scholarly journals Risk of developing gestational diabetes in women after assisted reproductive technologies

2019 ◽  
Vol 68 (2) ◽  
pp. 17-22
Author(s):  
Olga N. Arzhanova ◽  
Anna V. Rulyova ◽  
Yulia M. Paykacheva ◽  
Alina O. Ivanova ◽  
Natalya G. Nichiporuk
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Gestational Diabetes ◽  
Comparison Group ◽  
Assisted Reproductive Technologies ◽  
Polycystic Ovary ◽  
Significant Risk ◽  
Reproductive Technologies ◽  
Main Group ◽  
Reproductive Age

Hypothesis/aims of study. Gestational diabetes mellitus (GDM) is one of the leading causes of perinatal morbidity and mortality. The use of assisted reproductive technologies (ART) is an independent risk factor for the development of GDM. Among other risk factors are overweight, diabetes burdened heredity, previous GDM, previous birth weight more than 4 kgs, stillbirth, miscarriage in history, glucosuria, polyhydramnios in this pregnancy, age over 30 years, polycystic ovary syndrome. The most significant risk factor for GDM is excess weight before pregnancy. The aim of this study was to investigate the risks of GDM in patients after ART. Study design, materials, and methods. 342 case histories of women with single pregnancy for the period 2014–2017 were studied on archival material. The main group consisted of 234 women with single pregnancy after ART. The comparison group comprised 108 medical records of fertile women with a history of single pregnancy that occurred spontaneously. The exclusion criteria in the comparison group were pregestational diabetes mellitus and severe extragenital pathology. Results. The incidence of GDM was significantly higher in the group of women in whom pregnancy occurred after ART compared to the comparison group (15.4 ± 0.4% and 5.5 ± 0.4% respectively). In the main group, patients were more likely to have overweight, extragenital pathology and pregnancy complications. Conclusion. The increase in the frequency of GDM among patients after ART is probably associated with late reproductive age, initially negative somatic background at the time of entry into the IVF protocols, as well as long-term hormone therapy during pregnancies after ART, starting from early terms.

scholarly journals Effects of Inositol(s) in Women with PCOS: A Systematic Review of Randomized Controlled Trials

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Vittorio Unfer ◽  
John E. Nestler ◽  
Zdravko A. Kamenov ◽  
Nikos Prapas ◽  
Fabio Facchinetti
Keyword(s):  
Systematic Review ◽  
Insulin Resistance ◽  
Randomized Clinical Trials ◽  
Assisted Reproductive Technologies ◽  
Polycystic Ovary ◽  
Pathological Condition ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
Industrialized Nations

Polycystic ovary syndrome (PCOS) is a common endocrine disorder, with complex etiology and pathophysiology, which remains poorly understood. It affects about 5–10% of women of reproductive age who typically suffer from obesity, hyperandrogenism, ovarian dysfunction, and menstrual irregularity. Indeed, PCOS is the most common cause of anovulatory infertility in industrialized nations, and it is associated with insulin resistance, type 2 diabetes mellitus, and increased cardiovascular risk. Although insulin resistance is not included as a criterion for diagnosis, it is a critical pathological condition of PCOS. The purpose of this systematic review is the analysis of recent randomized clinical trials of inositol(s) in PCOS, in particular myo- and D-chiro-inositol, in order to better elucidate their physiological involvement in PCOS and potential therapeutic use, alone and in conjunction with assisted reproductive technologies, in the clinical treatment of women with PCOS.

scholarly journals Assisted Reproductive Technologies for Women with Polycystic Ovarian Syndrome

2021 ◽  
Vol 14 (3) ◽  
pp. 1305-1308
Author(s):  
Muhjah Falah Hassan ◽  
Pallav Sengupta ◽  
Sulagna Dutta
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Assisted Reproductive Technologies ◽  
Polycystic Ovary ◽  
Fetal Loss ◽  
Reproductive Technologies ◽  
Fertilization Rate ◽  
Reproductive Age ◽  
Treatment Modalities ◽  
Reproductive Techniques ◽  
Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is the most common cause of anovulatory fertility problems in women of reproductive age, with a prevalence as high as 40% to 75%. There are different treatment modalities for increasing the chance of pregnancy in PCOS patients. Since most of the PCOS patients suffer from ovulatory problems, therapeutic efforts are focused mainly towards restoring normal ovulation. However, even after pharmacological interventions to ameliorate ovulatory irregularities, women with polycystic ovary are still at high risk of fetal loss. Thus, assisted reproductive techniques (ARTs) have become popular approaches which significantly increase the chances of successful pregnancy in these women, bypassing the conditions of PCOS. The present mini-review ‘pinpoints’ on the suitability of ARTs for PCOS patients who fail to ovulate following the conventional infertility treatment. The article also briefly explains how intracytoplasmic sperm injection (ICSI), the most effectiveART, correlates with better biological parameters, fertilization rate and better quality of embryos in PCOS women.

Advances in Treatment Options for Polycystic Ovary Syndrome

2012 ◽  
Vol 08 (01) ◽  
pp. 57 ◽  
Author(s):  
Sanam Lathief ◽  
Lubna Pal ◽  
◽  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Ovulation Induction ◽  
Assisted Reproductive Technologies ◽  
Polycystic Ovary ◽  
Clomiphene Citrate ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
Comparable Efficacy ◽  
Hormonal Contraceptives ◽  
Ovary Syndrome

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy seen in women of reproductive age. Clinical concerns relating to PCOS range from ovulatory infertility and menstrual disorders to risk of diabetes and cardiovascular disease. Hormonal contraceptives have been the mainstay of the management of common PCOS symptoms, such as menstrual irregularity and clinical stigmata of androgen excess (i.e., hirsutism and acne). An appreciation of the relevance of metabolic pathways in the pathophysiology of PCOS is relatively recent, and has translated into an expansion of the therapeutic strategies available for the management of PCOS. Insulin sensitizers were one of the first metabolic modulators to be incorporated in the clinical management paradigm, albeit with mixed results. Recognizing that insulin resistance is central to the pathophysiology of PCOS, newer agents—e.g., thiazolidinediones— followed, with almost comparable efficacy to metformin. Statins and most recently incretins constitute novel therapies with distinct metabolic targets that seem to hold promise in the management of PCOS. In tandem with the expansion in pharmaceuticals, a host of complementary and alternative medical therapies have generated interest for purported promise in the management of PCOS, including vitamin D, acarbose, and myo-inositol. The therapeutic options for managing PCOS-related infertility have also expanded. Clomiphene citrate (CC) has long been the first-line strategy for ovulation induction in the setting of anovulatory infertility; however, aromatase inhibitors are fast gaining acceptance as an ovulation induction strategy, with results comparable or even better than those seen with CC. An increasing level of therapeutic sophistication is reflected in ovarian stimulation protocols judiciously using gonadotropins, gonadotropin-releasing hormone antagonists, the procedure of ovarian drilling, and assisted reproductive technologies within vitrooocyte maturation.

scholarly journals Improvement Effect of Metformin on Female and Male Reproduction in Endocrine Pathologies and Its Mechanisms

2021 ◽  
Vol 14 (1) ◽  
pp. 42
Author(s):  
Alexander O. Shpakov
Keyword(s):  
Diabetes Mellitus ◽  
Pregnancy Outcomes ◽  
Hormonal Regulation ◽  
Ovarian Function ◽  
Assisted Reproductive Technologies ◽  
Polycystic Ovary ◽  
Health Effect ◽  
Reproductive Technologies ◽  
Male Reproduction ◽  
Endocrine Disorders

Metformin (MF), a first-line drug to treat type 2 diabetes mellitus (T2DM), alone and in combination with other drugs, restores the ovarian function in women with polycystic ovary syndrome (PCOS) and improves fetal development, pregnancy outcomes and offspring health in gestational diabetes mellitus (GDM) and T2DM. MF treatment is demonstrated to improve the efficiency of in vitro fertilization and is considered a supplementary drug in assisted reproductive technologies. MF administration shows positive effect on steroidogenesis and spermatogenesis in men with metabolic disorders, thus MF treatment indicates prospective use for improvement of male reproductive functions and fertility. MF lacks teratogenic effects and has positive health effect in newborns. The review is focused on use of MF therapy for restoration of female and male reproductive functions and improvement of pregnancy outcomes in metabolic and endocrine disorders. The mechanisms of MF action are discussed, including normalization of metabolic and hormonal status in PCOS, GDM, T2DM and metabolic syndrome and restoration of functional activity and hormonal regulation of the gonadal axis.

Possibilities of ovarian stimulation in patients with reduced ovarian reserve

2020 ◽  
Vol 19 (5) ◽  
pp. 51-56
Author(s):  
N.L. Shamugiya ◽  
◽  
M.S. Borisova ◽  
N.M. Podzolkova ◽  
◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Ovarian Stimulation ◽  
Comparison Group ◽  
Assisted Reproductive Technologies ◽  
Young Patients ◽  
Reproductive Technologies ◽  
Main Group ◽  
Etiological Factor ◽  
Unknown Etiology

Objective. To increase the efficiency of assisted reproductive technologies (ART) in young patients with reduced ovarian reserve after ovarian surgery. Patients and methods. 141 patients were examined. In the first group (main), 56 patients with reduced ovarian reserve after unilateral/bilateral ovarian resection were included. In the second group (comparison group) – 85 patients with reduced ovarian reserve of unknown etiology were included. Results. There were no differences in the assessment of ovarian reserve in groups (p > 0.05). Stimulation protocols in groups differed in terms of the daily and total dose of gonadotropins (p < 0.05). The main group and the comparison group differed in terms of the quality of the obtained oocytes (3.11 ± 1.69 vs 3.99 ± 2.38; p = 0.0244) and embryos (1.25 ± 1.19 vs 1.73 ± 1.55; p = 0.0465). Perinatal outcomes in groups did not differ significantly (p > 0.05), but in the main group there was a greater number of spontaneous miscarriages and premature births (3.1% versus 1.9%), which may indicate the influence of etiological factor in reducing the ovarian reserve on carrying a pregnancy. Conclusion. To increase the effectiveness of ART in patients with reduced ovarian reserve, etiological factor should be taken into account when selecting the optimal protocol for ovarian stimulation. Age is a decisive factor in the outcomes of ART in this group of patients. Key words: infertility, ovarian response, assisted reproductive technologies, ovarian reserve, ovarian stimulation, in vitro fertilization

Influence of microbiome on a woman’s reproductive function

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.

scholarly journals Gestational Diabetes Mellitus Is a Significant Risk Factor for Long-Term Maternal Renal Disease

2015 ◽  
Vol 100 (4) ◽  
pp. 1412-1416 ◽  
Author(s):  
Ofer Beharier ◽  
Ilana Shoham-Vardi ◽  
Gali Pariente ◽  
Ruslan Sergienko ◽  
Roy Kessous ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Gestational Diabetes ◽  
Renal Disease ◽  
Gestational Diabetes Mellitus ◽  
Significant Risk ◽  
Significant Risk Factor

Gestational diabetes mellitus is a significant risk factor for long-term ophthalmic morbidity

2017 ◽  
Vol 295 (6) ◽  
pp. 1477-1482 ◽  
Author(s):  
Ofer Beharier ◽  
Ruslan Sergienko ◽  
Roy Kessous ◽  
Irit Szaingurten-Solodkin ◽  
Asnat Walfisch ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Significant Risk ◽  
Significant Risk Factor

Gestational Diabetes Mellitus in Women with Polycystic Ovary Syndrome Undergoing Assisted Reproduction

MedPharmRes ◽  
2019 ◽  
Vol 2 (4) ◽  
pp. 26-31
Author(s):  
Chau Tran ◽  
Lan Vuong
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Polycystic Ovary Syndrome ◽  
Gestational Diabetes Mellitus ◽  
Polycystic Ovary ◽  
First Trimester ◽  
Reproductive Age ◽  
Ovary Syndrome ◽  
Logistic Regression Models ◽  
Increased Risk

Polycystic ovary syndrome (PCOS) is a common endocrine metabolic disorder in women of reproductive age. PCOS is often associated with insulin resistance and carries an increased risk of gestational diabetes mellitus (GDM). The aim of this study was to evaluate the risk of GDM in women with a history of PCOS. This was a retrospective cohort study conducted at a single center in Vietnam between January 2014 and December 2017. A total of 400 women who conceived through assisted reproductive technology (ART) were included, 200 who had been diagnosed with PCOS, and 200 without a PCOS diagnosis as controls. Multivariable logistic regression models were used to examine the association between risk of GDM and PCOS after adjusting for confounders. GDM was present in 37% of those with PCOS, compared with 26.5% in those without PCOS (RR 1.4, 95% CI 1.04–1.87, p=0.02). The prevalence of GDM did not differ significantly between PCOS phenotype groups (p=0.28). Women with PCOS undergoing ART had a higher risk of GDM after adjusting for differences in age, pre-pregnancy body mass index, type of infertility, ART indications, and type of ART (adjusted OR 2.04, 95% CI 1.06–3.92). First-trimester fasting plasma glucose (FPG) was also an independent predictor for GDM (adjusted OR 1.54, 95% CI 1.01–2.34). This study suggests that PCOS and first-trimester FPG are independent risk factors for the development of GDM.

scholarly journals Obesity – threat to the reproductive potential of Russia

2019 ◽  
Vol 16 (3) ◽  
pp. 20-28 ◽  
Author(s):  
Elena N. Andreeva ◽  
Ekaterina V. Sheremetyeva ◽  
Valentina A. Fursenko
Keyword(s):  
Assisted Reproductive Technologies ◽  
Polycystic Ovary ◽  
Reproductive Potential ◽  
Reproductive Technologies ◽  
The Body ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Short Term ◽  
Cancer Breast

Obesity is a recurring polyetiological disease. Overweight are 3060% of women of reproductive age, and 2527% are obese. By 2025, it is expected that 50% of women on our planet will be obese. Obesity in women of reproductive age is accompanied by a high frequency of anovulation, hyperandrogenism, menstrual irregularities, endometrial pathology, infertility. During pregnancy, this group of women has a higher risk of short term loss, including pregnancy in the outcome of assisted reproductive technologies. Weight gain and obesity can lead to decreased fertility in women. The body mass index of a woman of reproductive age negatively affects the course of pregnancy, namely: the risk of gestational diabetes, increased blood pressure, eclampsia, the pathological course of the birth act and the pathology of the newborn increase. Obesity in women of reproductive age is an independent risk factor for cancer: breast cancer and endometrial cancer, and also leads to a decrease in the survival rate for ovarian cancer. Obesity often accompanies polycystic ovary syndrome, which occurs in every 10th patient of reproductive age. The combination of these diseases increases the risk of cardiometabolic conditions such as impaired glucose tolerance, type 2 diabetes and dyslipidemia. Weight loss in these patients is a necessary component of complex therapy aimed at improving reproductive potential.

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