Higher interleukin-18 and mannose-binding lectin are present in uterine lumen of patients with unexplained infertility

Abstract

The uterine luminal environment was explored with regard to interleukin-18 (IL-18) and mannose-binding lectin (MBL) and the possibility that the procedure of flushing the uterine cavity would optimize the physiological initial pseudo-inflammatory uterine reaction. Uterine flushings were performed among 175 IVF/intracytoplasmic sperm injection (ICSI) patients at the time of oocyte retrieval and the cycles were compared with a control group matched for age, number of previous attempts and type of assisted reproductive procedure (IVF or ICSI) in which no flushing were performed (n = 175). Samples collected were divided into two groups according to the presence/absence of endometrial cells in samples. IL-18 and MBL expressions were explored by enzyme-linked immunosorbent assay. Implantation rates were significantly higher in those patients who underwent the uterine flushing compared with controls (P = 0.04). Luminal concentrations of IL-18 and MBL were higher if endometrial cells were present in flushings, suggesting endometrial origin of the secretion. Both concentrations of MBL and IL-18 were higher in patients with unexplained infertility compared with patients involved in IVF/ICSI for male or tubal infertility (P = 0.005 and 0.02, respectively). The exploration of the endoluminal environment before oocyte retrieval may enhance pregnancy rates and show distinct features in patients with unexplained infertility.

Analysis of interleukin-18 promoter polymorphisms and changes in interleukin-18 serum levels underscores the involvement of interleukin-18 in recurrent spontaneous miscarriage

“…Functionally, both variants were linked with reduced IL-18 availability, evidenced by a progressive reduction in serum IL-18 levels in heterozygous and homozygous carriers in both patients and control women. These findings underscore the significance of reduced IL-18 levels in the maintenance of normal pregnancy (12,21), and in the pathogenesis of pregnancy complications (6,8,28), including RSM (21).…”

MBL Interferes with Endovascular Trophoblast Invasion in Pre-Eclampsia

“…The level of MBL in the vaginal cavity changes during the menstrual cycle being produced locally by vaginal cells [16]. MBL seems to play an important role in embryo implantation since the analysis of uterine flushings, obtained at the time of oocyte retrieval for the in vitro fertilisation, revealed an increased level of MBL in patients with unexplained infertility compared with patients involved in IVF/ICSI for male or tubal infertility [17]. …”

Evolution of (our) Concepts on Key Determinants of a Successful Pregnancy

“…Interestingly, MBL deregulations were also observed in human. Higher concentrations of MBL were observed locally in the uterine cavity of sterile patients with unexplained infertility compared to control fertile ones, and interestingly this was linked with high IL-18 [92].…”