scholarly journals Female Factors of Infertility in a Couple

Health of Man ◽  
2021 ◽  
pp. 8-13
Author(s):  
Iryna Ventskivs’ka ◽  
Oleksandra Zahorodnia
Keyword(s):  
Inflammatory Diseases ◽  
Polycystic Ovary ◽  
Pelvic Cavity ◽  
Ovary Syndrome ◽  
Sexually Transmitted ◽  
Hypothalamic Syndrome ◽  
Comprehensive Examination ◽  
Psychological Significance ◽  
Gonadotropic Hormones ◽  
Adhesion Process

The problem of infertility is relevant to the whole world, that is explaned both by the prevalence (at least 50 million couples on the planet are diagnosed) and by the enormous medical, ecoomic, social and psychological significance. Another important aspect of infertility is the heterogeneity of its causes – about 40% of infertile marriages are caused by the female factor, 35% – male, 20% – a combination of male and female factors and 5% – have no identified factor. In 2019, the American Collegue of Obstetricians and Gynecologists updated the guidelines for the timing and scope of examinations of infertile couples. In particular, if a woman is 35–40 years old, examination and elimination of the probable factor of infertility should be started after 6 months of non-pregnancy, and in the case of age older than 40 years – immediately after the couple’s accost. The expected tactics should not be used if the patient has oligo- or amenorrhea, known uterine and fallopian tube abnormalities, grade III or IV severity of endometriosis, and the couple has known male infertility factors. Ovulation disorders as a factor of infertility include hypothalamic syndrome, polycystic ovary syndrome, premature ovarian failure and hyperprolactinemia, which differ in the content of gonadotropic hormones and ovarian hormones. The adhesion process of the pelvic organs, which restricts the transport of sperm and fertilized egg through the fallopian tubes, is a consequence of endometriosis and inflammatory diseases caused mainly by sexually transmitted pathogens. Endometriosis, in addition to the formation of adhesions in the pelvic cavity, which is characteristic of stage III and IV of the disease, is also a factor in infertility due to elevated concentrations of prostaglandins and proinflammatory cytokines, failed endometrial reciprocity. Among the uterus abnormalities in the violation of fertility are the uterine membrane, leiomyoma with submucosal localization of the node and uterine synechiae. As part of a comprehensive examination of patients with infertility, it is necessary to take into account the study of thyroid function.

scholarly journals Characteristics of phenotypes (clinical variants) of polycystic ovary syndrome in women of reproductive age

2021 ◽  
Vol 2 ◽  
pp. 27-31
Author(s):  
V.G. Syusyuka ◽  
M.Y. Sergienko ◽  
G.I. Makurina ◽  
O.A. Yershova ◽  
A.S. Chornenka
Keyword(s):  
Polycystic Ovary ◽  
Free Testosterone ◽  
Main Group ◽  
Reproductive Age ◽  
Control Group ◽  
Women Of Reproductive Age ◽  
Ovary Syndrome ◽  
Comprehensive Examination ◽  
Clinical Variants ◽  
Research Show

The objective: on the basis of a comprehensive examination of women of reproductive age to establish the frequency of phenotypes (clinical variants) of polycystic ovary syndrome (PCOS).Materials and methods. 34 patients (main group) who complained of menstrual disorders and/or dermatopathies by recommendation of a dermatologist were examined. The control group is represented by 30 women without gynecological and somatic pathology. The mean age of women in the main group was 26,4±0,9 years and 29,1±0,9 years in the control group (p>0,05). The age of women in the study groups ranged from 18 to 35 years. Patients underwent a comprehensive examination to assess the severity of hirsutism and the severity of acne, as well as the body mass index was determined. All women underwent ultrasound examination in the dynamics and quantitative assessment of the concentration of hormones in the blood plasma, namely cortisol, thyroid-stimulating hormone, prolactin, free testosterone and its index, androstenedione, dehydroepiandrosterone sulfate, 17-α-OH-progesterone, sex hormone binding globulin. Variation-statistical processing of the results was carried out using the program «STATISTICA 13».Results. The results of the conducted research show that 73,5% had menstrual irregularities, and 52,9% – infertility. Acne and hirsutism in every 3rd woman were combined and were diagnosed in 47,1% and 41,2% of women, respectively. Ultrasound signs of polycystic ovaries were found in 94,1% of patients according to the criteria for the diagnosis of PCOS, and in 88,2% – anovulation. According to the laboratory examination, hyperadrogenism was found in 55,9%, which is confirmed by statistically significant (p<0,05) predominance in the main group compared with the control group of androstenedione, free testosterone and its index. In addition, it should be noted statistically significant (p<0,05) higher levels of 17-α-OH-progesterone and prolactin in the main group, but their indicators were within the reference values of the norm. Analyzing the frequency of phenotypes (clinical variants) of PCOS, it was found that phenotype A (classical) occurred in 32,4%. Phenotype B (incomplete classical) was diagnosed in 14,7%, and phenotype C (ovulatory) – only 8,8%. The most often, namely in 15 (44,1%) women with PCOS, the phenotype D (non-androgenic) was established.Conclusions. The results of the conducted research show that in women with PCOS clinical symptoms are characterized by menstrual dysfunction (73,5%), infertility (52,9%) and dermatopathies, namely acne (47,1%) and hirsutism (41,2%). According to the laboratory exanination, hyperadrogenism was found in 55,9%, which is confirmed by statistically significant (p<0,05) predominance in the main group compared with the control group of androstenedione, free testosterone and its index. Among the clinical variants of PCOS, the non-androgenic phenotype (phenotype D) was the most often diagnosed, the frequency of it was 44,1%. Classical (phenotype A) and incomplete classical (phenotype B) were found in 32,4% and 14,7%, respectively. It should be noted that only 8,8% of women with PCOS are diagnosed with phenotype C (ovulatory).

scholarly journals Studying of the incidence of inflammatory processes and vaginal bacterial flora in polycystic ovary syndrome under conditions of increased

2018 ◽  
Vol 82-83 (2-3) ◽  
pp. 71-77
Author(s):  
S.V. Gunkov
Keyword(s):  
Escherichia Coli ◽  
Polycystic Ovary Syndrome ◽  
Sexually Transmitted Infections ◽  
Enterococcus Faecalis ◽  
Polycystic Ovary ◽  
Bacterial Flora ◽  
Ovary Syndrome ◽  
Sexually Transmitted ◽  
Vaginal Microflora ◽  
Inflammatory Processes

In previous studies, high serum concentrations of manganese and nickel were established in women with polycystic ovary syndrome (PCOS). Increased level of exposure of the population of Ukraine to manganese and nickel has been demonstrated. The objective of this study is studying the incidence of inflammatory processes and composition of vaginal bacterial flora in healthy women and in women with PCOS. Materials and methods. The control group consisted of 57 women without reproductive system conditions and 64 women who had established PCOS according to the Rotterdam Consensus criteria. In both groups, the presence of sexually transmitted infections was excluded by PCR. The analysis of the incidence of inflammatory processes was carried out according to the microscopic characteristics of vaginal microbiocenosis. Vaginal microflora was examined by the culture method. Evaluation of the resulting validity was performed using Student’s t-test, Mann-Whitney U-test and χ2. Results. Studies have shown that women with PCOS are much more likely to show signs of inflammatory processes in the vagina, as well as colonization of vagina with bacteria and fungi. Compared to control, lactobacilli are less common, while the diversity of bacterial flora is increasing, with a predominance of the representatives of intestinal flora (Enterococcus faecalis, Escherichia coli) and Candida albicans. The analysis of quantitative parameters showed a significant decrease in Lactobacillus spp. (Р=0,0003), increase in Escherichia coli (Р=0,0026), Enterococcus faecalis (Р=0,0003), and Enterococcus Durans (Р=0,0272). Meanwhile, the quantitative parameters of other representatives of the vaginal microflora virtually did not change compared with the control. Conclusion. Inflammatory processes in PCOS may not be associated with sexually transmitted infections or body mass index. Increased exposure to manganese and nickel can affect vaginal microflora and its individual representatives. Key words: polycystic ovary syndrome, inflammation, microflora, vagina, manganese, nickel.

Hyperandrogenism. Cases of Combination of Different Variants of Hyperandrogenism in Adolescent Girls with the Peripheral Form of Hyperandrogenism

2015 ◽  
Vol 6 (1) ◽  
pp. 62-67
Author(s):  
Elena Magometovna Bogatyreva ◽  
Galiya Fettyakhovna Kutusheva ◽  
Irina Nikolaevna Gogotadze ◽  
Anastasia Dmitrievna Zernyuk
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Adolescent Girls ◽  
Polycystic Ovary ◽  
Free Testosterone ◽  
Pathological Process ◽  
Ovary Syndrome ◽  
Laboratory Parameters ◽  
Hypothalamic Syndrome ◽  
Level Increase ◽  
System Functioning

Hyperandrogenism is a pathological process associated with an excessive effect of androgens in a female organism. In addition to the appearance changes hyperandrogenism (HA) can declare itself by some disorders of reproductive system functioning (anovulation, sterility, miscarriage). The causes of hyperandrogenism can be absolutely different by their pathogenesis conditions. Such external (peripheral) manifestations of hyperandrogenism as hirsutism can be determined by the only reason - excess of 5a-reductase enzyme. There are more cases of combined (associated) forms in the clinical practice. The article considers the cases of combinations of various forms of hyperandrogenism with peripheral forms and their influence on the change of clinical and laboratory parameters. The highest frequency of the excess of 5a-reductase enzyme was found in the group of girls with congenital adrenal dysfunction - 75 %, among the girls with a polycystic ovary syndrome the frequency of this pathology was 9,5 %, and among the girls with hypothalamic syndrome of pubertal period - 14,3 %. The combination of any hyperandrogeny form with the excess of 5a-reductase enzyme was accompanied by hirsutism increase, reduction of mammary glands in adolescents, suprarenal hormones level increase - DEA-s and 17-OHPg. In the case of combination of congenital adrenal dysfunction or hypothalamic syndrome of pubertal period with the excess of 5a-reductase enzyme the laboratory parameters of hyperandrogenism (testosterone, index of free testosterone) were expressed more intensively. In the case of the combination of the excessive production of 5a-reductase enzyme with a polycystic ovary syndrome the diagnosis was more complicated because the index of free testosterone was normal. In the case of combined forms polycystic ovary syndrome is not frequently proved by the laboratory hyperandrogenism, more often these are the cases of incomplete polycystic ovary syndrome.

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