OPTIMIZATION OF TREATMENT OF TUBAL-PERITONEAL INFERTILITY CAUSED BY CHRONIC SALPINGITIS

Author(s):  
Kalinkina O.B.

The outpatient stage of therapy is the primary and very responsible link in the introduction of patients with chronic forms of VZOMT, since this pathology has a significant impact on such indicators as perinatal, maternal morbidity and mortality. In addition, VZOMT directly affects the development of infertility, ectopic pregnancy, habitual miscarriage, as well as a decrease in the ovarian reserve after unsuccessful attempts of in vitro fertilization, surgical interventions on the appendages of the uterus. To preserve the reproductive function in patients with VZOMT, an important stage is the implementation of a number of therapeutic and rehabilitation measures. The problems of treatment and rehabilitation of patients with VZOMT undoubtedly remain relevant, since cases of relapses and chronization of inflammatory processes significantly worsen the prognosis for a woman's reproductive function. These problems are both social and economic. Taking into account the wide range of infectious agents of VZOMT, it is recommended to use a complex of antibacterial drugs that cover as many varieties of pathogenic and conditionally pathogenic flora as possible. Moreover, an important aspect of the treatment of inflammatory diseases of the female reproductive system is the use of different forms of drugs and ways of their administration. It is rational to combine oral or parenteral with intravaginal. This combination makes it possible to increase the effectiveness of treatment and contributes to the prevention of relapse of the disease. The inclusion of prednisolone – 21 phosphate in the therapy complex also contributes to increasing the effectiveness of therapy, since it creates favorable conditions for the vital activity of normal microflora and unfavorable conditions for conditionally pathogenic microflora. The results obtained in the study indicate a good clinical effectiveness of complex therapy with the inclusion of Elzhina in the treatment regimen for the treatment of fibrotic processes in the fallopian tubes. The use of a combined drug for intravaginal use containing ornidazole-500 mg, prednisolone-3 mg, econazole-150 mg, neomycin 65000ME (Elzhina drug) allows optimizing the management tactics of patients with tubal – peritoneal infertility caused by chronic salpingitis and increasing the fertility rates in this group of patients.

2019 ◽  
Vol 13 (3) ◽  
pp. 255-260
Author(s):  
A. D. Makatsariya

The licensed edition of Rebecca Fett's book, “It Starts with the Egg” has been published in Russian. Given its medical contents, it seems important to evaluate the information contained in the book from the perspective of a practicing obstetrician-gynecologist, focusing on the problem of miscarriage and pregravid preparation. Importantly, the book is based on evidence-based medicine: although the book is intended for a wide scope of readers, it contains a list of primary references similarly to that in peer-reviewed journals.The author analyzed and summarized the data from over 60 scientific articles. Although based on primary academic sources, the author used a simple and understandable language to explain the complex pathogenesis of infertility and the manipulations used in the assisted reproductive technology (ART).The book consists of 3 parts; each of them contains several chapters reviewing the causes of reproductive disorders and the ways to correct them. The first part addresses the reasons for poor quality of women’s eggs. The second part describes nutraceuticals and dietary supplements that can improve the quality of eggs. The third part of the book examines the diet, which helps improve this quality. A step-by-step action plan for improving reproductive function is also presented. The basic plan is suitable for those who are just thinking about pregnancy and those who have no reason to expect any difficulties, as well as for couples who have been struggling with infertility for several years. The mid-level plan is intended for those who already have some concerns about conceiving, but are not yet aware of personal problems with their reproductive function, as well as for women with polycystic ovary syndrome (PCOS) or irregular ovulation. The plan for those having serious problems is intended for women with recurrent miscarriage, as well as for couples with a decrease in the ovarian reserve who are trying to get pregnant using in vitro fertilization (IVF).Despite some remarks regarding the role of vitamin D and magnesium in pregravid preparation, the book contains a large number of useful and balanced recommendations that can improve the woman’s health and increase her chances to get pregnant and give birth to a healthy baby. Therefore, the book can be recommended for a wide range of readers.


Nanomaterials ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 547
Author(s):  
Marina Ramal-Sanchez ◽  
Antonella Fontana ◽  
Luca Valbonetti ◽  
Alessandra Ordinelli ◽  
Nicola Bernabò ◽  
...  

Since its discovery, graphene and its multiple derivatives have been extensively used in many fields and with different applications, even in biomedicine. Numerous efforts have been made to elucidate the potential toxicity derived from their use, giving rise to an adequate number of publications with varied results. On this basis, the study of the reproductive function constitutes a good tool to evaluate not only the toxic effects derived from the use of these materials directly on the individual, but also the potential toxicity passed on to the offspring. By providing a detailed scientometric analysis, the present review provides an updated overview gathering all the research studies focused on the use of graphene and graphene-based materials in the reproductive field, highlighting the consequences and effects reported to date from experiments performed in vivo and in vitro and in different animal species (from Archea to mammals). Special attention is given to the oxidized form of graphene, graphene oxide, which has been recently investigated for its ability to increase the in vitro fertilization outcomes. Thus, the potential use of graphene oxide against infertility is hypothesized here, probably by engineering the spermatozoa and thus manipulating them in a safer and more efficient way.


2007 ◽  
Vol 51 (8) ◽  
pp. 2811-2819 ◽  
Author(s):  
Diptesh Sil ◽  
Anurupa Shrestha ◽  
Matthew R. Kimbrell ◽  
Thuan B. Nguyen ◽  
Ashok K. Adisechan ◽  
...  

ABSTRACT Lipopolysaccharide (LPS), or endotoxin, a structural component of gram-negative bacterial outer membranes, plays a key role in the pathogenesis of septic shock, a syndrome of severe systemic inflammation which leads to multiple-system organ failure. Despite advances in antimicrobial chemotherapy, sepsis continues to be the commonest cause of death in the critically ill patient. This is attributable to the lack of therapeutic options that aim at limiting the exposure to the toxin and the prevention of subsequent downstream inflammatory processes. Polymyxin B (PMB), a peptide antibiotic, is a prototype small molecule that binds and neutralizes LPS toxicity. However, the antibiotic is too toxic for systemic use as an LPS sequestrant. Based on a nuclear magnetic resonance-derived model of polymyxin B-LPS complex, we had earlier identified the pharmacophore necessary for optimal recognition and neutralization of the toxin. Iterative cycles of pharmacophore-based ligand design and evaluation have yielded a synthetically easily accessible N 1,mono-alkyl-mono-homologated spermine derivative, DS-96. We have found that DS-96 binds LPS and neutralizes its toxicity with a potency indistinguishable from that of PMB in a wide range of in vitro assays, affords complete protection in a murine model of LPS-induced lethality, and is apparently nontoxic in vertebrate animal models.


Author(s):  
Georgina L. Jones ◽  
Victoria Lang ◽  
Nicky Hudson

AbstractThe year 2018 marked 40 years since the birth of Louise Brown, the first baby born as a result of pioneering in vitro fertilization (IVF) treatment. Since then, advances have seen a wide range of reproductive technologies emerge into clinical practice, including adjuvant treatments often referred to as IVF “add-ons.” However, these “optional extras” have faced growing criticism, especially when they have often come at additional financial cost to the patient and have little evidence supporting their efficacy to improve pregnancy or birth rates. Despite this, according to the latest national patient survey by the Human Fertilisation and Embryology Authority, three quarters of patients who had fertility treatment in the United Kingdom in the past two years had at least one type of treatment add-on highlighting the growing demand for these interventions. This article uses a psychosocial perspective to consider the motivations behind patient and clinician behavior along with the wider societal and economic factors that may be impacting upon the increase in the use of adjuvant treatments in fertility clinics more widely. It suggests the reasons fertility patients use unproven “optional extras” are complex, with interpersonal, psychological, and social factors intertwining to generate an increase in the use of IVF add-ons.


2017 ◽  
pp. 28-31
Author(s):  
Yu.P. Vdovichenko ◽  
◽  
N.P. Goncharuk ◽  
Ye.Yu. Gurzhenko ◽  
◽  
...  

The objective: was to study the level of abdominal delivery, its structure according to indications from the fetus, the effect of cesarean sections on perinatal losses in acute fetal hypoxia. Patients and methods. The study was conducted on the basis of the Kyiv City Maternity Hospital №1 for the period from 2001 to 2011. The frequency of cesarean sections was studied and analyzed, the percentage of urgent and planned operations was established, the structure of cesarean sections according to the indications from the fetus was determined, the frequency of cesarean sections in acute hypoxia Fetus, perinatal losses were studied, an analysis of the dependence of perinatal losses on the frequency of cesarean sections during fetal distress was carried out. The analysis used the history of delivery of women giving birth, which culminated in cesarean section. Results. In analyzing the structure of cesarean sections, the fetal indications are as follows: fetal hypoxia, confirmed by objective methods, in the absence of conditions for urgent delivery per vias naturales; Pelvic presentation of the fetus at a mass of more than 3700 g; in vitro fertilization; incorrect position of the fetus after the outflow of amniotic fluid. The conclusion. An increase in the frequency of cesarean sections was noted. Attention is drawn to the positive trend of decreasing the frequency of urgent surgical interventions. The expected decrease in the number of perinatal losses with an increase in the level of caesarean sections due to fetal distress has not been confirmed. Key words: cesarean section, acute fetal hypoxia, cardiotocographic monitoring.


2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Guillermo U. Ruiz-Esparza ◽  
Xichi Wang ◽  
Xingcai Zhang ◽  
Sofia Jimenez-Vazquez ◽  
Liliana Diaz-Gomez ◽  
...  

AbstractMore than 90% of surgical patients develop postoperative adhesions, and the incidence of hospital re-admissions can be as high as 20%. Current adhesion barriers present limited efficacy due to difficulties in application and incompatibility with minimally invasive interventions. To solve this clinical limitation, we developed an injectable and sprayable shear-thinning hydrogel barrier (STHB) composed of silicate nanoplatelets and poly(ethylene oxide). We optimized this technology to recover mechanical integrity after stress, enabling its delivery though injectable and sprayable methods. We also demonstrated limited cell adhesion and cytotoxicity to STHB compositions in vitro. The STHB was then tested in a rodent model of peritoneal injury to determine its efficacy preventing the formation of postoperative adhesions. After two weeks, the peritoneal adhesion index was used as a scoring method to determine the formation of postoperative adhesions, and STHB formulations presented superior efficacy compared to a commercially available adhesion barrier. Histological and immunohistochemical examination showed reduced adhesion formation and minimal immune infiltration in STHB formulations. Our technology demonstrated increased efficacy, ease of use in complex anatomies, and compatibility with different delivery methods, providing a robust universal platform to prevent postoperative adhesions in a wide range of surgical interventions.


2021 ◽  
pp. 17-26
Author(s):  
G.Zh. Anartaeva ◽  
A.M. Kurmanova ◽  
N.M. Mamedalieva ◽  
S.B. Baikoshkarova

Relevance: To date, the success of in vitro fertilization (IVF) programs in Kazakhstan is 38%. The purpose of the study was to evaluate the mechanisms of influence of various risk factors on endometrial receptivity in women in IVF programs. Materials and Methods: This review was based on a search conducted for domestic and foreign publications available in Russian and international search systems (PubMed, eLibrary) for the past 25 years. Results: Chronic endometritis is a verified cause of impaired receptivity. Many studies have proven the beneficial effect of complex empirical treatment using antibacterial, anti-inflammatory, hormonal therapy with transdermal forms of estrogens and vitamin therapy on the outcome of IVF. Conclusion: The problem of recurrent implantation disorders in IVF programs is multifactorial. Women with unrealized reproductive function require rehabilitation after an unsuccessful fertilization attempt to prevent disorders of homeostasis and ensure adequate pain relief during transvaginal puncture of ovarian follicles. In addition to hormone therapy with transdermal forms of estradiol, complex rehabilitation measures shall include immunomodulatory therapy, psychotherapy, and vitamin therapy.


2017 ◽  
Vol 4 (4) ◽  
pp. 208-213
Author(s):  
Ara L. Unanyan ◽  
Yu. M Kossovich ◽  
T. A Demura ◽  
D. V Baburin ◽  
I. S Sidorova ◽  
...  

Morphofunctional state of the endometrium is one of the key factors determining both the successful implantation and full development of the embryo, including in cycles of «in vitro fertilization» (IVF). The most common cause of the impairment of the structure and function of the endometrium being chronic endometritis (CE), the frequency of its detection in infertile patients varies between 13 and 68%, reaching its maximum in women with tubal peritoneal factor and unsuccessful attempts of IVF in the anamnesis. The increasing prevalence and steady growth of the currently occurrence rate of CE cases in infertility is promoted by an increase in the role of intrauterine contraception and intrauterine interventions, including artificial abortions. On the other hand, happened in the last decades the evolution of the etiologic factor of CE towards the predominance of associations of facultative and obligate anaerobic microorganisms and viruses in the endometrium often leads to the development of erased, sluggish and atypical forms of the disease, which significantly hamper the diagnosis of CE and significantly reduce the effectiveness of traditional schemes of its treatment. CE is a clinically significant nosological form requiring the timely detection and treatment. The complex phased and pathogenetically substantiated therapy of CE in most cases leads to the restoration of the morphofunctional potential of the endometrium and, as a consequence, promotes the successful realization of the reproductive function.


GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 53-59
Author(s):  
K G Serebrennikova ◽  
N A Arutyunyan ◽  
A I Alekhin

Currently, the urgency of the problem of chronic endometritis is of medical and social importance, since it leads to impaired reproductive function. Among the risk factors there is a predominance of intrauterine devices and inflammatory complications after childbirth and abortion. Prolonged persistence of infectious agents in the endometrium in chronic endometritis leads to marked changes in the structure and function of the tissue, causes proliferative disorders, as well as disorders in cyclic transformation. Morphofunctional damage to the endometrium is not only the cause of infertility, unsuccessful attempts of in vitro fertilization (IVF) and embryo transfer (PE), miscarriage, and a decrease in the quality of life of women due to chronic pain, dyspareunia, uterine bleeding and discharge from the genital tract. Timely and accurate diagnosis is key to the success of the restoration of reproductive function. Treatment of chronic endometritis is a complex, phased process. One of the new methods is photodynamic therapy, which leads to the development of a photochemical reaction that destroys bacterial and tumor cells, and also has an antiviral effect.


2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Renato Gomes Campanati ◽  
Bernardo Hanan ◽  
Sérgio Simões de Souza ◽  
Rodrigo Gomes da Silva

Pseudomyxoma peritonei is usually a benign tumor that is slightly more common in women. However, it requires aggressive surgical treatment and chemotherapy, often compromising future reproductive function. This report presents a case of pregnancy in a 35-year-old woman who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for treatment of pseudomyxoma peritonei. The tumor was diagnosed during a laparoscopic examination on a workup for infertility in 2008. Two months later, she underwent a peritonectomy followed by hyperthermic intraperitoneal chemotherapy and, regarding her will to conceive, ovaries and fallopian tubes were preserved. In March 2011, she went through an in vitro fertilization followed by an uneventful pregnancy and delivered a healthy child 39 weeks later. Ovaries are usually resected during the cytoreductive surgery, since they are common sites for neoplastic implants, and, even when not performed, little is known about the effects of local chemotherapy on female fertility. The largest international survey on this matter only describes seven similar cases. This particular report not only describes a rare condition but also adds to the upcoming discussion about whether ovaries can be preserved in specific situations, therefore keeping the prospect of conceiving after this treatment.


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