Anatomo-functional characteristics of the pelvic organs in women with habitual miscarriage and chronic endometritis

Chronic endometritis is a clinical and morphological syndrome, which under the influence of an infectious agent contributes to the violation of cyclic biotransformation and reciprocity of the endometrium. In the diagnosis of gynecological pathology, in particular chronic endometritis, or habitual miscarriage on the background of chronic endometritis, ultrasonography is a mandatory, non-invasive and highly specific method of research. The aim of the study was to assess the anatomical and functional condition of the pelvic organs in women with habitual miscarriage and chronic endometritis using ultrasound (ultrasound and Doppler) criteria. We examined 98 women of childbearing age who applied to the Inomed clinic in the city of Vinnytsia during 2019-2020. Patients were divided into two groups: the main group – 68 women with habitual miscarriage and chronic endometritis; control group – 30 re-pregnant women without previous pregnancy loss. Initially, ultrasound examination (ultrasound) of the pelvic organs was performed on day 5-7 of the menstrual cycle, and to monitor folliculogenesis, the study was repeated on day 13-17 of the cycle. One of the main signs of chronic endometritis is the heterogeneity of the structure of the endometrium, which was found in the vast majority of examined patients of the main group (80.88% at n=68). When determining the thickness of the endometrium, two diametrically opposite processes were established, namely: atrophy (39.71% at n=68) and atypical glandular hyperplasia (22.05% at n=68). In the second half of the menstrual cycle there was a significant thinning of the endometrial layer <0.6 cm. In the control group during the ultrasound examination revealed the following disorders: increased uterine peristalsis, dilation of the arcuate plexus, the heterogeneity of the subendometrial layer, and when re-ultrasound took into account the data of folliculogenesis. Follicular cysts were detected in 10.3% of cases in the main group and 3.3% in the control group of women. At the time of re-ultrasound in each ovary was observed 5-8 antral follicles (the size of which ranged from 6.8 mm to 11.5 mm) with the presence of one dominant, the size of which ranged from 18.2 to 23.4 mm. In order to increase the informativeness of ultrasound, Doppler was additionally performed. Thus, ultrasonography is a highly specific method for determining the anatomical and functional characteristics of the pelvic organs, in particular the pathology of the endometrium in women with habitual miscarriage. The main ultrasound characteristics of chronic endometritis, as one of the causes of reproductive losses, are changes in endometrium structure, thickness, the presence of additional structures (polyps) and fluid component. Informativeness of ultrasound examination of structural changes in the endometrium in chronic endometritis is complemented by Doppler characteristics of blood flow in the basal and spiral arteries of the uterus.

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ANATOMIC-FUNCTIONAL STATE OF PELVIC ORGANS IN WOMEN WITH INFERTILITY AND OVARICOVARICOCELE

INTERNATIONAL ACADEMY JOURNAL Web of Scholar ◽

10.31435/rsglobal_wos/28022020/6919 ◽

2020 ◽

pp. 52-57

Author(s):

Astakhova OlenaVasylivna ◽

Hryhorenko Andrij Mykolajovych ◽

Malinina Olena Bohdanivna ◽

Taran Oksana Anatoliivna

Keyword(s):

Menstrual Cycle ◽

Functional State ◽

Comparison Group ◽

Ultrasound Examination ◽

Varicose Veins ◽

Morphological Changes ◽

Pathological Process ◽

Main Group ◽

Pelvic Organs ◽

Yellow Body

Introduction. High informativeness and accessibility of ultrasound examination in infertile patients provides for the exclusion or confirmation of morphological changes in genitals, the degree of damage to the organ and the involvement structures, in particular, varicose veins of the gonadal veins, which can be explained by the emergence of ovarian dysfunction. In addition, the polymorphism of semiotics of echographic signs of pathological changes in pelvic organs in the examined patients confirms the complexity of determining the main and concomitant etiological factors of the emergence of functional infertility in women, the development of disorders of reproductive function and causes the need to involve other methods. The aim of the work was to study the anatomical and functional characteristics of the pelvic organs by ultrasound, medical diagnostic laparoscopy and hysteroscopy to determine the degree of morphological changes of the genitals in women with infertility and ovaricovaricocele. Materials and methods. To solve the goals and objectives, 117 pregnant women of reproductive age (21-44 years old) with functional infertility were prospectively examined and divided into 2 groups for the comparative analysis: the main group was 62 women with infertility and varicose veins in the ovaries; a comparison group was 55 women with infertility without varicose veins. The study of the anatomical and functional state of the uterus, ovaries and fallopian tubes in women of the studied groups was performed by standard ultrasound examination on the PHILIPS ATL-HDI 4000, PHILIPS HD 11-XE with the analysis of folliculogenesis. Laparoscopic intervention was performed by the patients of the main group on the apparatus "Karl Storz" (Germany) in the first phase of the menstrual cycle. Diagnostic hysteroscopy in order to clarify the state of the uterus and endometrium was performed simultaneously with laparoscopy in the 1st or 2nd phase of the menstrual cycle using the equipment "Karl Storz" (Germany).Results. In women of the main group with a combination of functional infertility and ovaricoaricocele, there is a statistically significant increase in the percentage of incorrect position of the uterus - 36 (58.1%) in normal form and size of the uterus, both in the main group of women and in the comparison group - 53 (85,5%) and 48 (87.3%) cases respectively. Analyzing the indicators of ovarian size and the number of antral follicles, a statistically significant difference was found in the direction of its reduction in women with functional infertility and ovaricovaricocele women without varicose dilatation of ovarian veins - 4.1 ± 0.1 cm3 vs. 5.8 ± 1 , 4 cm3 and 3.9 ± 1.1 versus 5.6 ± 1.4, respectively, in two groups. In addition, there is a tendency to reduce the size of the ovary of the protradiental age in women of all the studied groups with statistically significant rates in the patients of the main group. Also, there is a difference in the right ovary volume relative to the left in women with infertility and ovaricovaricocele in the direction of decreasing the size of the latter, which may be due to the predominant localization of the enlarged gonadal vein, and this difference is statistically significant. In determining the functional state of the ovaries in the overwhelming number of women in all of the studied groups ovulation was noted, however, when studying the characteristics of the functional state of the yellow body according to echographic signs, decrease in the thickness of the endometrium in the middle of the luteal phase of the menstrual cycle in patients of the main group, as well as the absence in the overwhelming majority cases of its adequate secretory changes, which is statistically significant against the women of the comparison group. In patients, both the main group and the comparison groups, there is a decrease in the ratio of the volume of the yellow body and ovarian volume and the decrease in the thickness of the wall of the yellow body, respectively, against the control group women, which is an ultrasound sign of inferiority of the yellow body and lack of luteal phase of the menstrual cycle. In addition, women in the main group have a statistically significant reduction in the rates against the women in the comparison group. In women of the main group, a large percentage of varicose veins of the small pelvis are found in the absence of organic changes in the uterus and adnexies (73.3%) in the presence of infertility of obscure genesis.Conclusions. Ultrasound study in combination with color Doppler of patients with ovaricovaricocele is a highly informative method of research, because it allows to perform topical diagnosis, to determine the morphological character of the lesion, to differentiate the type of pathological process and to identify the concomitant pathology of the pelvic organs. The conducted study suggests that ovaricovaricocele should be considered not only as an accompanying symptomatic changes in diseases of the female genitals, but also as one of the causes of ovarian dysfunction with delay or termination of growth of the follicles, change in their size, degenerative-dystrophic changes in the ovaries, which leads to a violation hormonal homeostasis and manifested by reproductive disorders. In the perspective of further research it is necessary to consider a complex analysis of the morphological and functional characteristics of the internal genital organs, which will establish the presence of a certain functional and organic gynecological pathology and will enable to diagnose the initial and minimal course of the pathological process of the pelvic organs, finally verify the final diagnosis and appoint pathogenetic treatment.

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Clinical characteristics of women with recurrent pregnancy loss and chronic endometritis

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2020-24(4)-12 ◽

2020 ◽

Vol 24 (4) ◽

pp. 629-633

Author(s):

P. M. Nevhadovska ◽

S. B. Chechuga ◽

Е. A. Nochvina ◽

N. P. Dzis

Keyword(s):

Pregnancy Loss ◽

Uterine Cavity ◽

Main Group ◽

Control Group ◽

Prevention Measures ◽

Childbearing Age ◽

Reliability Factor ◽

Adequate Treatment ◽

Chronic Endometritis ◽

Reproductive Losses

Annotation. The purpose of the work is to analyze the gynecological, somatic, reproductive history, as well as to determine the risk factors and etiopathogenetic factors of miscarriage on the background of endometritis. We examined 98 women of childbearing age who applied to the Innomed Clinic in Vinnytsia during 2019–2020. Patients were divided into two groups: the main group – 68 women (the average age was 27.25±0.29) with habitual miscarriage and chronic endometritis; control group – 30 re-pregnant women (the average age was 26.74±0.18) without previous pregnancy loss. Statistical processing, as well as analysis of the obtained data was performed using the program “Microsoft Excel” using the methods of mathematical statistics. Statistical evaluation was performed using the Student’s test. The obtained results were considered reliable at a reliability factor p <0.05 (95% significance level). Distribution of patients of the main group by number of reproductive losses was as follows: twice – 45 women, three times – 15 women, 4 and more – 8 women. Structural distribution of pregnancy losses in women of the main group (n=68) was next: miscarriage – 41, missed abortion – 21, anembryonic pregnancy – 6. The number of reproductive losses in the first trimester was 71.7%. Reproductive losses detected during 13–22 weeks reached 28.3%. Concomitant impressions of extragenital organs and systems were found in 46 (67.6%) women of the main group and 7 (23.3%) women of the control group. The leader of somatic morbidity was endocrine pathology. Among gynecological pathology, chronic endometritis was observed in 100% (n = 68) of the examined women of the main group. In addition, 55 patients (80.9%) of this group in the structure of gynecological pathology had other lesions, among which a significant indicator belongs to chronic salpingo-oophoritis (22 (32.4%)) and various menstrual disorders (18 (26.5%)). The vast majority of women in the main group had a history of instrumental revision of the walls of the uterine cavity for various pregnancy losses in the anamnesis (28 (41.2%)). That is why the qualitative analysis of clinical data of women with habitual miscarriage and chronic endometritis is an important area of research, as it allows to carry out adequate treatment and prevention measures at the stage of pre-pregnancy training.

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CHARACTERISTICS OF METABOLIC PROCESSES IN THE FORMATION OF MENSTRUAL FUNCTION DISORDERS IN ADOLESCENT GIRLS WITH OBESITY

Neonatology surgery and perinatal medicine ◽

10.24061/2413-4260.xi.4.42.2021.5 ◽

2021 ◽

Vol 11 (4(42)) ◽

pp. 28-33

Author(s):

A. Borshuliak ◽

O. Andriets ◽

A. Andriets ◽

A. Semeniak

Keyword(s):

Insulin Resistance ◽

Body Mass Index ◽

Body Weight ◽

Menstrual Cycle ◽

Body Mass ◽

Adolescent Girls ◽

Main Group ◽

Leptin Resistance ◽

Control Group ◽

Menstrual Dysfunction

Іntroduction. Today, a quarter of the population of economically developed countries has a body weight that is 15% larger than the norm. According to various authors, the timely onset of menarche in women with various forms of obesity and reproductive dysfunction is observed in 31% of cases only. Obesity results in insulin resistance, which in its turn results in hyperinsulinemia. The main reason of the connection of insulin resistance with reproductive function disorders consists in the specific influence of insulin on ovaries. Insulin suppresses apoptosis, binding to receptors of various growth factors that promotes long existence of atresizing follicles. In the pathogenesis of the metabolic syndrome, along with the development of hyperinsulinemia and insulin resistance, a significant role belongs to the imbalance of adipocytokines, one of which is adiponectin. The aim is to analyze metabolic processes in the formation of menstrual dysfunction in adolescent girls with obesity to improve diagnostic methods of menstrual disorders. Material and methods. Clinical and laboratory examination of adolescent girls aged 12-18 years was held, among which 79 had obesity and complaints about menstrual dysfunction (the main group); 31 with normal body weight and regular menstrual cycle (the control group). Research methods: general clinical, biochemical (indicators of lipid and carbohydrate metabolism were determined), instrumental (ultrasound), statistical. Results. It was found that 53.3% of the girls from the main group had the beginning of the first menstruation after 14 years, delayed menstruation from 42 days to 6 days, duration 2.1 ± 0.05 days, which was significantly shorter, the volume of 10.2 ± 0.05; 0.4 points (average 1-2 pads per day) was significantly lower (p <0.05). Ultrasound showed uterine hypoplasia in almost every second girl in the main group - 36 (45.46%). Hyperleptinemia and leptin resistance was found in obesity of the first degree 34.8 ± 1.75, in obesity of the second degree 37.15 ± 2.12, in obesity of the third degree 40.64 ± 2.0. It was 14.35 ng / ml in the control group, p<0,01. Hyperleptinemia in the main group was accompanied by hyperinsulinemia in 26% of cases and insulin resistance. The relationship between low values of adiponectin and elevated body mass index in patients of the main group was established, which was confirmed by the results of correlation analysis (adiponectin & body mass index: ρ = -0.74). Analysis of the results revealed a decrease of A/L level in the main group by 4.3 times. Based on our own results, the A/L and HOMA-AD models can be considered more accurate for determining insulin resistance. Conclusions. 1. Changes of the menstrual cycle in overweight girls were found. The association of adipokines secretion disorders is characterized by hyperleptinemia, leptin resistance, decreased Adiponectin / Leptin index and hypoadiponectinemia, which, in combination with insulin resistance, indicates the participation of adipokines in the genesis of oligomenorrhea. The algorithm of adolescents’ treatment with menstrual dysfunction on the background of obesity must include the calculation of Adiponectin/Leptin and HOMA-AD, which will make it possible to avoid overdiagnosis of insulin resistance.

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Endometrial E-cadgerin Expression in Women with Reproductive Dysfunctions and Healthy Fertile Women with Ovulatory Menstrual Cycle

Translational Medicine ◽

10.18705/2311-4495-2019-6-3-44-52 ◽

2019 ◽

Vol 6 (3) ◽

pp. 44-52 ◽

Cited By ~ 1

Author(s):

S. S. Aganezov ◽

V. N. Ellinidi ◽

A. V. Morotskaya ◽

A. S. Artemyeva ◽

A. O. Nuganen ◽

...

Keyword(s):

Menstrual Cycle ◽

Endometrial Biopsy ◽

Main Group ◽

Control Group ◽

Luminal Epithelium ◽

History Of ◽

Design And Methods ◽

To Receive ◽

Fertile Women ◽

E Cadherin

Background. E-cadherin is known as one of the endometrial receptivity biomarkers.Objective: to conduct a comparative analysis of the endometrial E-cadherin expression in healthy fertile women and patients with reproductive dysfunctions with the ovulatory menstrual cycle.Design and methods. The main group consisted of patients with infertility (n = 81) and early pregnancy loss (n = 40), the control group — of 16 healthy fertile women. All subjects underwent endometrial biopsy and venipuncture to receive peripheral blood sample (to determine estradiol and progesterone levels) at 6–8 days after ovulation. Endometrial specimens were assessed by histological and immunohistochemical (evaluation of e-cadherin expression) methods.Results. In patients with reproductive failure, the frequency of apparent E-cadherin expression in the luminal (89 %, n = 84 out of 94) and glandular (74 %, n = 89 out of 121) epithelium did not differ from the corresponding indicators in fertile women (luminal epithelium — 94 %, n = 15 out of 16, gland — 88 %, n = 14 out of 16) (p > 0.05 for all indicators). The frequency of reduced E-cadherin endometrial expression was similar in patients of the main group with complete secretory transformation of the endometrium (1), incomplete secretory transformations (2) and in healthy women (3): respectively in the luminal epithelium — 7 % (n = 3 out of 43) (1), 14 % (n = 7 out of 52) (2), 6 % (n = 1 out of 16) (p > 0.05); in the glands — 20 % (n = 10 out of 51) (1), 31 % (n = 22 out of 70) (2), 13 % (n = 2 out of 16) (3) (p > 0.05).Conclusion. In patients with the history of reproductive disfunctions freaquency of lower/higher E-cadherin expression was similar to those in healthy fertile women.

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ОПТИМІЗАЦІЯ ЛІКУВАННЯ ЖІНОК З ХРОНІЧНИМ ЕНДОМЕТРИТОМ ЯК РЕЗЕРВ ПІДВИЩЕННЯ ФЕРТИЛЬНОСТІ

World Science ◽

10.31435/rsglobal_ws/31102018/6175 ◽

2018 ◽

Vol 1 (10(38)) ◽

pp. 28-32

Author(s):

Донська Ю. В. ◽

Лоскутова Т. О. ◽

Сімонова Н. В. ◽

Петулько А. П.

Keyword(s):

Menstrual Cycle ◽

Reproductive Potential ◽

Clinical Manifestations ◽

Reproductive Function ◽

Women Of Childbearing Age ◽

Childbearing Age ◽

Demographic Situation ◽

Chronic Endometritis ◽

The Creation

The worsening demographic situation encourages the search for new reserves to improve reproductive potential. The maximum incidence of chronic endometritis (97.6%) is 26-35 years old - the most important in the implementation of reproductive function. The lack of a single concept for the pathogenesis of HE, the purge of clinical manifestations impedes the creation of well-grounded therapy in women of childbearing age. The aim of the study was to increase the effectiveness of treatment of patients with confirmed chronic endometritis in order to restore fertility. It is proved that the use of the scheme, which includes antibacterial (doxycycline 100 mg orally 2 times a day and metronidazole 500 mg 2 times a day for 14 days in one menstrual cycle) and cyclic progestogen (didrogesterone at a dose of 20 mg per day with 15 to 25 days of the menstrual cycle - within three months), therapy can restore the morpho-functional endometrium potential by 88% compared with the initial rates.

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Features of the nuclear steroid receptors expression in endometrium of women with failed in vitro attempts in history

HEALTH OF WOMAN ◽

10.15574/hw.2016.115.155 ◽

2016 ◽

pp. 155-158

Author(s):

N.V. Kotsabyn ◽

◽

O.M. Makarchuk ◽

Keyword(s):

Menstrual Cycle ◽

In Vitro Fertilization ◽

Morphological Structure ◽

Endometrial Polyp ◽

Control Group ◽

Point System ◽

Immunoperoxidase Method ◽

Chronic Endometritis ◽

Vitro Fertilization

Structural and functional maturity of the endometrium is formed in a condition of dynamic fluctuations of ovarian steroid hormones – estrogens and progesterone during the menstrual cycle. The objective: of the research was to determine the reactivity of estrogene core receptors-б and progesterone core receptors in endometrial stroma and glands. Patients and methods. Endometrial samples were obtained during hysteroscopy in 42 patients with infertility on day LH + 6 – LH + 11 of the menstrual cycle. The control group (CG) consisted of 18 healthy women who had at least one physiological pregnancy that resulted in the birth of a healthy child. Receptivity of the endometrium to the hormones was studied by immunoperoxidase method using mouse MAbs for estrogen receptors-a (ER-a) (clone ID5, «DAKO», Denmark) and progesteron receptor (RP) (clone A6, «DAKO», Denmark). The color intensity was assessed by tree-point system. The expression levelі of ER-a and RP were set by calculating semiquantitative index: IRS = SI ґ PP, where IRS – immunoreactivity index; SI – optical intensity staining; PP – the percentage of positively stained nuclei. Results. Normal ER-a and RP immunoreactivity was observed in 8 (19.05%) women with failed in vitro fertilization attempts in history, total reduction of ER-a and RP immunoreactivity (medium and severe) in glands and stroma was observed in 6 (14.29%) of infertile patients. Normal levels of ER-a and RP immunoreactivity were observed among KG women. Noteworthy is the presence of comorbidity. So in 4 of the six cases of endometrial polyp appeared on the background of chronic endometritis. In 4 women diagnosed with simple hyperplasia without atypia the defective rejection of the endometrium from the previous cycle and the incompatibility of endometrium structure to the day of cycle were found. In the group of infertile women high reactivity of receptors was observed only in 8 (19.05%) biopsies. Deviation of the morphological structure of the endometrium in this subgroup was observed significantly more often than in KG: incompatibility of morphological endometrial structure to the day of menstrual cycle was found in 12.50% of cases, simple hyperplasia without atypia – of 55.00%, endometrial polyp – 12.50%, chronic endometritis – 25.00%. Conclusions. The change of immunoreactivity of estrogen receptor-б and progesterone plays an important role in the formation of implantation failure in women with unsuccessful in vitro fertilization attempts. The obtained data confirm the hypothesis of multiple factors of development regulation of the endometrium in natural cycles and in IVF cycles. High frequency of structural and functional inferiority of the endometrium is the indication for in-depth study. Correction of the endometrial condition need to be done before pregnancy. Key words: infertility, failed in vitro fertilization attemp, immunoreactivity, receptors estrogen-a, progesterone receptors.

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The role of hysteroresectoscopy in the diagnosis and treatment of reproductive age women with uterine leiomyoma

Reproductive health of woman ◽

10.30841/2708-8731.5.2021.240028 ◽

2021 ◽

Vol 5 ◽

pp. 61-64

Author(s):

M.A. Flaksemberg

Keyword(s):

Menstrual Cycle ◽

Histological Examination ◽

Uterine Leiomyoma ◽

Endometrial Hyperplasia ◽

Ultrasound Examination ◽

Uterine Cavity ◽

Reproductive Age ◽

Chronic Endometritis ◽

Reproductive Age Women ◽

Ultrasound Findings

The objective: to investigate the features of hysteroscopic picture of the uterine cavity and endometrium condition in women with uterine leiomyoma (UL) and the possibility of using the results to choose a treatment method.Materials and methods. A total amount of reproductive age women with uterine leiomyoma that was examined is 216. Among them 118 women underwent surgical treatment for UL and 98 patients treated with conservative therapy. In addition to general clinical methods, ultrasound examination, hysterorectoscopy, and histological examination of the obtained material was performed, followed by a comparative analysis of the findings.Results. According to hysteroresectoscopy, the uterine cavity in women with UL was more frequently characterized by irregular wall relief (47.7%) and irregular shape (43.1%) due to submucosal (14.4%) and intramural nodes with centripetal growth (30.6% ), which was significantly more frequent compared to ultrasound findings (13.9%, p<0.05). Endometrial polyps predominated among endometrial pathology (55.6%), which was consistent with the histological finding (59.7%) and was twice as frequent as ultrasound findings (23.1%, p<0.05). And endometrial hyperplasia (14.8%), which was consistent with ultrasound findings (18.1%) but was twice as rare compared to histological examination (36.6%, p<0.05). Chronic endometritis was detected at hysteroscopy in less than 1% of subjects, whereas at histological examination, it was 26.4%, p<0.05. Ultrasound examination revealed no endometrial transformation during the cycle in 30.1% of women, which was consistent with a mismatch in endometrial development to the chronological day of the menstrual cycle according to histological examination (23.1%).Conclusion. Hysteroresectoscopy is an important stage in the examination of women with UL, which helps to assess the condition of the uterine cavity, in particular, the degree of deformation of leiomatous nodules, which determines the clinical course of the disease and is a contributing factor to infertility, and affects the choice of treatment tactics in this cohort of patients. Hysteroresectoscopy when combined with ultrasound and histological examination of the endometrium, a more comprehensive characterisation of the endometrial condition (chronic endometritis, mismatch of the day of the menstrual cycle) and the presence of associated pathological processes (polyps and endometrial hyperplasia) that require correction can be obtained.

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Clinical factors of development of squamous intraepithelial cervical lesions of high grade in patients with papillomavirus infection

Research n Practical Medicine Journal ◽

10.17709/2409-2231-2020-7-2-2 ◽

2020 ◽

Vol 7 (2) ◽

pp. 22-29

Author(s):

T. A. Dimitriadi ◽

D. V. Burtsev ◽

E. A. Dzhenkova

Keyword(s):

Menstrual Cycle ◽

Chronic Diseases ◽

Assessment Tool ◽

Histological Diagnosis ◽

Control Group ◽

Cervical Lesions ◽

Categorical Data Analysis ◽

Bacteriological Study ◽

Pelvic Organs ◽

Hpv Test

Purpose of the study. To assess the chances of development of squamous intraepithelial cervical lesions of high degree (H‑SIL) in patients infected with human papillomavirus (HPV).Patients and methods. 75 HPV positive patients. The main group — with a histological diagnosis of H‑SIL (n=50), the control group — with a histological diagnosis without H‑SIL (n=25). Liquid-based cytology, colposcopy, cervical excision; HPV test, diagnosis of sexually transmitted infections — PCR in real time; a comprehensive bacteriological study. Assessment tool interconnections — odds ratio, categorical data analysis — statistical packages STATISTICA 6.0 and SPSS 22 "Statistical Package for the Social Sciences".Results. In the age group up to 30 years, the chances of H‑SIL development are 26 times higher, 30–40 years — 38 times higher compared to patients over 50 years (p<0.05). With a menstrual cycle of more than 35 days, the chances of H‑SIL development are 71 times greater than in patients with a normal menstrual cycle (p<0.05).Comparison of the chances of the presence of abnormal colposcopic patterns — the presence of significant lesions related to the II degree of colposcopic changes increases the chances of H‑SIL 8.4 times compared to the normal colposcopic pattern. The chances of development of H‑SIL in patients with colposcopy results of minor lesions (I degree), do not differ from those who have a normal colposcopic picture (p>0.05). The presence of chronic inflammatory diseases of the pelvic organs. Earlier treatment of cervical diseases by destruction reduces the risk of H‑SIL 0.08 times. The presence of chronic diseases of the pelvic organs increases the risk of H‑SIL 24 times (p<0.05).Conclusion. The group at greatest risk of having H‑SIL -women 30–40 years, whose menstrual cycle is more than 35 days, with significant lesions according to the results of colposcopic examination, chronic diseases of the pelvic organs, which had not previously been carried out destruction of the cervix.

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Prolactin level correction in restoration of menstrual cycle in obese women

Reproductive Endocrinology ◽

10.18370/2309-4117.2021.62.53-58 ◽

2021 ◽

pp. 53-58

Author(s):

T.F. Tatarchuk ◽

N.V. Kosei ◽

S.I. Reheda ◽

M.I. Hlamazda ◽

I.M. Shakalo

Keyword(s):

Metabolic Syndrome ◽

Menstrual Cycle ◽

Reference Values ◽

Prolactin Level ◽

Experimental Studies ◽

Main Group ◽

Reproductive Age ◽

Control Group ◽

Upper Limit ◽

Cycle Disorders

Obesity is a common problem among women of reproductive age. There are data from clinical and experimental studies indicating the role of hyperprolactinemia in the development of metabolic syndrome, as well as the metabolic benefits of treating hyperprolactinemia.Research objective: to evaluate the clinical efficacy of Vitex Agnus Castus standardized extract on hormonal and metabolic status in women with menstrual cycle disorders and obesity.Materials and methods. 60 women aged 19 to 35 years with obesity and menstrual cycle disorders with laboratory-confirmed insulin resistance and prolactin near the upper limit of the reference values or was slight increase were examined. All the patients were given recommendations for lifestyle modification. 30 of them, who formed the main group, received Cyclodynon. 30 patients of the control group were not prescribed Cyclodynon therapy.Results. At the end of the treatment, the menstrual cycle was normalized in 93.3% patients of the main group, and in 66.3% patients of the control group (p < 0.05). Ovulation signs were detected in 86.67% women of the main group and only in 30.0% women of the control group (p < 0.05). The mean prolactin value and the HOMA index were significantly lower in the main group; prolactin level did not exceed the physiological values in 86.67% women in the main group after 6 months, and in 40.0% of the control group, p < 0.05. There was a decrease in body mass index and waist/hip circumference ratio in patients of the studied groups; the dynamics was slightly higher in the main group but did not differ significantly. Conclusions. Cyclodynon is effective for the treatment of menstrual cycle disorders and metabolic disorders in women with obesity and metabolic syndrome. Good tolerability, absence of side effects, and sufficient efficacy of Cyclodynon allow it to be recommended as the drug of choice in patients with prolactin levels near the upper limit of the reference values or a slight increase of it and in patients with intolerance to synthetic dopamine agonists.

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Clinical experience of non-hormonal correction of the luteal phase deficiency in women of reproductive age

HEALTH OF WOMAN ◽

10.15574/hw.2019.140.24 ◽

2019 ◽

pp. 24-26

Author(s):

T.R. Streltsova ◽

◽

N.R. Simonov ◽

Keyword(s):

Menstrual Cycle ◽

Blood Loss ◽

Luteal Phase ◽

Main Group ◽

Reproductive Age ◽

Control Group ◽

Second Phase ◽

Menstrual Disorders ◽

Women Of Reproductive Age ◽

Cycle Disorders

The objective: to study the clinical efficacy of two schemes of using the monocomponent herbal preparation Cyclodynon® in women of reproductive age with complaints of various menstrual cycle disorders diagnosed with latent hyperprolactinemia and second phase failure of the menstrual cycle based on the results of clinical and hormonal studies. Materials and methods. The study included 60 patients aged 25–38 years suffering from PMS. The main group (n = 30) received Cyclodynon® in an ascending pattern: from 1 to the 14th day of the menstrual cycle – 40 drops 1 time a day and from the 15th day to the end of the cycle – 40 drops 2 times a day. The control group (n = 30) – 40 drops 1 time per day until the end of the cycle for three menstrual cycles. Results. After 3 months in the main group there was a more significant decrease in the level of prolactin (from 28.3 to 18.4 ng / ml) as compared with the control (from 27.8 to 23.1 ng / ml). Increased progesterone and estradiol production was also more significantly observed in the main group. The dynamics of normalization of the duration of the menstrual cycle and the volume of blood loss was also more significant in the main group and amounted to 93.3%. Conclusion. The use of an increasing treatment regimen with Cyclodynon® in women with a luteal phase deficiency on the background of hyperprolactinemia has advantages over the use of a standard continuous regimen with respect to a more rapid normalization of hormonal homeostasis, the duration of the menstrual cycle and blood loss. Key words: luteal phase deficiency, hyperprolactinemia, menstrual disorders, Cyclodynon®.

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