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https://doi.org/10.14300/mnnc.2016.11067

The syndrome of undifferentiated connective tissue dysplasia in a combination with hereditary thrombophilia as a cause of primary female in fertility

[CTD in adults]
Evgenia Kogan; Vladimir Nikolenko; Alexander Zanozin; Tatyana Demura; Dmitry Kolosovsky;

Morphological and immunophenotypic features of the endometrium in patients with primary infertility at the background of undifferentiated connective tissue dysplasia (uCTD) syndrome and hereditary thrombophilia (HT) are studied. The study was performed on paypel-biopsies of the endometrium, taken in the “window of implantation” from 81 patients with a clinical diagnosis uCTD (13 women), with HT (40), with a combination of uCTD and HT (19) and the control group – healthy surrogate mothers (9). Morphological, immunohistochemical and morphometric study of paraffin sections of biopsies of the endometrium was conducted. Immunohistochemical reactions were carried out with primary antibodies against ER, PgR, LIF, PAI-1, VEGF, Collagen I, Collagen III, fibronectin, laminin, MMP-2, MMP-9. Groups uCTD, NT, NT + uCTD showed signs of reducing of endometrial receptivity in the form of reducing the percentage of mature pinopodies, slowing of endometrial maturation, receptivity expression of marker LIF decrease and deviation of stromal progesterone-estrogen index from the norm. Sclerosis foci with the accumulation of type III collagen were detected in the endometrial stroma. Syndromes of uCTD and NT, and their combinations are frequently comorbidity and risk factors of infertility in women. The uCTD syndrome slows down the process of remodeling of the connective tissue, which leads to increased process of endometrial stroma sclerosis, endometrial receptivity reduce and infertility. The most pronounced changes in the morphological and immunophenotypic characteristics develop in uCTD + HT.

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Keywords: connective tissue dysplasia, hereditary thrombophilia, female infertility