近年来乌克兰普遍存在的人口危机、俄罗斯联邦侵略造成的战争状态、育龄妇女的生育能力丧失是现代妇产科最紧迫的问题之一。纠正生殖功能受损最有效的方法之一是体外受精。开发一种药理复合物，用于预防体外受精妇女体内 CD68 /CD163 蜕膜巨噬细胞失衡。105 名孕妇分为 3 组参加了研究。第一组包括 20 名已怀孕且生理状况正在进行的女性。第二组由85名因体外受精而怀孕的妇女组成，其中包括37名拒绝预防性纠正早产威胁的孕妇和48名接受预防性纠正早产威胁的孕妇：复杂处方从怀孕 18 至 20 周开始，每天口服 2 次维生素 D3 2000 IU、每天 2 次微粉化黄体酮 200 毫克和每天 2 次 L-精氨酸天冬氨酸 1000 毫克。早产时，宫颈粘液中观察到诱导型 NO 合酶活性和肿瘤坏死因子-α 浓度局部升高，精氨酸酶活性和白细胞介素 10 水平降低。它们在胎盘蜕膜巨噬细胞上的 CD163 表达较低，而 CD68 表达增加，这表明巨噬细胞的极化从抗炎表型转变为促炎表型。预防性治疗的使用使研究的参数更接近于生理上怀孕的女性的结果。在通过体外受精怀孕的女性中，在怀孕 28-30 周时，促炎表型的特异性变化观察到蜕膜巨噬细胞。维生素 D3、微粉化黄体酮和 L-精氨酸天冬氨酸的复合给药可恢复蜕膜巨噬细胞的抗炎表型。© 2023 作者。

The demographic crisis that prevailed in Ukraine in recent years, the state of war as a result of the aggression of the Russian Federation, reproductive losses among women of childbearing age are one of the most urgent problems in modern obstetrics and gynecology. One of the most effective methods of correcting impaired reproductive function is in vitro fertilization.is to develop a pharmacological complex for the prevention of imbalance of CD68+/CD163+ decidual macrophages in vitro fertilized women.105 pregnant women who were divided into 3 groups took part in the study. The first group included 20 women whose pregnancy occurred and is proceeding physiologically. The second group consisted of 85 women who became pregnant as a result of in vitro fertilization, including 37 pregnant women who refused prophylactic correction of the threat of premature birth, and 48 pregnant women who received prophylactic correction of the threat of premature birth: complex prescription of vitamin D3 2000 IU orally 2 times a day, micronized progesterone 200 mg 2 times a day and l-arginine aspartate 1000 mg 4 times a day, starting from 18 to 20 weeks of pregnancy.In women who refused prophylactic correction of the threat of premature birth, a local increase in the activity of inducible NO-synthase and concentration of tumor necrosis factor-α, and a decrease in the activity of arginase and in the level of interleukin-10 were observed in the cervical mucus. They have a lower expression of CD163+ on placental decidual macrophages and an increased expression of CD68+, which indicates a shift in the polarization of macrophages from an anti-inflammatory to a pro-inflammatory phenotype. The use of prophylactic treatment brings the studied parameters closer to the results of women in whom pregnancy occurred physiologically.In women who became pregnant as a result of in vitro fertilization, at 28-30 weeks of pregnancy, changes specific for pro-inflammatory phenotype of decidual macrophages were observed. Complex administration of vitamin D3, micronized progesterone and l-arginine aspartate lead to restoration of anti-inflammatory phenotype of decidual macrophages.© 2023 The Authors.