scholarly journals OVARIAN INFERTILITY FACTOR IN PATIENTS OF LATE REPRODUCTIVE AGE

2020 ◽  
Vol 11 (1) ◽  
pp. 14-20
Author(s):  
K. V. Uryupina ◽  
I. I. Kutsenko ◽  
E. I. Kravtsova ◽  
P. A. Gavryuchenko

Objective: in women over 35 years of age, there is a progressive and age-related decline in fertility, which is due to multiple consequences, including a decrease in follicular reserve. Cytokines play a role, mediating the interaction between oocytes and other cells. In addition, there is a change in the expression of mRNA of a number of genes, leading to a decrease in the ability to bear children. The goal is to highlight the problem of reducing fertility in women of older reproductive age. Materials and methods: medLine, Pubmed, RISC, etc. Results: analysis of literature data shows that fertility decline is determined by a combination of physiological, molecular and genetic factors that play an increasing role as we age.Conclusion: the development of modern technology can solve the problem of infertility in the vast majority of cases. However, the lack of effectiveness of assisted reproductive technologies (ART) for women over 35 years of age requires optimizing a care strategy for these women.

Author(s):  
Kh. M. Omarova ◽  
E. S.-А. Ibragimova ◽  
T. Kh.-M. Khashaeva ◽  
I. Kh. Magomedova ◽  
R. G. Omarova ◽  
...  

Objective. To assess the condition of newborns from women of the late reproductive period (LRP), depending on the parity of births.Material and methods. The authors examined 130 pregnant women and their 130 newborns. Group I consisted of 60 primiparous women of late reproductive period and their 60 newborns, Group II included 40 multiparous women of the late reproductive period and their 40 newborns, Group III (control group) consisted of 30 healthy pregnant women aged from 18 to 25 years and their 30 newborns. The authors performed a retrospective analysis of the gestation course and perinatal outcomes. Ultrasound and neurosonography were used among the instrumental research methods.Results. Women of the late reproductive period gave birth to children in a state of asphyxia twice more often, who develop neurological disorders 1,5 times more often and complex postnatal adaptation and disorders of the perinatal period are twice more likely. Among women of the late reproductive period, primiparous women gave birth to children with the most severe disorders.Conclusion. The high incidence of neurological diseases in children born from women of the late reproductive period is associated with age-related changes in their germ cells, the implementation of assisted reproductive technologies, and the intake of hormonal drugs in early pregnancy. The data obtained should be taken into account by obstetricians in the course of pregnancy in women of late reproductive age; they should be included in the group of high risk of developing neurological disorders in children.


Author(s):  
Kalinkina O.B. ◽  
Tezikov Yu.V. ◽  
Lipatov I.S. ◽  
Aravina O.R.

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.


Genes ◽  
2021 ◽  
Vol 12 (4) ◽  
pp. 475
Author(s):  
Maria Santa Rocca ◽  
Ludovica Dusi ◽  
Andrea Di Nisio ◽  
Erminia Alviggi ◽  
Benedetta Iussig ◽  
...  

Telomeres are considered to be an internal biological clock, and their progressive shortening has been associated with the risk of age-related diseases and reproductive alterations. Over recent years, an increasing number of studies have focused on the association between telomere length and fertility, identifying sperm telomere length (STL) as a novel biomarker of male fertility. Although typically considered to be repeated DNA sequences, telomeres have recently been shown to also include a long non-coding RNA (lncRNA) known as TERRA (telomeric repeat-containing RNAs). Interestingly, males with idiopathic infertility show reduced testicular TERRA expression, suggesting a link between TERRA and male fertility. The aim of this study was to investigate the role of seminal TERRA expression in embryo quality. To this end, STL and TERRA expression were quantified by Real Time qPCR in the semen of 35 men who underwent assisted reproductive technologies (ART) and 30 fertile men. We found that TERRA expression in semen and STL was reduced in patients that underwent ART (both p < 0.001). Interestingly, TERRA and STL expressions were positively correlated (p = 0.010), and TERRA expression was positively associated with embryo quality (p < 0.001). These preliminary findings suggest a role for TERRA in the maintenance of sperm telomere integrity during gametogenesis, and for the first time, TERRA expression was found as a predictive factor for embryo quality in the setting of assisted reproduction.


2017 ◽  
Vol 2017 ◽  
pp. 1-22 ◽  
Author(s):  
Bettina P. Mihalas ◽  
Kate A. Redgrove ◽  
Eileen A. McLaughlin ◽  
Brett Nixon

In their midthirties, women experience a decline in fertility, coupled to a pronounced increase in the risk of aneuploidy, miscarriage, and birth defects. Although the aetiology of such pathologies are complex, a causative relationship between the age-related decline in oocyte quality and oxidative stress (OS) is now well established. What remains less certain are the molecular mechanisms governing the increased vulnerability of the aged oocyte to oxidative damage. In this review, we explore the reduced capacity of the ageing oocyte to mitigate macromolecular damage arising from oxidative insults and highlight the dramatic consequences for oocyte quality and female fertility. Indeed, while oocytes are typically endowed with a comprehensive suite of molecular mechanisms to moderate oxidative damage and thus ensure the fidelity of the germline, there is increasing recognition that the efficacy of such protective mechanisms undergoes an age-related decline. For instance, impaired reactive oxygen species metabolism, decreased DNA repair, reduced sensitivity of the spindle assembly checkpoint, and decreased capacity for protein repair and degradation collectively render the aged oocyte acutely vulnerable to OS and limits their capacity to recover from exposure to such insults. We also highlight the inadequacies of our current armoury of assisted reproductive technologies to combat age-related female infertility, emphasising the need for further research into mechanisms underpinning the functional deterioration of the ageing oocyte.


Author(s):  
P. A. Awoyesuku ◽  
D. A. MacPepple ◽  
B. O. Altraide ◽  
D. H. John

Background: Gynaecological disorders are a particularly common cause of morbidity and mortality among women of reproductive age and a common cause of hospital presentation/admission and surgery. Objective: This study sought to review gynaecological diagnoses and surgeries performed in a tertiary health facility from 2012 to 2017 and its implication for healthcare planning and budgeting. Methodology: This was a retrospective review of all gynaecological diagnoses and surgeries seen in the Rivers State University Teaching Hospital (RSUTH) from 2012 to 2017. Data were retrieved using a proforma comprising of year, gynaecological diagnosis and gynaecological surgeries. Data obtained was entered into Microsoft Excel for descriptive analysis. Results: The proportion of clinic attendees declined from an average of 23% in the first three years (2012-2014) to about 10% in the last three years (2015-2017). The most common gynaecological diagnosis were uterine fibroid (33.3%), infertility 28.1% (primary 5.7%, secondary 22.4%), PID (5.9%), ovarian tumour (4.2%), secondary amenorrhea (3.4%) and pelvic malignancies (3.4%). The commonest major surgeries were myomectomy 441(33.7%), salpingectomy 345(26.4%), hysterectomy 168(12.8%) and cervical cerclage 122(9.3%). The commonest minor surgeries were manual vacuum aspiration 314(41.0%), examination under anaesthesia and biopsy 110(14.3%) and adhesiolysis for synechiae 97(12.6%). The duo of uterine fibroid and infertility made up 50%-70% of all gynaecological diagnoses. Conclusion: This study showed that there has been a steady decline in gynaecological consultations over the years. However, the duo of uterine fibroid and infertility made up half to three-quarter of all gynaecological diagnoses over the 6 years. Infertility and uterine fibroids have a long cause and effect association. Healthcare policies and budgeting should be increased towards tackling these conditions, especially the setting up of a fertility center to provide assisted reproductive technologies and laparoscopy to improve practice and patient outcome.


2021 ◽  
Vol 67 (1) ◽  
pp. 85-90
Author(s):  
Alyena Chernyshova ◽  
Vitaly Аntipov ◽  
Larisa Коlomiets ◽  
Vladimir Chernov ◽  
Victor Gyunter ◽  
...  

The development and implementation of organ-preserving treatment modalities is the priority trend in the current cancer treatment of patients of the reproductive age. Methods of expanding indications for organ-preserving treatment in cancer patients are becoming relevant. We present our experience in performing radical trachelectomy with uterine transposition in patients with stage IB-II cervical cancer. Our surgical technique allows the preservation of the uterus and adnexa in patients with invasive cervical cancer, who need to receive combined modality treatment including extended surgery followed by chemotherapy or radiation therapy to the pelvis. Transposition of the uterus and adnexa after radical abdominal or laparoscopic trachelectomy allows the movement of the uterus and ovaries out of the radiation field. After completion of radiation therapy, the uterus with adnexa is repositioned into the pelvis and uterine-vaginal anastomosis is formed using an implant made of titanium nickelide. Independent pregnancy and the use of assisted reproductive technologies are permitted after passing the time when distant metastases are most likely to develop.  


Author(s):  
Spiridenko G.Yu. ◽  
Petrov Yu.A. ◽  
Palieva N.V.

Infertility is currently a priority problem for women of reproductive age. One of the reasons for this condition may be premature ovarian insufficiency. This is a pathological process causes by primary hypogonadism that occurs in women under 40 years of age. Its prevalence varies from 1:10,000 at the age of 20 to 1:100 at an older age. The absence of specific clinical manifestations of the disease complicates its early diagnosis and timely treatment. This pathological process manifests itself as secondary oligo-or amenorrhea, infertility. Less often, before the onset of reproductive disorders, there are manifestations of estrogenic insufficiency - vasomotor disorders - hot flashes, hyperhidrosis, cephalgia, tachycardia, arterial hypertension, emotional and vegetative disorders-irritability, asthenic manifestations, anxiety, depression, hypo - thymia, decreased libido. The lack of accurate data on etiological factors makes it harder to find methods for preventing this disease. The main direction of treatment is hormone replacement therapy, aimed at eliminating the insufficiency of natural estrogens in the woman's body. The chances of successful realization of the reproductive potential depend on the value of the follicle-stimulating hormone, since its high concentration affects the mitotic activity of granulosa cells of the follicle, which confirms the validity of hormone replacement therapy. The non-occurrence of pregnancy after therapy forces the patient to use assisted reproductive technologies using donor embryos and oocytes, while the effectiveness of in vitro fertilization does not exceed 58%. To prevent this outcome, if a woman has risk factors for developing premature ovarian insufficiency, it is necessary to timely assess the ovarian reserve with the preservation of her own oocytes for subsequent assisted reproductive technologies.


2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Vittorio Unfer ◽  
John E. Nestler ◽  
Zdravko A. Kamenov ◽  
Nikos Prapas ◽  
Fabio Facchinetti

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.


Author(s):  
Marie Thoma ◽  
Carie Cox ◽  
Jasmine Fledderjohann ◽  
Rudolph Kantum Adageba

This is an advance summary of a forthcoming article in the Oxford Research Encyclopedia of Global Public Health. Please check back later for the full article. Infertility remains a neglected area in sexual and reproductive health, yet its consequences are staggering. Infertility is estimated to impact about 15% (estimates range from 48 million to 180 million) of couples of reproductive age worldwide. It is associated with adverse physical and mental health outcomes, financial distress, severe social stigma, increased risk of domestic abuse, and marital instability. While men and women are equally likely to be infertile, women often bear the societal burden of infertility, particularly in societies where a woman’s identity and social value is closely tied to her ability to bear children. Despite these consequences, disparities in access to infertility treatment between low- and high-income populations persist, given the high cost and limited geographic availability of diagnostic services and assisted reproductive technologies. In addition, a significant proportion of infertility arises from preventable factors, such as smoking, sexually transmitted infections, pregnancy-related infection or unsafe abortion, and environmental contaminants. Accordingly, programs that address the equitable prevention and treatment of infertility are not only in keeping with a reproductive rights perspective, but can also improve public health. However, progress on infertility as a global concern in the field of sexual and reproductive health and rights is stymied by challenges in understanding the global epidemiology of infertility, including its causes and determinants, barriers to accessing quality infertility care, and a lack of political will and attention to this issue. Tracking and measurement of infertility is highly complex, resulting in considerable ambiguity about its prevalence and stratification of reproduction globally. A renewed global focus on infertility epidemiology, risk factors, and access to and receipt of quality of care will support individuals in trying to reach their desired number and spacing of children and improve overall health and well-being.


Sign in / Sign up

Export Citation Format

Share Document