LEVELS OF CYTOKINES, Α2-MACROGLOBULIN, AND ITS ACTIVE TRANSPORT FORM IN THE WOMEN WITH TUBAL INFERTILITY DURING IN VITRO FERTILIZATION

Abstract. We performed measurements of serum interleukin-6 (IL-6), interferon-γ (IFNγ), tumor necrosis factor-α (TNFα), as well as total contents of α2-macroglobulin (MG) in blood and concentration of its active transport form, i.e., circulating complexes with plasmin (MG-PL) in women at their reproductive age, suffering with tubal infertility, who participated in an in vitro fertilization (IVF) program. We have found that the cohort of women with tubal infertility is initially heterogeneous and consists of persons with relative enhancement of either humoral, or cellular immune response. Stimulation of superovulation upon IVF in the women with increased humoral immune reactivity promotes normalization of cytokine levels, increases total contents of MG and maintains its active form (MG-PL), both by transporting bioactive substances, which are necessary to growth of the embryo, favors better access of MG-PL to cells due to reduction of IFNγ levels. Finally, it brings about positive results of the IVF procedure. In women with increased cellulartype immune reactivity, the MG levels are initially low, along with high IFNγ levels, thus diminishing transport of biologically active substances to the cells by MG-PL, as well as high and non-decreasing TNFα concentrations after stimulated superovulation, and, probably, an increased activity of NK-cells and cytotoxic lymphocytes. These factors minimize the possibility of favorable IVF outcome. With respect of the trends revealed, we would like to recommend determinations of serum cytokines and MG-PL complexes, as an additional prognostic tool when carrying out IVF programs.

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