Expression of progesterone receptors in multiple pregnancy

Abstract

Hormonal disorders, specifically progesterone insufficiency, constitute the primary cause of pregnancy loss. The role of progesterone insufficiency in the genesis of obstetric and gynecological losses is actively discussed worldwide. Progesterone and the quantity of its receptors play a crucial role in the maintenance and prolongation of pregnancy. The placenta, being the main site of progesterone synthesis, represents a significant source of information and serves as an essential diagnostic object. The obtained data during placental research are indispensable for understanding the etiopathogenic changes in pregnancy loss in the case of multiple pregnancies. Purpose - to analyze the immunohistochemical changes in the expression of progesterone receptors in placental structures of parturients with dichorionic diamniotic twins depending on the method of conception. Materials and methods. We conducted a clinical-statistical analysis of the course of pregnancy and childbirth in women with multiple pregnancies induced by assisted reproductive technologies (ART). To determine the expression of progesterone receptors, immunohistochemical research of placentas from women with dichorionic and diamniotic twins resulting from ART was carried out. Results.The study revealed that women with multiple pregnancies induced by ART had a complicated somatic and obstetric-gynecological history, which subsequently negatively influenced the outcomes and course of pregnancy. A complicated pregnancy not only affects the process of childbirth but also the timing of delivery, as premature births in multiple pregnancies occur twice as often as in singleton pregnancies. Immunohistochemical analysis of the placenta showed the highest quantity of progesterone receptors and their expression in the nuclei of decidual cells (50%) of the maternal structure of the placenta in women with dichorionic and diamniotic twins resulting from ART. Conclusions.The obtained data on the expression of progesterone receptors indicate an evident connection between structural interactions of the placenta and endometrium, which is a key component in the advisability of prescribing progesterone therapy for the prevention of obstetric and perinatal losses. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.