scholarly journals Assessment of the hormonal levels in different management strategies for women with cervical insufficiency and a history of anovulatory infertility

2021 ◽  
Vol 23 (1) ◽  
pp. 98-104
Author(s):  
L. V. Pakharenko ◽  
O. M. Perkhulyn

Cervical insufficiency (CI) is one of the causes of preterm birth. The rate of CI is higher in women after in vitro fertilization treatment for infertility compared to the general population. The aim. To assess the hormonal level in women with CI and a history of anovulatory infertility in the second and third trimesters of pregnancy in different management strategies for CI. Materials and methods. 60 pregnant women with CI who conceived through in vitro fertilization treatment for anovulatory infertility were divided into two groups: in the I group (30 women), CI was corrected only with cervical cerclage / pessary in the II trimester of pregnancy, in the II group (30 persons), cervical cerclage / pessary was combined with vaginal progesterone 200 mg ones a day until 34 full weeks of gestation. 30 pregnant women without СІ or infertility with the physiological course of pregnancy were controls. The concentrations of estradiol, progesterone, placental lactogen, prolactin and cortisol were determined in the terms of 19–22 and 30–32 weeks of gestation in the maternal blood serum. Results. In the patients with CI at 19–22 gestational weeks, the estradiol and placental lactogen concentrations were slightly lower in the I and II groups than those in the control women, the level of progesterone was less in the I group by 13.44 %, in the II group – by 17.30 % (P < 0.05) compared to the controls; the levels of prolactin and cortisol in the I and II groups were increased significantly (P < 0.001). At 30–32 gestational weeks, the levels of estradiol (P < 0.05), progesterone (a decrease of 23.10 %, P < 0.001) and placental lactogen (a decrease of 10.74 %, P < 0.05) were significantly less as compared to the physiological ranges, while these parameters in the II group patients were on the lower limit of normal. In the I group, the concentrations of prolactin and cortisol were higher by 41.70 % (P < 0.001) and 27.36 % (P < 0.001), respectively, than the controls, in the II group – only by 24.10 % (P < 0.05) and 13.70 % (P < 0.05), respectively. Conclusions. In the women with cervical insufficiency after in vitro fertilization treatment for anovulatory infertility, the levels of estradiol, progesterone and placental lactogen are not significantly different from physiological indices, but the prolactin and cortisol concentrations are much higher. Adjunctive vaginal progesterone treatment to cervical cerclage/pessary in the third trimester of pregnancy promotes the normalization of progesterone, estradiol and placental lactogen levels, the decrease in prolactin and cortisol indices at 30–32 gestational weeks compared to the women with cervical cerclage/pessary alone.

2021 ◽  
Vol 74 (10) ◽  
pp. 2412-2416
Author(s):  
Oksana M. Perkhulyn ◽  
Lyudmyla V. Pakharenko ◽  
Vladyslav S. Sukhin ◽  
Oleksiy V. Saltovskiy ◽  
Viktoriia M. Kovalchuk ◽  
...  

The aim: To assess the levels of hormones in women with cervical insufficiency and infertility in the history in the II trimester of gestation. Materials and methods: 120 pregnant women with cervical insufficiency and anovulatory infertility in the history were examined in the II trimester of gestation: in the I group (60 persons) pregnancy occurred after hormonal treatment of infertility, in the II group (60 individuals) – after in vitro fertilization. 30 pregnant women without cervical insufficiency and a history of infertility were controls. The levels of estradiol, progesterone, placental lactogen, prolactin and cortisol were determined in the blood serum. Results: The concentration of maternal progesterone was lower in the persons in the I group on 12.36 %, in the II group – on the 15.37 % (p=0.03) compared to the healthy women. Cortisol and prolactin amounts were statistically higher in I and II groups (p<0.001) than in controls. While the levels of estradiol and placental lactogen were slightly less in the subjects with cervical insufficiency and a history of anovulatory infertility compared to the healthy women. Conclusions: In pregnant women with cervical insufficiency and a history of anovulatory infertility in the II trimester of gestation there are decrease progesterone level and high prolactin and cortisol concentrations in blood serum. The changes in estradiol and placental lactogen amounts are not significant compared to healthy women.


2021 ◽  
Vol 3 ◽  
pp. 34-36
Author(s):  
O.M. Perkhulyn ◽  
L.V. Pakharenko

Cervical insufficiency is one of the most frequent reasons for late miscarriage and preterm birth. Its rate is increased in women who conceived after the use of additional reproductive technologies. The objective: to assess the parameters of cervical elastography in women with cervical insufficiency and anovulatory infertility in a history. Materials and methods. 40 pregnant women with cervical insufficiency who conceived after treatment of infertility associated with anovulation were examined in the term of 16–20 weeks: in the I group (20 persons) pregnancy conceived after conservative treatment of infertility, in the II (20 patients) – after in vitro fertilization. 20 women with the physiological course of pregnancy without cervical insufficiency and with spontaneous gestation were controls. Cervical elastography index was used to assess the strain of cervical tissue. Results. According to the results of compression elastography all patients in the I and II groups had red or yellow color of the internal cervical os and cervical canal. In the persons without cervical insufficiency the cervical tissue was firm (purple and blue color). The number of women with purple color of the anterior labia of the cervix in the I and II groups was in 4.67 (р=0.001) and 2.33 (р=0.03) times less compared to the controls, of the posterior labia – in 3,2 times (р=0.001) in both groups. Conclusion. In women with cervical insufficiency and a history of anovulatory infertility there are considerable changes of strain in internal os and cervical canal of the cervix.


2021 ◽  
Vol 7_2021 ◽  
pp. 202-209
Author(s):  
Kirienko K.V. Kirienko ◽  
Osina E.A. Osina ◽  
Apryshko V.P. Apryshko ◽  
Voloshanenko V.V. Voloshanenko V ◽  
Yakovenko S.A. Yakovenko S ◽  
...  

2010 ◽  
Vol 93 (2) ◽  
pp. 544-553 ◽  
Author(s):  
Karin J. Middelburg ◽  
Maaike L. Haadsma ◽  
Maas Jan Heineman ◽  
Arend F. Bos ◽  
Mijna Hadders-Algra

Reproduction ◽  
2002 ◽  
pp. 181-196 ◽  
Author(s):  
BD Bavister

Although in vitro fertilization (IVF) is used widely for a variety of purposes, it is often not appreciated how this technology was developed. A large number of experiments beginning in 1878 contributed to the first successful reports of IVF over 75 years later. The discovery of sperm capacitation in 1951 was central to the development of IVF technology, and it was rapidly followed by the first convincing reports of IVF in several species. The ability to fertilize oocytes in vitro has allowed major advances to be made into understanding the mechanisms involved in fertilization and early development, and IVF now supports reproductive biotechnology in animals and in humans. This article is a historical review of key experiments that helped to provide the basis for present day IVF procedures, placed into context with current practice.


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