Effectiveness of vaccination in the treatment of early lesions of the cervix in women with infertility
Authors:   Kyiv City Center of Perinatal and Reproductive Care, Ukraine, Shalko M.N. , Sereda K.V. ,   Kyiv City Center of Perinatal and Reproductive Care, Ukraine
Published: June 2024

Infertility is a common pathology that has not only medical, but powerful social and economic consequences. The aim of the study - to investigate the impact of human papillomavirus (HPV) vaccination on indicators of local cervical immunity in women with infertility. Materials and methods. 133 patients with infertility were examined, in whom abnormal cytological findings and DNA of one or more HPV strains were detected during the initial examination. Among them, 28 women had infertility of endocrine origin (the Group I), 52 women had tubo-peritoneal origin (the Group II) and 53 patients had male factors of infertility (the Group III). After treatment, which included the elimination of pathogens and excision of the affected epithelium, the patients were divided into subgroups A and B. Subgroup IA included 13 patients, subgroup IV included 13 patients, IIA included 28 patients, IIV included 24 patients, IIIA included 27 patients, IIIB included 26 patients. Patients of subgroup A were offered vaccination with a 2-component vaccine against HPV, patients of subgroup B were limited to traditional therapy. In the control group were 37 healthy women with normal cytological results. The concentration of interleukin 8 (IL-8), IL-6, lactoferrin (L) and secretory leukocyte proteinase inhibitor (SLPI) was assessed before the start of treatment, 3 and 6 months after treatment. Results. In all patients with infertility and early cervical lesions (ECL), a three-fold increased concentration of IL-8, IL-6, as well as SLPI and L, which has a direct impact on fertility disorders, was found. Against the background of traditional therapy, a decrease in IL-6 was found in all patients after 6 months, and in patients with infertility of endocrine origin was found in the concentration of L. Additional vaccination allows to achieve a decrease in the cervical content of all inflammatory markers within 6 months, which is important for the further restoration of reproductive function. Conclusions. Increased cervical content of pro-inflammatory markers: IL-6, IL-8, SLPI and L, which are important in the pathogenesis of reproductive function disorders, were found in patients with ECL against the background of infertility. Against the background of anti-inflammatory therapy and surgical treatment for 6 months, there is a slight decrease in the cervical concentration of IL-8 and SLPI. Vaccination with a bivalent vaccine against HPV in combination with anti-inflammatory therapy and surgical treatment in women with ECL and infertility led to the normalization of the concentration of pro-inflammatory markers in cervical mucus. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the women was obtained for the research. No conflict of interests was declared by the authors.