Babayeva Gulchin, Purut Yunus Emre, Giray Burak, Oltulu Pembe, Alakuş Rabia, Çolakoğlu Mehmet Cengiz
Necmettin Erbakan University Meram Faculty of Medicine, Department of Obstetrics and Gynecology, Konya, Turkey.
Zeynep Kamil Women and Children Diseases Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey.
Turk J Obstet Gynecol. 2020 Dec;17(4):236-239. doi: 10.4274/tjod.galenos.2020.90359. Epub 2020 Dec 10.
Implantation failure is a multifactorial problem of reproductive medicine. However, the mechanism of this process is still not fully understood. There is increasing evidence that these cases of recurrent implantation failure might have an immunologic background. Uterine natural killer (NK) cells provide immune-modulation at the interface between maternal decidua and the trophoblast. The aim of this study to evaluate whether there was a significant difference in the number of endometrial CD56+ NK between women with a history of recurrent implantation failure and women who had a live birth.
Patients with a history of recurrent implantation failure were included in the study. Twenty-five women with a history of recurrent implantation failure were assigned to the case group, and 25 women who had one or more live births were assigned to the control group. Endometrial biopsies were obtained during the luteal phase on the 21-24 day of the menstrual cycle.
There was a statistically significant difference between the groups concerning the number of deliveries (p<0.001) and miscarriages (p<0.001). The mean number of uNK was 10.5±10.5 cells/mm in the case group and 19.2±11.2 cells/mm in the control group. There was a statistically significant difference between the two groups (p=0.003).
Implantation failure is a multifactorial problem of reproductive medicine. The results of our study suggest that uterine NK play a role in the progress of normal pregnancy and reduced uterine NK cell numbers were associated with implantation failure.
着床失败是生殖医学中的一个多因素问题。然而，这一过程的机制仍未完全阐明。越来越多的证据表明，这些反复着床失败的病例可能具有免疫背景。子宫自然杀伤（NK）细胞在母体蜕膜与滋养层之间的界面提供免疫调节。本研究的目的是评估有反复着床失败史的女性与有活产史的女性之间，子宫内膜CD56+NK细胞数量是否存在显著差异。
有反复着床失败史的患者纳入本研究。25例有反复着床失败史的女性被分配到病例组，25例有一次或多次活产史的女性被分配到对照组。在月经周期第21 - 24天的黄体期进行子宫内膜活检。
两组在分娩次数（p<0.001）和流产次数（p<0.001）方面存在统计学显著差异。病例组uNK细胞的平均数量为10.5±10.5个/mm，对照组为19.2±11.2个/mm。两组之间存在统计学显著差异（p = 0.003）。
着床失败是生殖医学中的一个多因素问题。我们的研究结果表明，子宫NK细胞在正常妊娠过程中发挥作用，子宫NK细胞数量减少与着床失败有关。
