Deep infiltrative endometriosis. Contentious issues: pros and cons

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 50-56
Author(s):  
Elena I. Rusina ◽  
Maria I. Yarmolinskaya ◽  
Valeriia O. Piankova
Keyword(s):  
System Analysis ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Current Data ◽  
Management Planning ◽  
Pregnancy And Childbirth ◽  
Pubmed Database ◽  
Risk Condition ◽  
Reproductive Life ◽  
Deep Infiltrative Endometriosis

Relevance.Deep infiltrative endometriosis (DIE) is a particular form of endometriosis with a more severe symptoms and dysfunction of the neighboring organs. Inspite of the fact that in recent years, much had been done to understand the pathogenesis of the disease and its associated symptoms; there are still several unresolved issues. Aim.To describe debated issues of pathogenesis and management of patients with DIE using current data. Materials and methods. Foreign and domestic scientific articles on this topic that is available in PubMed database and on Internet resources have been examined over the past 5 years. Results.The review consisted of a system analysis of data on the pathogenesis of pain, infertility, the choice of conservative or surgical treatment in dealing with specific problems of managing patients with DIE. Conclusion.Despite there are different options of managing and treating, most specialists agree that the treatment strategy should be based on the assumption that it is a chronic recurrent disease. The treatment choice should be personal depending on the severity of symptoms, dysfunction of the neighboring organs affected by endometriosis, such as the intestines, bladder, ureters, as well as the womans age and reproductive life plans. Depending on the clinical case, it is possible to use various regimens of conservative management. Surgical management planning should be highly balanced. A radical surgery with removing foci of endometriosis performed by an experienced surgeon in a specialized hospital in coupled with pharmacotherapy and assisted reproductive technologies increases the patients chances of pregnancy, a healthy childbearing. Subsequent combination therapy provides a long-term remission. Pregnancy and childbirth in patients with deep infiltrative endometriosis should be considered as a high risk condition for the severe complications.

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.

scholarly journals Inositol and folates in the restoration of reproductive function in women and prevention of congenital malformations

2021 ◽  
pp. 95-100
Author(s):  
H.I. Reznichenko ◽  
Y.H. Reznichenko
Keyword(s):  
Folic Acid ◽  
Reproductive Health ◽  
Congenital Malformations ◽  
Ovarian Function ◽  
Assisted Reproductive Technologies ◽  
Polycystic Ovary ◽  
Reproductive Technologies ◽  
Late Gestation ◽  
Trophoblast Invasion ◽  
Pregnancy And Childbirth

In recent years, Ukraine has seen a significant deterioration in the reproductive health of women in the face of declining birth rates. One of the main causes of comorbidity of infertility and background pathologies is the insufficient supply of a woman's body in the pre-pregnancy period with micronutrients – folate, vitamins, myo-inositol and others. This increases the risk of complications during pregnancy and childbirth and congenital malformations.Literature analysis showed that myo-inositol in combination with folate are an extremely important way to prevent fertility disorders, complications of pregnancy and childbirth, congenital malformations and support the reproductive health of the next generation. Myo-inositol in combination with folic acid promotes the effects of luteinizing and follicle-stimulating hormones, normalization of ovarian function, oocyte quality, trophoblast invasion during blastocyst attachment, prevention of congenital malformations by neutralizing the action of homocysteine with metafolin in the pregravid period and during pregnancy and assisted reproductive technologies, reducing the incidence of miscarriage, preeclampsia and other complications. The neuroprotective effect of myo-inositol indicates the importance of its use for fetal neuroprotection in late gestation, especially in hypoxia.Fertifolin, which contains an improved combination of natural nutrients as myo-inositol 1000 mg and folic acid 100 µg in the form of metafolin (calcium L-methylfolate), successfully copes with this goal. Metafolin has greater bioavailability and more actively helps to increase the level of folate in blood plasma, in contrast to folic acid. Metafolin is characterized by fewer drug interactions and less often masks the symptoms of B12-deficient anemia, reduces the risk of anemia, placental dysfunction, malformations of the neural tube. Fertifolin is also effectively used as an adjunct in polycystic ovary syndrome and in assisted reproductive technology protocols.

Fate of the germ cells in mammalian ovary: A review

2020 ◽  
Vol 3 ◽  
pp. 3
Author(s):  
Pramod K. Yadav ◽  
Anumegha Gupta ◽  
Alka Sharma ◽  
Anil Kumar Yadav ◽  
Meenakshi Tiwari ◽  
...  
Keyword(s):  
Germ Cells ◽  
Assisted Reproductive Technologies ◽  
Mammalian Species ◽  
Polar Body ◽  
Reproductive Technologies ◽  
Fetal Life ◽  
Oocyte Activation ◽  
Follicular Atresia ◽  
First Polar Body ◽  
Reproductive Life

Ovary has a fix number of germ cells during fetal life in mammals. The germ cells are depleted rapidly and a large number of germ cells (≥99%) are eliminated from the cohort of ovary through follicular atresia during prepubertal life. The various cell death pathways including apoptosis, autophagy, necrosis, and necroptosis are involved in follicular atresia. Hence, <1% of germ cells are culminated into oocytes that are available for meiotic maturation and ovulation during entire reproductive life. These oocytes are arrested at diplotene stage of meiotic prophase-I and remain arrested for few months to several years during entire reproductive life. Resumption from diplotene arrest in follicular oocytes starts in response to gonadotropins surge and progresses through metaphase-I to metaphase-II stage that extrudes first polar body at the time of ovulation. Surprisingly, oocytes do not wait for fertilizing spermatozoa and quickly undergo abortive spontaneous oocyte activation (SOA) in few mammalian species including humans. The abortive SOA makes oocyte unfit for fertilization and limits assisted reproductive technologies outcome. Indeed, majority of germ cells and oocytes are eliminated from the cohort of ovary and only few oocyte that are of good quality get selectively recruited to become right gamete after ovulation during entire reproductive life span in mammals.

scholarly journals Features of pregnancy and delivery course in women after programs of assisted reproductive technologies

2021 ◽  
Vol 38 (5) ◽  
pp. 61-69
Author(s):  
I. V. Fomina ◽  
M. S. Boichenko ◽  
A. S. Zhilina ◽  
M. V. Martynenko
Keyword(s):  
Pregnancy Complications ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Premature Births ◽  
Art Programs ◽  
Pregnancy And Childbirth ◽  
Gynecological Diseases ◽  
Pregnancy And Delivery ◽  
Perinatal Center ◽  
Infertile Patients

Objective. To study the features of the course of pregnancy and childbirth in women after ART programs. Medical care for families with infertility, in particular through assisted reproductive technologies (ART) programs, is an important area of comprehensive government policy to promote fertility. Materials and methods. The retrospective study was carried out on the basis of GBUZ TO Perinatal Center, Tyumen. We analyzed 237 birth histories of women whose pregnancies occurred with the use of ART and 237 birth histories of patients whose pregnancies occurred on their own. The material for the study was the birth histories of patients. Results. The results showed a higher incidence of pregnancy complications in women after ART programs. Thus, a higher number of premature births, placental disorders, isthmic-cervical insufficiency (ICI) were noted, as well as a significantly higher percentage of operative delivery by cesarean section. Conclusions. The presence of an initially large "baggage" of concomitant and gynecological diseases in infertile patients, whose pregnancies occurred with the use of ART programs, leads to a higher percentage of pregnancy complications and a high number of surgical deliveries.

Pregnancy and childbirth in patients with endometriosis

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (1) ◽  
pp. 6-11
Author(s):  
Natalia V. Artymuk ◽  
Ekaterina N. Vaulina ◽  
Olga A. Zotova
Keyword(s):  
Preterm Labor ◽  
Assisted Reproductive Technologies ◽  
Placenta Previa ◽  
Reproductive Technologies ◽  
Perinatal Complications ◽  
Pregnancy And Childbirth ◽  
Increased Risk ◽  
Fertility Problems ◽  
Severity Of The Disease ◽  
Risk Of Preeclampsia

Aim. To review the current publication highlighting the features of pregnancy and childbirth outcomes in patients with endometriosis. Materials and methods. The analysis of 45 foreign and domestic publications on this topic has been carried out. Results. Patients with endometriosis have fertility problems, and when pregnancy occurs, it was characterized by a higher risk of preeclampsia, placenta previa, gestational diabetes, miscarriage and preterm labor, as well as delivery by caesarean section. Newborns in women with endometriosis have an increased risk of prematurity and small for gestational age. Probably, in addition to the presence of endometriosis, the risk of obstetric and neonatal complications is influenced by the localization and severity of the disease, as well as the use of assisted reproductive technologies. Conclusion. The results obtained indicate that patients with endometriosis have a high risk of perinatal complications and require additional antenatal monitoring and care.

scholarly journals Dilemmatic tensions around parenthood: the ambiguous third-party role in Assisted Reproductive Technologies and Surrogacy in France and Portugal

2019 ◽  
Vol 56 (2) ◽  
pp. 381-404 ◽  
Author(s):  
Catarina Delaunay
Keyword(s):  
Assisted Reproductive Technologies ◽  
Reproductive Potential ◽  
The United States ◽  
Reproductive Technologies ◽  
Third Party ◽  
Special Focus ◽  
Human Beings ◽  
Reproductive Process ◽  
Gay Couples ◽  
Pregnancy And Childbirth

This article analyzes couples’ attitudes towards the third-party role in Assisted Reproductive Technologies with gamete donation, and problematizes parenthood and kinship. I base my analysis on 66 in-depth interviews with different ART actors (from beneficiaries to professionals) in France and Portugal, conducted as part of a research project already completed. Special focus is given to 19 interviews with heterosexual and homosexual couples who used third-party reproduction in Europe and the United States. I found a physical and moral detachment operation among heterosexual and lesbian couples vis-a-vis the donor of reproductive potential, who is depersonalized and reduced to a functionality. The objective is to preserve the intimacy of the couple and the autonomy of the parental project. This contrasts with innovative and enlarged family dynamics developed by gay couples, who integrate both female figures (surrogate and oocyte donor) in their children’s family history, through bonding efforts in a logic of reciprocity (gift and counter-gift). The purpose is to reject the negative image of a woman’s body being commodified while preserving the natural appearance of procreation. I conclude that a naturalist conception of kinship persists —one based on shared biogenetic substances that bind together one parent and the donor-conceived child— along with the centrality of biological processes such as pregnancy and childbirth. There are different ways of easing tensions inherent to the contractual intervention of third parties in the reproductive process. ART re-elaborates the line of demarcation between commodities and gifts and between living things and human beings, while reconfiguring family concepts.

scholarly journals Pregnancy loss after overcoming the sterility with methods of auxiliary reproductive technologies

2021 ◽  
Vol 51 (4) ◽  
pp. 13-15
Author(s):  
V. S. Korsak ◽  
O. N. Arganova ◽  
Y. L. Gromyko ◽  
E. V. Isakova
Keyword(s):  
Pregnancy Loss ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Special Program ◽  
Laboratory Examination ◽  
Pregnancy And Childbirth

Miscarriage is a serious problem of pregnancies resulting from overcoming infertility using assisted reproductive technologies (ART). The overall frequency of losses due to miscarriages of various periods and non-developing pregnancies reaches 30-35%. In order to optimize the outcomes of pregnancies resulting from ART, we have developed a special program that includes activities that are carried out at various stages, including at the stage of preparation for ART. In accordance with this program, all women in the period of preparation for the procedure undergo a full clinical and laboratory examination, including the consultation of a therapist, and, if indicated, other specialists (endocrinologist, ophthalmologist, etc.) in order to identify and correct concomitant diseases that can have an unfavorable influence on the course of pregnancy and childbirth.

scholarly journals The clinical case of infertility treatment caused by male factor (globozoospermia type 1) by the intracytoplasmic morphologically normal sperm injection with activation of the oocytes by Ca2+-ionophore

2019 ◽  
Vol 20 (3) ◽  
pp. 78-85
Author(s):  
V. V. Litvinov ◽  
A. N. Sulima ◽  
M. A. Kharitonova ◽  
A. A. Klepukov ◽  
I. Yu. Ermilova ◽  
...  
Keyword(s):  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Infertility Treatment ◽  
Severe Form ◽  
Ionophore A23187 ◽  
Male Factor ◽  
Pregnancy And Childbirth ◽  
Normal Sperm ◽  
Severe Disorder

A case of infertility treatment in couple with a male factor, the severe form of teratozoospermia (total globozoospermia (type 1)) was presented. This pathology is extremely rare (0.1 % at andrological patients). Globozoospermia (type 1) is an insufficiently studied disease and is a severe disorder of spermatogenesis that leads to 100 % of male infertility. Assisted reproductive technologies with using of intracytoplasmic morphologically normal sperm injection and the activation of oocytes – by Ca2+-ionophore A23187 in a man with globozoospermia (type 1) helped in the treatment of infertility in matrimony. Pregnancy and childbirth proceeded favorably.

scholarly journals PREVENTION OF ORPHAN DISEASES: CONTEMPORARY ASPECTS AND NEW CHALLENGES

2019 ◽  
Vol 20 (4) ◽  
pp. 226-232
Author(s):  
R. F. Shavaliev ◽  
Sabina Sh. Yafarova ◽  
S. Ya. Volgina
Keyword(s):  
Genetic Counseling ◽  
Preventive Measures ◽  
Assisted Reproductive Technologies ◽  
Fetal Surgery ◽  
Reproductive Technologies ◽  
Current Data ◽  
Orphan Diseases ◽  
Rapid Diagnostics ◽  
Medical Genetic ◽  
New Challenges

The authors represent current data concerning the management of the prevention of orphan diseases. Determinations of modes and levels of the prevention have been formulated. The importance of pre-gravity care, medical genetic counseling, assisted reproductive technologies, methods of prenatal diagnosis and fetal surgery, neonatal screening at certain stages of the organization of preventive measures is reflected. Specific features of screening for rare diseases with the use of rapid diagnostics methods are described: a solid approach, mass character, preventive orientation and stage-by-stage approach. Topical issues of the prevention of orphan diseases are considered.

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