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

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.

scholarly journals Thyroid Dysfunction and Infertility of Women of Reproductive Age

2020 ◽  
pp. 124-132
Author(s):  
Ekaterina Andreevna Sterlyova ◽  
Tatiana Kharitonovna Timokhina ◽  
Yuriy Viktorovich Sivkov ◽  
Alexandr Anatolyevich Markov ◽  
. Huldani ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Thyroid Dysfunction ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
Thyroid Peroxidase ◽  
American Thyroid Association ◽  
Women Of Reproductive Age ◽  
Intervention Level ◽  
The Relationship

Autoimmunity of the thyroid gland (TAI) or its dysfunction is quite common among women of reproductive age, and there are suggestions in the literature that they are associated with an unfavorable level of fertility and a negative outcome of pregnancy, as in the case of spontaneous conception or after assisted reproductive technologies (ART). This assumption makes it necessary to screen autoantibodies to thyrotropin (TSH) and thyroid peroxidase among infertile women who have made a number of attempts to become pregnant. Some authors have conducted a number of studies where they have examined the relationship between autoimmunity of the thyroid gland, thyroid function, and fertility. However, there is currently no consensus on the upper limit of the norm for TSH to determine thyroid dysfunction and the limits for intervention. Despite the recent update of the American thyroid Association (ATA) on guidelines for the diagnosis and treatment of thyroid diseases during pregnancy and the postpartum period, many issues remain unresolved in ART. The author came to the following conclusions: open thyroid dysfunction often leads to menstrual disorders, fertility problems, and pregnancy complications, and therefore should be treated accordingly. Currently, there is little evidence to recommend treatment with levothyroxine at TSH levels between 2.5 and 4.0 MMU / l, given the possible side effects of overtreatment, especially in patients with mild thyroid dysfunction. We suggest careful longitudinal monitoring, especially in the presence of thyroid antibodies in women undergoing ART. The 4 MMU / l limit for TSH appears as the intervention level for SCH treatment in women with and without transabdominal utrasound in ART.

scholarly journals CHARACTERISTICS OF MORBIDITY OF CHILDREN BORN USING ASSISTED REPRODUCTIVE TECHNOLOGIES

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.

CLINICAL CASE OF SUCCESSFUL TREATMENT OF INFERTILITY IN A PATIENT WITH FAILURE IVF RESULTS IN ANAMNESIS

2020 ◽  
pp. 61-67
Author(s):  
Kalinkina O.B. ◽  
Tezikov Yu.V. ◽  
Lipatov I.S. ◽  
Aravina O.R.
Keyword(s):  
Assisted Reproductive Technologies ◽  
Transvaginal Ultrasound ◽  
Clinical Manifestations ◽  
Reproductive Function ◽  
Abnormal Uterine Bleeding ◽  
Clinical Situation ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
Deficiency Anemia ◽  
Number Of Publications

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.

Genetic polymorphisms of reproductive hormones and their receptors in assisted reproduction technology for patients with polycystic ovary syndrome

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Yulia A. Koloda ◽  
Yulia V. Denisova ◽  
Natalia M. Podzolkova
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Assisted Reproductive Technologies ◽  
Polycystic Ovary ◽  
Ovarian Response ◽  
Reproductive Technologies ◽  
Reproductive Hormones ◽  
Current Data ◽  
Nucleotide Polymorphisms ◽  
Ovary Syndrome ◽  
Art Programs

Abstract Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in women of childbearing, which is defined by the accumulation of multiple, small fluid-filled ovarian cysts without the selection of a single dominant follicle. Most PCOS phenotypes are characterized by the absence of spontaneous ovulation, resistance toward ovulation inductors, the production of a large immature oocytes number, and the high prevalence of ovarian hyperstimulation syndrome, resulting in reduced assisted reproductive technologies (ART) programs effectiveness. The review analyses current data about the relationship between polymorphism genotypes of KISS genes, follicle stimulating hormone (FSH), luteinizing hormone (LH), anti-Müllerian hormone (AMH) and their receptors genes, gonadotropin-releasing hormone (GnRH), estrogen, and progesterone receptors genes, the PCOS risk and the features of ovarian response to stimulation during ART cycles. The use of single nucleotide polymorphisms (SNPs) as prognostic markers of ART programs outcomes would provide a personalized approach to the drugs and doses choice for ovarian stimulation and significantly increase the chance of pregnancy.

The birth of a healthy child in the assisted reproductive technologies program after autologous co-culture of embryo with cumulus cells and a new CAT transfer technology. Case report

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (3) ◽  
pp. 270-274
Author(s):  
Gunai R. Asfarova ◽  
Veronika I. Smol'nikova ◽  
Natalia P. Makarova ◽  
Iuliia S. Drapkina ◽  
Anastasiia P. Sysoeva ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Healthy Child ◽  
Assisted Reproductive Technologies ◽  
Cumulus Cells ◽  
Reproductive Technologies ◽  
Biologically Active ◽  
Human Embryos ◽  
Implantation Failure ◽  
Recurrent Implantation Failure ◽  
Art Programs

Cumulus cells are essential during oocytes growth and development, as well as during their maturation and fertilization. Research results have shown that embryo co-cultivation with autologous cumulus cells increases the frequency of blastocyst formation, and also improves the effectiveness of ART programs. Embryo transfer in such programs is recommended to be carried out using the CAT technology (Cumulus-Aided embryo Transfer), which includes embryo cultivation on a layer of cumulus cells and embryo transfer with a certain amount of diluted cumulus cells. Patient G., 38 years old, came to the department with infertility for 15 years and recurrent implantation failure in history. The patient had ART program with autologous co-cultivation of embryos with cumulus cells and a new CAT transfer technology. The patient fell pregnant and gave birth to a healthy child. Autologous cumulus cells can be a source of biologically active substances and improve embryological parameters and implantation rate in ART programs. Embryo co-cultivation with cumulus cells is especially important for patients with recurrent implantation failure. This technique can become an alternative for optimizing human embryos culturing.

Superovulation Influences Methylation Reprogramming and Delays Onset of DNA Replication in Both Pronuclei of Mouse Zygotes

2018 ◽  
Vol 156 (2) ◽  
pp. 95-105 ◽  
Author(s):  
Elif Diken ◽  
Matthias Linke ◽  
Jan Baumgart ◽  
Leonid Eshkind ◽  
Dennis Strand ◽  
...  
Keyword(s):  
Dna Replication ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Mouse Embryos ◽  
Negative Effect ◽  
Independent Replication ◽  
Mouse Zygotes ◽  
Pn Stage ◽  
Significant Expression ◽  
First Time

Although an essential component of assisted reproductive technologies, ovarian stimulation, or superovulation, may interfere with the epigenetic reprogramming machinery during early embryogenesis and gametogenesis. To investigate the possible impact of superovulation particularly on the methylation reprogramming process directly after fertilization, we performed immunofluorescence staining of pronuclear (PN) stage embryos with antibodies against 5mC and 5hmC. PN stage embryos obtained by superovulation displayed an increased incidence of abnormal methylation and hydroxymethylation patterns in both maternal and paternal pronuclear DNA. Subsequent single-cell RT-qPCR analyses of the Tet1, Tet2, and Tet3 genes revealed no significant expression differences between PN stage embryos from spontaneously and superovulated matings that could be causative for the abnormal methylation and hydroxymethylation patterns. To analyze the possible contribution of TET-independent replication-associated demethylation mechanisms, we then determined the 5mC and 5hmC levels of PN stage mouse embryos using immunofluorescence analyses after inhibition of DNA replication with aphidicolin. Inhibition of DNA replication had no effect on abnormal methylation and hydroxymethylation patterns that still persisted in the superovulated group. Interestingly, the onset of DNA replication, which was also analyzed in these experiments, was remarkably delayed in the superovulated group. Our findings imply an impact of superovulation on both replication-dependent and -independent or yet unknown demethylation mechanisms in PN stage mouse embryos. In addition, they reveal for the first time a negative effect of superovulation on the initiation of DNA replication in PN stage mouse embryos.

scholarly journals INFLUENCE ON THE OUTCOME OF ART PROGRAMS OF FROZEN-THAWED BLASTOCYSTS EXPANDED ON FIVE OR SIX DAY

2021 ◽  
pp. 68-75
Author(s):  
A.O. Polumiskova ◽  
S.I. Tevkin ◽  
T.M. Jussubaliyeva ◽  
M.S. Shishimorova
Keyword(s):  
Pregnancy Rate ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
Miscarriage Rate ◽  
Art Programs ◽  
Group A ◽  
The Difference ◽  
Group B

In order to increase the effectiveness of assisted reproductive technologies (ART) programs, it is essential to improve and develop conditions of embryo culture prior its transfer or cryopreservation of expanded blastocysts on the day 5 or 6. The aim of the study was to assess the effect of human blastocysts’ expansion timing on clinical pregnancy rate (CPR), miscarriage rate (MR) and take-home baby rate (THBR) in frozen-thawed cycles during ART programs. The study involved 2275 frozen embryo transfers (FET) of blastocysts expanded on the day 5 (group A) and 170 FET of blastocysts expanded on the day 6 (group B). The pregnancy rates in both groups were 50.8% and 46.5% respectively. There were no statistically significant differences in clinical pregnancy rate 37.4% and 37.0%, miscarriage rate 26.0% and 21.5% in both groups, respectively. THBR, as the main indicator of efficiency in the programs with transfer of post thawed expanded blastocysts on the day 5 (group A) or 6 (group B) were 36.5% and 35.2%, respectively (the difference is insignificant). In conclusion, in cryoprotocols the day of blastocyst expansion (day 5 or 6 of development) does not statistically affect PR, MR and THBR. In FET programs the quality of blastocyst (excellent and good) should be prioritized regardless of the day of cryopreservation.

Optimization of pregnancy tactics and early preterm labor in women after assisted reproductive technologies

2018 ◽  
pp. 104-107
Author(s):  
A.S. Mandrykova ◽  
Keyword(s):  
Peripheral Blood ◽  
Premature Birth ◽  
Preterm Labor ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Perinatal Complications ◽  
Premature Rupture ◽  
Practical Medicine ◽  
Objective Reduction ◽  
Ifn Γ

The objective: reduction of the frequency of perinatal complications in women with early preterm labor after the ART, based on the improvement and implementation of the algorithm for diagnostic and therapeutic and prophylactic measures. Materials and methods.We analyzed the course of 130 single-pregnancy pregnancy women with restored fertility after the use of therapeutic assisted reproductive technologies programs that ended with early premature births. The study of the subpopulation composition of lymphocytes and the content of activation markers of peripheral blood lymphocytes was performed using the method of quadratic color laser flow cytometry and a set of monoclonal antibodies. The concentration of cytokines IFN- γ, IL-4, IL-17A, IL-17F, IL-21 and IL-22 in serum of pregnant women was determined by solid-phase immunoassay analysis. The material for studying and analyzing the morpho-functional state of the fetoplacental complex was the results of pathomorphological study of the litter in all cases of early premature birth. By our own research, we established the frequency, structure and leading causes of early premature birth after assisted reproductive technologies, optimized the tactics of conducting induced pregnancies of high obstetric risk, formulated practical recommendations for implementation in practical medicine of Ukraine. Results. For introduction into practical medicine of Ukraine with the purpose of decreasing the frequency of perinatal complications and effective provision of obstetric and gynecological care, we recommend that the following provisions be included in the clinical protocol for the management of pregnancy of high obstetric risk in women after assisted reproductive technologies: 1. To predict the risk of early premature birth in women after ancillary reproductive technologies, the diagnostic algorithm should additionally include the definition of the main indicators of the serum cytokine profile: proinflammatory serum cytokines IFN- γ, IL-2, IL-12, IL-18; anti-inflammatory regulatory cytokine IL-10; quantitative indicators of NK cells with the phenotype CD3-CD16+CD56+, CD94+ lymphocytes and peripheral blood CD71 transferrin. 2. Use of medication correction – Micronized progesterone (200 mg/day). 3. At the gestational age of 28–33 weeks, with the premature rupture of the membranes optimal and effective is the expectant management of pregnancy for 5 days with subsequent delivery of women through the natural birth canal, which makes it possible to achieve the maximum possible degree of maturity of the fetus with a minimum risk of ascending infection in newborns. Conclusions. The effectiveness of our improved algorithm is a significant reduction in women after assisted reproductive technologies, early preterm labor (2.8 times), placental dysfunction (2.3 times), premature rupture of the membranes (in 2, 1 time), fetal distress (3,6 times), abdominal degeneration (2.9 times) and implementation of intraaminal infections (2.6 times; p<0.05). The total morbidity of newborns in the early neonatal period decreased 2.4 times, and perinatal losses were absent. Key words: assisted reproductive technologies, RPP, PRPO, markers of activation of lymphocytes, cytokines.

Effectiveness and outcomes of embryo cryopreservation programs in assisted reproductive technologies

2014 ◽  
Vol 63 (4) ◽  
pp. 39-46 ◽  
Author(s):  
Yana Nikolayevna Kravchuk ◽  
Alla Stanislavovna Kalugina ◽  
Olga Vladimirovna Bystrova ◽  
Svetlana Aleksandrovna Shlykova
Keyword(s):  
Embryo Transfer ◽  
Assisted Reproductive Technologies ◽  
Negative Impact ◽  
Perinatal Outcomes ◽  
Reproductive Technologies ◽  
Embryo Cryopreservation ◽  
Control Group ◽  
Fresh Embryo Transfer ◽  
Art Programs ◽  
Thawed Embryo Transfer

Background. Embryo cryopreservation is an essential part of ART programs today. In recent years vitrification method is used increasingly widely. Purposes and tasks. To compare the effectiveness of ART programs using vitrified and fresh embryos, as well as different endometrial preparation regimes for frozen\thawed embryo transfer (modified natural cycle (MNC) and the preparatory hormone therapy(PHT)). To analyze the course of pregnancy and perinatal outcomes after vitrified embryo transfer. Materials and methods. We prospectively assessed the ART programs effectiveness and perinatal outcomes in 153 patients (I group), who underwent vitrified embryo transfer in 2011-2013 year. To prepare the endometrium for thawed embryo transfer in 83 patients PHT (Ia subgroup) and MNC in 70 patients (Ib subgroup) were used. Control group consisted of 70 patients, who underwent fresh embryo transfer. Results. The clinical pregnancy rate, birth rate and “take home baby” rate were not significantly different between the I (47,5 %; 30,9 %; 30,9 %) and II (53,0 %; 34,9 %; 32,5 %) groups, and between Ia (48,3 %; 28,4 %; 28,4 %) and IIb (46,6 %; 34,1 %; 34,1 %) subgroups. Complications during pregnancy and delivery, birthweight, length, Apgar score, congenital malformation rate did not differ significantly after vitrified and fresh embryo transfer. Conclusion. Vitrification is an effective method to achieve clinical results, comparable to native cycles. Application of PHT and MNC results in similar clinical outcomes. Transfer Vitrified embryo transfer does not have a negative impact on obstetric and perinatal outcomes when compared with native cycles.

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