Objective: To study the structural and immunohistochemical features of placentas in women after assisted reproductive technology (ART) with allogeneic eggs (oocyte donation and surrogate motherhood). Study Design: The study involved 89 women whose pregnancy occurred as a result of in vitro fertilization (IVF) with a donor egg in a surrogate motherhood program (IVF-SM, n = 47 patients) or oocyte donation (IVF-DO, n = 42). The comparison group consisted of 21 patients in whom pregnancy occurred as a result of IVF with their own egg (IVF-OE). A clinical and anamnestic analysis of the pregnant women was carried out. Morphological and immunohistochemical studies were performed on placental material. Immunohistochemical analysis of CD8, CD56, CD138, and CD25/CD4 markers indicating the processes of impaired tolerance in placenta was carried out. Results: We observed a predominance of women aged >40 (range 42.7–3.91) years with a burdened somatic and obstetric-gynecological history and a high incidence of hypertensive pregnancy complications, such as gestational arterial hypertension (27.4%) and preeclampsia (28.5%), in the IVF-DO group. The IVF-SM group included mainly somatically healthy women aged <30 (29.4–3.19) years with a high risk of termination of pregnancy in the third trimester (49.6%) and premature birth (21.6%). Placentas taken from women after allogeneic pregnancy had pronounced signs of immune alteration, such as chronic histiocytic intervillositis, lymphoplasmacytic deciduitis, chronic chorioamnionitis, chronic villitis, and perivillous fibrinoid with lymphocytes (p [F] < 0.05). Immunohistochemical study of the placentas showed accumulation of CD138+ plasma cells, CD8+ T lymphocytes, and uterine natural killer cells, and a decrease in the number of CD25/CD4+ regulatory T cells (Tregs) in the structures of the uteroplacental region (Kruskal-Wallis test, p < 0.05). Conclusion: Placentas after IVF with oocyte donation and surrogate motherhood programs are characterized by similar changes, associated with the development of chronic inflammation in the structures of the placenta and immunohistochemical signs of impaired immunological tolerance at the maternal-fetal interface. The data we obtained allow us to classify pregnancies under surrogate motherhood programs as a risk factor for the development of pregnancy complications with immune pathogenesis.

中文翻译：

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异基因妊娠胎盘的免疫形态学特征是产科并发症发生的背景

目的：研究同种异体卵子（卵母细胞捐赠和代孕）辅助生殖技术（ART）后女性胎盘的结构和免疫组织化学特征。研究设计：该研究涉及 89 名因代孕计划（IVF-SM，n = 47 名患者）或卵母细胞捐赠（IVF-DO，n = 42)。对照组由 21 名因使用自己的卵子进行体外受精（IVF-OE）而怀孕的患者组成。对孕妇进行了临床和回忆分析。对胎盘材料进行形态学和免疫组织化学研究。对指示胎盘耐受性受损过程的 CD8、CD56、CD138 和 CD25/CD4 标志物进行了免疫组织化学分析。结果：我们观察到超过 40 岁（范围 42.7-3.91）岁的女性占主导地位，她们有繁重的躯体和妇产科病史，并且高血压妊娠并发症的发生率很高，例如妊娠动脉高血压 (27.4%) 和先兆子痫 (28.5%)，在 IVF-DO 组中。IVF-SM 组主要包括身体健康的女性，年龄 <30 (29.4-3.19) 岁，在妊娠晚期终止妊娠 (49.6%) 和早产 (21.6%) 的风险很高。同种异体妊娠后女性的胎盘具有明显的免疫改变迹象，例如慢性组织细胞性绒毛间炎、淋巴浆细胞性蜕膜炎、慢性绒毛膜羊膜炎、慢性绒毛炎和具有淋巴细胞的绒毛周纤维蛋白样蛋白（p [F] < 0.05）。胎盘的免疫组织化学研究显示 CD138+ 浆细胞的积累，CD8+ T 淋巴细胞和子宫自然杀伤细胞，以及子宫胎盘区结构中 CD25/CD4+ 调节性 T 细胞 (Treg) 的数量减少（Kruskal-Wallis 检验，p < 0.05）。结论：IVF 后的卵母细胞捐赠和代孕计划的胎盘具有相似的变化，这与胎盘结构中慢性炎症的发展和母胎界面免疫耐受受损的免疫组织化学迹象有关。我们获得的数据使我们能够将代孕计划下的妊娠分类为发生具有免疫发病机制的妊娠并发症的风险因素。以及子宫胎盘区域结构中 CD25/CD4+ 调节性 T 细胞 (Treg) 的数量减少（Kruskal-Wallis 检验，p < 0.05）。结论：IVF 后的卵母细胞捐赠和代孕计划的胎盘具有相似的变化，这与胎盘结构中慢性炎症的发展和母胎界面免疫耐受受损的免疫组织化学迹象有关。我们获得的数据使我们能够将代孕计划下的妊娠分类为发生具有免疫发病机制的妊娠并发症的风险因素。以及子宫胎盘区域结构中 CD25/CD4+ 调节性 T 细胞 (Treg) 的数量减少（Kruskal-Wallis 检验，p < 0.05）。结论：IVF 后的卵子捐赠和代孕计划的胎盘具有相似的变化，这与胎盘结构中慢性炎症的发展和母胎界面免疫耐受受损的免疫组织化学迹象有关。我们获得的数据使我们能够将代孕计划下的妊娠分类为发生具有免疫发病机制的妊娠并发症的风险因素。与胎盘结构中慢性炎症的发展和母胎界面免疫耐受受损的免疫组织化学迹象有关。我们获得的数据使我们能够将代孕计划下的妊娠分类为发生具有免疫发病机制的妊娠并发症的风险因素。与胎盘结构中慢性炎症的发展和母胎界面免疫耐受受损的免疫组织化学迹象有关。我们获得的数据使我们能够将代孕计划下的妊娠分类为发生具有免疫发病机制的妊娠并发症的风险因素。