytokines were examined by the Luminex technique after protein extraction and Th1/Th2 ratios are measured. Results: No significant differences in all the endometrial specimens between 14 women who found to have CE and 25 women who did not have CE. However, in the RM group, we found a significantly increased expression of IFN-[Formula: see text] (2.89 pg/mL vs. 0.75 pg/mL, [Formula: see text] = 0.027) in women with CE. In addition, an elevated Th1/Th2 ratio (IFN-[Formula: see text] /IL-4: 288.83 vs. 75.29, [Formula: see text] = 0.027) and a decreased ratio of TNF-[Formula: see text] /IL-6 (1.25 vs. 3.11, [Formula: see text] = 0.006) were observed in RM women with CE than those without CE. Moreover, the levels of VEGF-D (14.63 pg/mL vs. 9.16 pg/mL, [Formula: see text] = 0.041) and EGF (25.13 pg/mL vs. 11.98 pg/mL, [Formula: see text] = 0.023) were higher in women with live births than those women without live births in RM group and infertility group, respectively. Conclusion: In this study, altered cytokine profiles and Th1/Th2 ratios in peri-implantation endometrium is of predictive value for subsequent pregnancy outcome in women with recurrent miscarriage.