Correction of the micronutrient composition of blood serum in women planning to realize reproductive function in programs of assisted reproductive technologies

Genital endometriosis is a disease of women of reproductive age, accompanied by infertility in 50% [1]. Adenomyosis can be considered as an endometriosis of the uterus. Histologically, this process is represented by ectopic, non-tumor endometrial glands, and stroma surrounded by hypertrophic and hyperplastic myometrium [2]. Adenomyosis is accompanied by pelvic pain of varying intensity as well as menstrual disorders [1]. The disease is accompanied by significant violations of reproductive function (infertility, unsuccessful attempts at pregnancy and miscarriage, abnormal uterine bleeding). Adenomyosis can be accompanied by a violation of the function of adjacent organs (such as the bladder, rectum). Often, one of the clinical manifestations of adenomyosis is the development of sideropenic syndrome, which is also caused by the development of chronic post-hemorrhagic iron deficiency anemia. This is accompanied by a deterioration in the general condition of patients, a decrease in their ability to work. Despite a large number of publications in Russian and foreign scientific sources devoted to this problem, reproductive doctors and obstetricians-gynecologists often underestimate the role of adenomyosis in pregnancy planning using assisted reproductive technologies. Without interpreting the anamnesis data obtained through an active survey, doctors do not prescribe additional methods for diagnosing this pathology, which is not complex and expensive. To confirm the diagnosis, a transvaginal ultrasound examination of the pelvic organs during the premenstrual period is sufficient. In cases that are difficult to diagnose, the MRI method of the corresponding anatomical area can be used. Underestimation of the clinical picture and under-examination of the patient did not allow prescribing timely correction of the pathology and led to unsuccessful attempts to implement the generative function using assisted reproductive technologies. The conducted examination with clarification of the cause of IVF failures and the prescribed reasonable treatment made it possible to achieve regression of endometriosis foci in this clinical situation, followed by the patient's ability to realize generative function.

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ENDOMETRIOSIS AND INFERTILITY. OPERATION OR ASSISTED REPRODUCTIVE TECHNOLOGIES?

V F Snegirev Archives of Obstetrics and Gynecology ◽

10.18821/2313-8726-2018-5-1-31-36 ◽

2018 ◽

Vol 5 (1) ◽

pp. 31-36

Author(s):

Natalya S. Kuzmina ◽

V. F Bezhenar ◽

A. S Kalugina

Keyword(s):

Surgical Treatment ◽

Ovarian Reserve ◽

Assisted Reproductive Technologies ◽

Transvaginal Ultrasound ◽

Statistical Significance ◽

Reproductive Function ◽

Ovarian Response ◽

Reproductive Technologies ◽

Ovarian Endometrioma ◽

Infertility Patients

The aim of the study was to study the influence of the ovarian endometrioma on the ovarian reserve, the ovarian response in ovarian hyperstimulation, and outcomes of assisted reproductive technologies (ART). Material and methods. The study included 43 infertility patients underwent the surgical treatment of an ovarian endometrioma in the history. During the study, the follicles were counted separately (according to transvaginal ultrasound), eggs and embryos were obtained from the operated and intact ovaries. Results. The number of follicles in the ovary, operated due to endometriosis, is significantly lower than in the contralateral ovary (p = 0.005). The number of ovules punctured from the ovary, operated for endometriosis, is less than the number of ovules obtained from the intact ovary, but the difference does not reach statistical significance (p = 0.07). The number of high-quality embryos obtained from the ovary, operated for endometrioma, is statistically significantly lower than the number of similar embryos obtained from the intact ovary (p = 0.013). Conclusion. According to the conducted study, it can be concluded that the surgical treatment of endometrioma in infertility patients with the need for the implementation of the reproductive function reduces the number of follicles in the operated ovary and, accordingly, does not lead to an improvement in indices of the infertility treatment using ART. At the same time, the very presence of endometrioma is also known to negatively impact on outcomes of ART. Therefore, in infertility patients with the reduced ovarian reserve, individualization of approaches to treatment is extremely important.

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Influence of microbiome on a woman’s reproductive function

HEALTH OF WOMAN ◽

10.15574/hw.2020.151-152.38 ◽

2020 ◽

pp. 38-42

Author(s):

M. Malachynska ◽

◽

N. Veresniuk ◽

◽

...

Keyword(s):

Comparison Group ◽

Assisted Reproductive Technologies ◽

Intrauterine Insemination ◽

Reproductive Function ◽

Reproductive Technologies ◽

Reproductive Organ ◽

Main Group ◽

The Subject ◽

Infertile Patients ◽

Functioning Mechanism

The interplay between the microbiome and the reproductive organ system is a complex functioning mechanism that continues to be the subject of much contemporary research. The microbiome of the reproductive sphere plays an important role in the onset and delivery of pregnancy, the frequency of live births, influences the result of assisted reproductive technologies and the like. This study substantiates the feasibility of using a multi-strain probiotic in the complex treatment of infertile patients. The objective: to investigate the efficacy of administering a multi-strain probiotic to patients with infertility. Materials and methods. Under our observation, from 2017 to 2020, there were 94 patients with infertility. The age of women ranged from 22 to 35 years. All participants in the main group, 64 patients, received a multi-strain probiotic, which included 5 strains of bacteria, 1 capsule once a day during meals, for 1 month before planning the pregnancy. The comparison group consisted of 30 women with infertility who did not take any probiotics. Results. Analyzing the results of vaginal biocenosis examination in the examined women, normocenosis was established in 33 (35.1%) patients. Bacterial vaginosis occurred in almost every fourth patient (23.4%), every third woman (30.9%) had an intermediate type of smear, and 10.6% of patients were diagnosed with nonspecific colpitis. Among the patients in the main group, pregnancy occurred in 21 women, accounting for 32.8%. At the same time, 4 patients (13.3%) became pregnant in the comparison group, one of whom was after intrauterine insemination and another was due to IVF (p<0.5). No women of the main group were observed side effects of the drug. Conclusion. The incidence of pregnancy in infertile patients who used a multisystem probiotic at the pre-gravid stage was 32.8%. The use of a multi-strain probiotic increases the incidence of implantation in infertile patients (p = 0.0464), however, more research is needed on this topic. Keywords: microbiome, lactobacillus, infertility, pregnancy.

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Use of assisted reproductive technologies in euthyroid women with antibodies to the thyroid gland. A literature review

Journal of obstetrics and women s diseases ◽

10.17816/jowd69599-104 ◽

2020 ◽

Vol 69 (5) ◽

pp. 99-104

Author(s):

Inga V. Gorelova ◽

Ksenia A. Prikhodko ◽

Maxim V. Rulev ◽

Irina E. Zazerskaya

Keyword(s):

Thyroid Gland ◽

Premature Birth ◽

Assisted Reproductive Technologies ◽

Reproductive Function ◽

Reproductive Technologies ◽

Negative Influence ◽

Thyroid Peroxidase ◽

Art Programs ◽

Negative Effect ◽

Meta Analyses

The presence of antibodies to thyroid peroxidase and thyroglobulin of the thyroid gland in women with infertility is more common than in the population. Some studies describe the negative effect of autoantibodies on reproductive function and the results of assisted reproductive technology (ART) programs even in the absence of impaired thyroid function. This article presents a review of literature data on the possible mechanisms of this negative influence. To date, there are no data on a significant decrease in the quality of oocytes, embryos and pregnancy rates in ART cycles in such patients. The negative effect of autoantibodies on the frequency of live births can be realized through such complications of pregnancy as miscarriage and premature birth. Currently, the possibilities for preventing these complications are poorly understood. According to recent meta-analyses, the use of levothyroxine in euthyroid patients with autoantibodies who are treated for infertility using ART methods does not result in a decrease in the frequency of miscarriage and premature birth.

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Ovarian endometriosis associated infertility: a modern view to the problem

GYNECOLOGY ◽

10.26442/20795696.2020.5.200405 ◽

2020 ◽

Vol 22 (5) ◽

pp. 44-49

Author(s):

Mekan R. Orazov ◽

Marina B. Khamoshina ◽

Marianna Z. Abitova ◽

Lyudmila M. Mikhaleva ◽

Snezhana V. Volkova ◽

...

Keyword(s):

Ovarian Reserve ◽

Assisted Reproductive Technologies ◽

Negative Impact ◽

Ovarian Tissue ◽

Reproductive Function ◽

Reproductive Technologies ◽

Reproductive Age ◽

Ovarian Endometriosis ◽

Surgical Interventions ◽

Ovarian Endometriomas

This review summarizes current understanding of the pathogenesis of one of the most common forms of external genital endometriosis ovarian endometriomas. Due to their frequent occurrence in young women of reproductive age and extremely negative impact on the morphophysiological state of the ovaries, this disease makes a significant contribution to the structure of endometriosis-associated infertility. The main determinant of the negative effect of ovarian endometriomas on reproductive function is a decrease in ovarian reserve, which can occur either due to the direct gonadotoxic effect of the endometriod cyst itself, or due to the unintentional removal of healthy ovarian tissue during surgery or the use of aggressive methods of electrosurgery. Hence, the question of methods for achieving hemostasis during surgery in terms of iatrogenic effects on healthy ovarian tissue is debatable. The management strategy for patients with infertility associated with ovarian endometriosis consists of two components: surgical treatment and/or the use of assisted reproductive technologies. Laparoscopic cystectomy is indicated for cysts larger than 3 cm. Repeated surgical interventions in case of endometriosis do not improve fertility outcomes. Assisted reproductive technologies methods should be considered as a priority tactic in patients of older reproductive age with low ovarian reserve indicators or infertility duration of more than 2 years, as well as in cases of recurrent ovarian endometriomas. Management of such patients must be personalized and take into account the age, state of the ovarian reserve, duration of infertility, stage and number of surgical interventions for this disease.

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Inhibin as a reproductive biomarker part 2. Clinical significance of inhibins in reproductive medicine

Journal of obstetrics and women s diseases ◽

10.17816/jowd68591-106 ◽

2019 ◽

Vol 68 (5) ◽

pp. 91-106

Author(s):

Zarina K. Abdulkadyrova ◽

Maria I. Yarmolinskaya ◽

Alexander M. Gzgzyan ◽

Lyailya Kh. Dzhemlikhanova ◽

Elena I. Abashova

Keyword(s):

Down Syndrome ◽

Ovarian Reserve ◽

Reproductive Medicine ◽

Prenatal Screening ◽

Assisted Reproductive Technologies ◽

Diagnostic Marker ◽

Reproductive Function ◽

Reproductive Technologies

In the early 2000s, the determination of inhibin levels was used actively for the diagnosis of ovarian tumors, as a diagnostic marker for prenatal screening of Down syndrome, as well as a prognostic marker for ovarian reserve when conducting assisted reproductive technologies. However, to date, inhibin is rarely used as a marker for reproductive function. At the same time, numerous studies of recent years indicate the crucial role of inhibin in folliculogenesis and spermatogenesis, as well as in implantation and placentation. This allows to significantly expand the diagnostic spectrum of inhibin levels in various disorders of the reproductive system of both women and men.

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CHRONIC ENDOMETRITIS AS A FACTOR OF FAILURE ATTEMPT IN ASSISTED REPRODUCTIVE TECHNOLOGIES

Likarska sprava ◽

10.31640/jvd.7-8.2019(2) ◽

2019 ◽

pp. 13-21

Author(s):

O. V. Onysko ◽

О. О. Korchynska ◽

Stefania Andrashchikova ◽

Sylvia Zhultakova ◽

Alena Shlosserova

Keyword(s):

Plasma Cells ◽

Assisted Reproductive Technologies ◽

Proteolytic Enzymes ◽

Uterine Cavity ◽

Reproductive Function ◽

Reproductive Technologies ◽

Careful Study ◽

Chronic Endometritis ◽

Vitro Fertilization

Increase in frequency of disorders of women's reproductive function justifies a careful study of the underlying pathological processes. In recent years, increased attention in solving fertility problems is paid to endometrial pathology when chronic endometritis plays an important role. Current worksarefeeding an in-depth study of the etiology and pathogenesis of chronic endometritis. However, results of research pose new questions with an imaginary comprehensive study of this problem. Chronic endometritis is one of the causes of infertility and may play a role in certain complications of pregnancy and childbirth (30.3 % in patients with repeated failures of in vitro fertilization, 9.3 % with recurrent miscarriages, 9.8 % in infertility). Clinically, chronic endometritis is often asymptomatic or accompanied by nonspecific symptoms such as pelvic pain, dyspareunia, abnormal uterine bleeding, and discharges. Previously, scientists considered the uterine cavity as a sterile container. But a team of Spanish scientists sought to test for the presence of intrauterine microflora, which differs from the vaginal. As a result, the study of endometrial fluid and vaginal samples from the same patients revealed different bacterial compositions. Microflora in the intrauterine fluid was classified as Lactobacillus, and women with non-lactobacillary flora of the endometrium had a significantly lower frequency of implantation. At the initial stage of endometrial inflammation is an activation of neutrophils and macrophages, increased cytokines synthesis, extracellular matrix degradation by proteolytic enzymes. Disorders of microcirculation and sclerotic processes in the area of injury lead to the ischemia and tissue hypoxia, which activates the processes of sclerosis and angiogenesis. Chronization of the process increases the expression of chemokines and adhesion molecules, that is lead to migration of B-lymphocytes from the bloodstream and their differentiation into plasma cells, increases the activity of matrix metalloproteinases, changes local expression of estrogen and progesterone receptors. Lack of a pronounced specific clinical picture of chronic endometritis, its later detection causes impaired reproductive function. Untimely diagnosis and treatment of chronic endometritis has significant consequences in terms of the possibility of implantation of a fertilized egg in the programs of assisted reproductive technologies.

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Infertile marriage in patients with diabetes mellitus

Diabetes Mellitus ◽

10.14341/2072-0351-5695 ◽

2009 ◽

Vol 12 (4) ◽

pp. 6-9 ◽

Cited By ~ 2

Author(s):

Irina Ivanovna Vityazeva ◽

Sergey Vladimirovich Bogolyubov ◽

Irena Adol'fovna Ilovayskaya ◽

Nataliya Petrovna Makarova ◽

Alesya Gennad'evna L'vova

Keyword(s):

Diabetes Mellitus ◽

Assisted Reproductive Technologies ◽

Reproductive Function ◽

Reproductive Technologies ◽

Cellular Level ◽

Endocrine Function ◽

Diabetic Patients ◽

Chronic Hyperglycemia ◽

Patients With Diabetes ◽

Different Levels

Diabetes mellitus affects reproductive function at different levels both in men and women. It disturbs regulation of the hypothalamo-pituitary axisand impairs gonadal endocrine function at the cellular level due to direct effect of acute and/or chronic hyperglycemia, oxidative stress and microvascularcomplications. Moreover, central dysregulation aggravates hormonal disorders. Assisted reproductive technologies (ART) provide a tool for thetreatment of male and female infertility in diabetic patients although many aspects of its application await in-depth studies.

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CHARACTERISTICS OF MORBIDITY OF CHILDREN BORN USING ASSISTED REPRODUCTIVE TECHNOLOGIES

Nauka molodykh (Eruditio Juvenium) ◽

10.23888/hmj202084629-634 ◽

2020 ◽

Vol 8 (4) ◽

pp. 629-634

Author(s):

K.A. Kuzmichev ◽

Keyword(s):

Large Scale ◽

Assisted Reproductive Technologies ◽

Reproductive Function ◽

Reproductive Technologies ◽

Current Data ◽

Number Of Children ◽

Neoplastic Processes ◽

Increased Risk ◽

Meta Analyses ◽

The Impact

Infertility is an important medical and social problem. Increasing numbers of infertile couples lead to an increase in the use of assisted reproductive technologies (ART), which is reflected in the increasing number of children born using these methods. Literature provides information on the specific features of neonatal and early postnatal diseases in such children, showing significantly lower health parameters compared to children born in result of spontaneous pregnancy. The issue of the long-term health status of children born after ART is still controversial. The first major meta-analyses have appeared quite recently permitting to reliably assess the morbidity of children born after ART. This review presents evidence that summarizes the current data on the morbidity of children born after ART. It shows the absence of a reliable difference in the level of occurrence of neoplastic processes, development of metabolic and psychiatric diseases. There is an increased risk of vascular-endothelial dysfunction, arterial hypertension, cardiovascular diseases. Contradictory data were obtained on the impact of ART methods on reproductive function: a decrease in ejaculate quality was observed in boys born after intracytoplasmic sperm injection. The presented data make it possible to form an idea on this issue, however, within the general morbidity framework. Nosological characteristics and the determination of incidence of certain diseases still remain a relevant task and require special large-scale prospective studies and observation of children born after ART throughout their lives to establish more accurate correlations.

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EVALUATION OF HORMONAL ASPECTS BY CERVICAL INSUFFICIENCY IN WOMEN WITH HISTORY OF INFERTILITY

Актуальні проблеми сучасної медицини Вісник Української медичної стоматологічної академії ◽

10.31718/2077-1096.20.2.76 ◽

2020 ◽

Vol 20 (2) ◽

pp. 76-79

Author(s):

O.M. Perkhulyn

Keyword(s):

Blood Serum ◽

Pregnant Women ◽

Assisted Reproductive Technologies ◽

Reproductive Technologies ◽

Main Group ◽

The Body ◽

Control Group ◽

Cervical Insufficiency ◽

The Past ◽

History Of

Introduction. Today, the frequency of infertility is increasing worldwide. Infertility, associated with anovulation, is especially challenging for the medical correction especially. The leading aspect of this problem is hormonal disorders in the body of a woman. The aim of this study was to assess the level of estradiol and progesterone in the blood serum of pregnant women with cervical insufficiency and infertility associated with anovulation in the history. Materials and methods. The main group included 30 pregnant women with the II trimester of pregnancy, who had cervical insufficiency and infertility associated with anovulation in the past medical history. They got pregnant after assisted reproductive technologies. The control group included 30 pregnant women without cervical insufficiency and with physiological gestation. Estradiol and progesterone levels in blood serum were determined at 20-22 and 30-32 weeks of gestation. Results. The average age of the women in the basic group was statistically higher relative to the control one – 31.30±1.16 and 27.30±0.92 years, respectively (p=0.02). There was no difference in the number of pregnancies in women between both groups. In the main group, 73.33% of the persons were primagravida, 10.00 % of patients had two pregnancies, and 16.67 % - three pregnancies. 56.67 % of the women in the control group were primagravida, 26.67 % had two pregnancies, 16.66 % - three pregnancies. Although primaparas predominated in both groups, the number of such women was in 1.47 times higher in the main group (93.33 %) than in control (63.33 % of patients; χ2=6.28, p=0.01); 6.67 % and 26.67 % women had two labors respectively and 10.00 % of healthy patients - three labors. The concentration of estradiol at the 20-22 and 30-32 weeks of pregnancy in women of the main group almost corresponded to physiological parameters. However, the progesterone level in women with cervical insufficiency and a history of infertility was by 13.44 % lower than in healthy pregnant women at 20-22 weeks, and by 17.02% at 30-32 weeks (p=0.003). Conclusions. In pregnant women with cervical insufficiency and infertility associated with anovulation, the level of estradiol in the II and III trimesters of gestation mainly corresponds to the level of physiological pregnancy. However, they have the decrease in progesterone concentration in the III trimester of pregnancy relative to healthy pregnant women (p<0.003).

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