scholarly journals Features of reproductive function in infertile women with hyperthyroidism

2021 ◽  
Vol 38 (1) ◽  
pp. 64-71
Author(s):  
L. M. Rzakulieva ◽  
A. E. Hajizade

Objective. The aim was to study the characteristics of reproductive function in women of fertile age with infertility and hyperfunction of the thyroid gland. Materials and methods. The object of the study was 148 women of fertile age. To compare the indicators obtained by special methods, the control group included the indicators of laboratory and instrumental examination of 30 non-pregnant women of reproductive age. Reproductive function was evaluated in 118 women with hyperthyroidism: 58 retrospectively (group I) and 60 prospectively (group II); the control group consisted of 30 healthy women of reproductive age. Hormonal studies were performed by radioimmune and enzyme immunoassay methods using the automatic analyzer "Cobb" ("Hoffmann La Roche", Switzerland), as well as DPS test systems the analyzer Immulite (USA). Ultrasound of the thyroid gland was performed by a linear sensor with a frequency of 7.5 MHz. The volume of the thyroid gland was calculated according to the Bruno formula. Results. For women of fertile age with hyperthyroidism, a decrease in ovarian reserve is characteristic that is manifested by a significant increase in FSH level (14.1 3.1 IU / L, p 0.05), and a decrease in inhibin B level (35.9 12,7 pg / ml, p 0.05). In 47.7 % of women of fertile age with hyperthyroidism, there is a decrease in ovarian volume and a significant reduction in the average number of antral follicles of normal size (4.34 1.56, p 0.05). Conclusions. Based on the results obtained, it can be assumed that in diffuse toxic goiter there are not only functional disorders (metabolism of hormones of the reproductive system), but also deep organic changes in the structure of the ovaries that leads to a rapid suppression of their functions. In cases of thyroid diseases, the clinical manifestation of these changes is premature and early menopause.

2016 ◽  
pp. 108-111
Author(s):  
T.F. Tatarchuk ◽  
◽  
D.G. German ◽  

The article presents the comparative analysis of the state of the cervix in women with endometrial polyps and micropolyps. Patients and methods. The study involved 130 patients aged 18-35 years: 70 patients with endometrial polyps (group I), 30 patients with micropolyps (group II) and 30 patients of the control group (group III). Results. According to the anamnesis of women in the I group were significantly more frequent diseases of the cervix, which corrected physical surgery methods, in particular cryodestruction. In group II, the representatives of these indicators were similar to healthy. Normal colposcopic picture met significantly less frequently in patients and I, and II group. The differences in the incidence of HPV high oncogenic risk in all groups were not statistically significant. Conclusion. Destructive methods used in the detection of any changes in the cervix are often overly aggressive, form scars and contributing to inflamaciones process. In the chain of events leading to the formation of PE, cervical pathology and its correction can take the basic place. Key words: endometrial polyp, micropolyps, chronic endometritis, uterine cervix, colposcopy.


2020 ◽  
Vol 73 (5) ◽  
pp. 868-872
Author(s):  
Iryna M. Nikitina ◽  
Volodymyr I. Boiko ◽  
Svitlana A. Smiian ◽  
Tetiana V. Babar ◽  
Natalia V. Kalashnyk ◽  
...  

The aim: The aim of the study was to improve the results of treatment of patients with endometriosis by using a combination method of therapy. Materials and methods: For two years, 136 women of reproductive age who underwent laparoscopic surgeries for ovarian endometriosis were monitored: Group I (n = 24) did not receive any hormonal treatment in the perioperative period; Group II (n = 32) – received gonadotropin-releasing hormone agonists within 3 months after surgery; Group III (n = 80) prior to laparoscopic removal of the ovarian cyst used gonadotropin-releasing hormone agonists – Triptorelin 3.75 mg intramuscularly for 2 months, as well as three months after surgery. The control group consisted of 30 healthy women of reproductive age with regular menstrual periods. All patients underwent transvaginal ultrasound, counting the number of antral follicles before and after treatment. Serum hormone levels (FSH, prolactin, thyrotropic hormone, anti-Mullerian hormone, inhibin B) were determined by enzyme-linked immunosorbent assay on Cobas e-411 analyzer (Roche Diagnostics, Switzerland) on day 2-3 of the menstrual cycle and on day 2–3 of the first menstrual period after the end of treatment. Laparoscopic removal of the cyst was performed with exfoliation of the cyst, hemostasis on the wound surface of the bed of the cyst was performed with a bipolar electrocoagulator. Bipolar coagulation and resection of the ovarian tissue with no potential was used during surgical treatment of the ovaries, which made it possible to preserve the intact portion of the ovary as much as possible. Results: Analysis of ovarian reserve indices, namely number of antral foliculs, number of antral follicles, AMG, and inhibin B levels in all examined patients with ovarian endometriomas were significantly lower than those of the control group before the start of treatment: in the ovarian endometrial group group 1.26 times (p <0.01), inhibin B – 1.5 times (p <0.01), the number of antral follicles – 1.2 times (p <0.01), due to the development dystrophic changes of the follicular apparatus due to prolonged compression, hypoxia, fibrosis in the ovaries. Patients who planned pregnancy were advised to have an active sexual life before menstruation was restored. In 23 (46.9%) of 49 patients who had reproductive plans, pregnancy occurred without first menstruation after a course of gonadotropin-releasing hormone agonists, 12 (24.5%) women became pregnant during the first three menstrual cycles. Extracorporeal fertilization was recommended for women who did not have pregnancy within 6 months of surgery. For two years in women who did not plan pregnancy, recurrence of endometriosis was not observed. Conclusions: The combination of laparoscopic treatment with gonadotropin-releasing hormone agonists in patients with endometriosis with infertility allowed to restore reproductive function in 71.4% of women, which indicates the effectiveness of the treatment method used. In addition, it helps to achieve lasting remission and addresses the socio-social problems of women’s health and maternity.


2020 ◽  
Vol 13 (4) ◽  
pp. 297-304
Author(s):  
M. M. Vysotskiy ◽  
I. I. Kuranov ◽  
O. B. Nevzorov

Aim: to characterize the function of the reproductive system in women after organ-preserving surgery for uterine myoma: hysteroresectoscopic (HRS) myomectomy and laparoscopic (LS) myomectomy.Materials and methods. Forty one patients were examined and divided into 2 groups: Group 1 – 18 patients after HRS myomectomy and Group 2 – 23 patients after LS myomectomy. The control group included 20 healthy women of reproductive age.Results. The HRS operation led to a significant decrease in the production of anti-Mullerian hormone (AMH), estradiol and progesterone, while the levels of luteinizing (LH) and follicle-stimulating (FSH) hormones increased. After myomectomy performed by the laparoscopic access, the levels of estradiol, progesterone, and AMH decreased but the levels of both LH and FSH increased so that the ratio LH/FSH remained unchanged. Almost all indices of gonadotropic and steroid hormone production became normalized over 6 months of the postoperative period.Conclusion. The main factors of unfavorable prognosis in patients with ovarian tecoma are tumor necrosis, degree of malignancy and mitotic activity.


2019 ◽  
Vol 19 (2) ◽  
Author(s):  
Mohd Andalas ◽  
Cut Rika Maharani ◽  
Rayhan Shafithri

Abstract. Stomach pain (dysmenorrhea) is abdominal cramps and pain during the menstrual period which can interfere with the daily activities of women of reproductive age. Dysmenorrhea is one of the symptoms that needs to be considered because it is often experienced by women and is an early sign of suffering from endometriosis. The presence of abdominal pain in women during menstruation, accompanied by pelvic pain, and infertility is a classic trias of symptoms used to diagnose endometriosis. Endometriosis occurs in almost 10% of women in the reproductive age period and more than 25-40% in infertile women. The risk of infertility is also linked because inflamed endometriosis tissue damages sperm and egg cells. Some treatments that can be done for patients with endometriosis are medical and surgical therapy. If medical therapy fails, operative laparoscopy can be alternative and hysterectomy can be considered for patients who no longer expect their reproductive function. Keywords: abdominal pain, endometriosis, infertility, dysmenorrhea. Abstrak. Nyeri Perut (dismenore) merupakan kram perut dan nyeri selama periode menstruasi yang dapat mengganggu aktivitas sehari-hari wanita usia reproduksi. Dismenore merupakan  salah satu gejala yang perlu dipertimbangkan karena kerap dialami wanita dan menjadi tanda awal  menderita endometriosis. Adanya nyeri perut pada wanita saat haid, disertai  nyeri panggul, dan infertilitas merupakan trias klasik gejala yang digunakan untuk mendiagnosis endometriosis. Endometriosis terjadi pada hampir 10% wanita dalam kurun  usia reproduksi dan lebih dari 25-40% pada wanita infertil (mandul). Risiko mandul juga dikaitkan karena jaringan endometriosis yang meradang merusak  sperma dan sel telur. Beberapa pengobatan yang dapat dilakukan pada penderita endometriosis adalah terapi medikamentosa dan pembedahan. Jika terapi medikamentosa gagal, laparoskopi operatif dapat menjadi altenatif dan histerektomi dapat dipertimbangkan pada pasien yang tidak mengharapkan fungsi reproduksi lagi. Kata Kunci: nyeri perut, endometriosis, infertilitas, dismenore.


2018 ◽  
pp. 118-122
Author(s):  
N.V. Drohomyretska ◽  

Violation of hemomicrocirculatory processes is in the basis of the development of diseases of various organs and systems. The study of hemomicrocirculation at all levels allows us to understand the complexity and universality of these processes, as well as opens up new perspectives in the pathogenetic approach to the treatment and prevention of the diseases. The homogeneity of the reaction of all parts of the hemomicrocirculatory bed in various diseases has been proved on the basis of clinico-morphological comparisons. Study of some areas allows us to judge the state of hemomicrocirculation as an integral system. The objective: to study and compare the changes of the hemomicrocirculatory bed (HMCB) of the conjunctiva of the eyeball and adventitia of varicose veins of the small pelvis (VVSP) in women with chronic inflammatory processes of the internal genital organs (CIPIGO). Materials and methods. There were examined 54 women with chronic inflammatory processes of internal genital organs against the background of varicose veins of the small pelvis (group I); 30 – practically healthy women (control group). The age of women was between 18 and 45 years old. Bulbar microscopy was performed using the SHL-2B slit lamp. The results of microscopy were evaluated according to the system of V.S.Volkov et al. To evaluate the restructuring of the HMCB of adventitia of VVSP, the operating material of 12 women of reproductive age was used. Mainly, these were pieces of the ovarian vein. The study of HMCB in the vein wall was performed by the non-injecting method of silver impregnation according to V.V. Kupriyanov. To standardize the results, the state of the HMCB of venous wall adventitia was studied in norm in 5 women of reproductive age, who died as a result of various injuries. Results. Clinical-morphological parallels between changes in the HMCB of the conjunctiva of the eyeball and adventitia of the varicose veins of the small pelvis were revealed after the performed research. The arteriols’ architectonics was almost unchanged. Venules were dilated, twisted, somewhere varicose-enlarged, filled with formed elements. The structure of capillaries was polymorphic. The capillary net was localized and concentrated or shaped in the form of a thick planar net, the capillaries were expanded. In the micropreparations of the adventitia, there were arterio-venular anastomosis. The nuclei of the endothelial cells were shortened. In some preparations, the diameter of the arterioles corresponded to the diameter of the collection venules. Conclusions. 1. Our studies confirm both clinically and pathomorphologically that one of the links of the pathogenesis of CIPIGO, which occur against the background of VVSP, is a violation of HMCB. 2. Firstly, changes in the HMCB of the conjunctiva of the eyeball and adventitia of the varicose veins of the small pelvis in women with CIPIGO show that they are systemic. 3. The results obtained by us prove the necessity of the use of medicines that improve hemomicrocirculation in the treatment of CIPIGO against the background of VVSP. Key words: hemomicrocirculatory bed, bulbar conjunctiva, adventitia, varicose veins of the small pelvis, chronic inflammatory diseases of the small pelvic organs.


2016 ◽  
pp. 109-112
Author(s):  
Lyudmyla Pakharenko ◽  

The objective: of research is to evaluate course of pregnancy and labor in women with premenstrual syndrome (PMS). Patients and methods. The research included 200 women of reproductive age with diagnosis of PMS and 50 women without diagnosis of PMS. Data of reproductive and obstetrical history were collected. Results. We determined that women with PMS have more pregnancies (in 1.59 times, c2=10.74, p=0.001) and labors (in 1.70 times, c2=10.56, p=0.001) compared with controls. Also they have a tendency for development of pathological course of pregnancy and labor. Complications of pregnancy and labor are the most typical for patients with edematous form of syndrome compared with healthy individuals (c2=4.71, p=0.03, OR=3.92, 95%CI=1.27–12.06, p=0.02). These persons have a greater share of late gestosis – in 4,55 times significantly greater incidences – 47.82% versus 10.52% of women in control group (c2=6.51, p=0.01, OR=7.79, 95%CI=1.61–37.65, p=0.01). Conclusion. Special attention should be paid to women with edematous form of PMS, which are significantly more marked the development of late gestosis. These women are at risk of pathological labor – caesarean section, forceps, hypotonic/atonic postpartum uterine bleeding and preterm labor. Key words: premenstrual syndrome, pregnancy, labor, complications.


2013 ◽  
Vol 62 (6) ◽  
pp. 40-46
Author(s):  
Galina Petrovna Pologoyko ◽  
Maria Igorivna Yarmolinskaya ◽  
Tatyana Mihajlovna Lekareva

The article represents influence of gestagen desogestrel on size and function of thyroid gland in women of reproductive age. Into the study we included 70 women who were prescribed gestagen desogestrel in a daily dose of 75 mg for a period of 12 months. All the patients were devided into two groups. The first group consisted of 20 women with diffuse nontoxic goiter, the second consisted of 30 women with autoimmune thyroiditis. Control group consisted of 20 women without thyroid gland pathology. Prior to therapy with desogestrel and after 12 month of treatment, serum levels of free triiodothyronine, free thyroxine and thyrotropin releasing hormone, thyroperoxidase antibodies were determined and thyroid gland sonigraphy was performed in all the patients. Obtained data show that gestagen desogestrel doesn’t influence the size and function of thyroid gland in healthy women and in patients with diffuse non-toxic goiter. In women with autoimmune thyroiditis implication of desogestrel significantly decreases blood levels of thyroperoxidase autoantibodies.


2018 ◽  
Vol 73 (1) ◽  
pp. 5-15
Author(s):  
A. I. Ishenko ◽  
A. L. Unanyan ◽  
E. A. Kogan ◽  
T. A. Demura ◽  
J. M. Kossovich

Background: The widespread prevalence of infertility, the low effectiveness of assisted reproductive technologies (ART), and the high incidence of chronic endometritis (CE) in infertile women determine the relevance of the considered problem. The aim of the study was to determine the clinical and anamnestic, laboratory, and instrumental features of CE associated with infertility and unsuccessful IVF cycles in women of reproductive age. Materials and methods: The study enrollred 150 women of reproductive age with morphologically established CE (main group, n=120) and without CE (control group, n=30). A subgroup I of the main group included 64 patients with infertility and IVF failures, a subgroup II – 56 fertile women. In addition to anamnesis collection and identification of CE clinical features, all patients underwent infectious screening, immunological and immunohistochemical analysis, ultrasound examination of pelvic organs with dopplerometry, and office hysteroscopy. A comparative analysis of the data obtained from subgroups of the main group was conducted. Results: Histological study of endometrial pipelle-biopsy specimens on the 7−10th day of the cycle revealed CE in all patients of the main group. We found prevalence of mean duration of CE in the subgroup I relative to subgroup II ― 5.5±0.06 years and 2.4±0.07 years, respectively (p0.001). Infectious screening showed that 58 (90.6%) patients of the I subgroup had sterile endometrial seeding which was 16.9 times higher than in subgroup II (p0.0001). Immunological analysis determined the presence of AEAT in all patients of the subgroup I, 43 of which (67.2%) were above 265 U/ml, while 51 (91.1%) of subgroup II had no AEAT (p0.001). Immunohistochemical analysis of the endometrium on the 18th−24th day of the cycle established high expression of CD16 , CD20 , CD56 , and HLA-DRII in 58 (90.6%) patients of the subgroup I, whereas in 54 patients (96.4%) of II subgroup high expression of CD16 and CD20 with low amount of CD56- and HLA-DRII-positive cells was registered (p0.001). We determined prognostically significant clinical and anamnestic risk factors predisposing to the development of infertility in patients with CE (p0,05). We revealed certain echographic, dopplerometric, and hysteroscopic criteria of CE demonstrating the critical disruption of endometrial receptivity in infertile women. Conclusion: Most patients (90.6%) with infertility had autoimmune component of CE characterized by prolonged (more than 5 years) course, high serum level of AEAT, sterile endometrial crops, and high expression of inflammation markers CD16 , CD20 , CD56 and HLA-DRII .


2017 ◽  
pp. 77-82
Author(s):  
V.O. Beyuk ◽  
◽  
O.A. Shcherba ◽  
L.D. Lastovetska ◽  
◽  
...  

Bacterial vaginosis is the most common cause of the treatment of women of reproductive age to the gynecologist. It accounts for up to 50% of cases of pathological discharge from the genital organs. In 50-75% of cases, bacterial vaginosis is asymptomatic. The examination of the patient occupies one of the key positions in the effective treatment of the patient. Nitrosamines, which are metabolites of obligate anaerobic bacteria and coenzymes of carcinogenesis, and may be one of the cause for the genesis of cervical cancer. The objective: assess the condition of the mucous membrane of the vagina and cervix in bacterial vaginosis, the effectiveness of its treatment in women of reproductive age. Materials and methods. Оf investigation 64 women of reproductive age with bacterial vaginosis were examined and treated, of which 34 patients (group I of the study) conducted our therapy which received the Tyloron and the local combined preparation of dexpanthenol and chlorhexidine bigluconate, followed by the introduction of lactobacilli in standard doses. 30 patients (group II of the study) received standard treatment. The control group consisted of 27 healthy women. Results. Results of treatment of bacterial vaginosis in women of reproductive age are presented. In 94.1% and a group of cases, we achieved a clinically significant effect, compared with group II (76.7%) of 10 days of treatment. Three months after the end of treatment, 97.1% of the patients in the main group recovered (group II – 86.6%). Conclusions. The use of the complex therapy of bacterial vaginosis proposed by us showed a high rate of recovery, and a low rate of recurrence in women of reproductive age. Key words: bacterial vaginosis, diagnosis, treatment, tyrolon, dexpanthenol, chlorhexidine.


2021 ◽  
pp. 12-17
Author(s):  
Svitlana Pandei ◽  
Dmytro Ledin ◽  
Oleksandra Lubkovska

The aim. Reducing the recurrence of vulvovaginal candidiasis (VVC) in combination with bacterial vaginosis (BV) in women of reproductive age by studying the pathogenesis and improving the algorithm of treatment and prevention measures. Materials and methods. During the study, 150 women of reproductive age who had the same clinical manifestations of VVC and BV were selected and divided into 3 groups of 50 women: Group I was treated with an antimicrobial combination drug (miconazole with topical metronidazole), group II – the same drug in combination with probiotic (lactobacilli) in candles, group III – according to the algorithm improved by the authors. In addition, a control group was formed, which included healthy women of reproductive age.  To establish the pathogenesis of VVC in combination with BV in the studied women, the concentration of cytokines and adhesion molecules in the blood before and after treatment was determined and compared with the control group. The clinical effect of different treatments was assessed at 3, 7, 10, 14 days, and the presence of relapses – 1, 3, 6 months after treatment. Results. The occurrence of a combination of VVC and BV in women of reproductive age is accompanied by a significant increase in the level of intercellular adhesion molecules (ICAM-1) and vascular cell adhesion molecules (VCAM-1) along with a statistically significant increase in proinflammatory cytokines (interleukin-6) (IL-6), interleukin-8 (IL-8)) and tumor necrosis factor (TNF) - TNF-α. As a result of the application of the algorithm improved by the authors, higher clinical efficiency and the ability to avoid recurrence of VVC in combination with BV in women of reproductive age were obtained. Conclusions. The authors' substantiated improvement of the algorithm of VVC treatment in combination with BV in women of reproductive age makes it possible to reduce the frequency of their recurrence and restore the biocenosis of the vagina to normal. In the case of this pathology there is an increase in the level of pro-inflammatory cytokines (IL-6, IL-8), TNF-α and ICAM-1 and VCAM-1.


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