CLINICAL AND IMMUNOLOGICAL CHANGES IN TREATMENT OF ADENOMYOSIS IN PATIENTS WITH INFERTILITY

Aim. The aim of this study was to asses changes of adhesion molecules (L-selectin, neopterin and interleukin-6) in patients with adenomyosis-related infertility during the therapy.

Materials and methods. 49 patients with infertility caused by adenomyosis were examined and divided into 3 clinical groups: 1 group – 26 patients (35,1%) and 2 group – 23 patients (31,1%) with adenomyosis-associated infertility; 3 group (control) – 25 patients (33,8%). Adhesion molecules detection was performed by enzyme immunoassay (EIA). Visual evaluation scale was used for estimating of clinical aspects of adenomyosis.

Results. The diagnostic utility of L-selectin for monitoring the adenomyosis therapy effectiveness was shown. The difference between L-selectin levels before and after treatment was statistically significant, the correlation coefficient (R) reached 0,584. The gestagens application is preferable due to reliable normalization of L-selectin levels and decrease in intensity of algomenorrhea (in the 1st group – 1,3 times less, than in 2nd group) and dyspareunia (in the 1st group – 2,2 times less, than in the 2nd group) on visual evaluation scale.

Conclusions. Adenomyosis not accompanied by a significant increase in the production of systematic inflammatory response markers (neopterin and IL-6), the increase of adhesion molecules (L-selectin) indicates the imbalance of endothelial-thrombocyte-leukocyte interaction.