scholarly journals Clinical characteristics of women with infertility and ovaricovaricocele

Author(s):  
O.V. Astakhova

Despite numerous studies devoted to the etiological factors and pathogenetic aspects of infertility, the lack of a comprehensive analysis of the causes of ovarian dysfunction and the exact diagnosis leads to the polypharmacy of hormonal drugs and their low effectiveness. One of the less well known and poorly studied factors is pelvic venous complications, including varicose veins of the ovaries. Violation of venous circulation in the pelvic organs plays a significant role in the structure of gynecological pathology, particularly in the development of ovarian dysfunction. The purpose of our study was to analyze the clinical characteristics of women with functional infertility and ovaricovaricocele, namely the features of anamnesis of life, gynecological and somatic anamnesis, the study of which allows to assess and determine the risk factors, possible causes of ovarian dysfunction and the formation of varicose veins. To solve the goals and objectives, were prospectively examined and divided into 2 groups for the comparative analysis 117 pregnant women of reproductive age (21–44 years old) with functional infertility: the main group was 62 women with infertility and varicose veins in the ovaries; comparison group has 55 women with infertility without varicose veins. Patients were examined by a specially designed questionnaire, which included the results of gynecological and somatic anamnesis, anamnesis of life. In the main group of women there is an increased proportion of women with intellectual differentiation of labor and psycho-emotional and physical activity, which may be the basis for the formation of maladaptation syndrome with the subsequent occurrence of functional disorders of the reproductive system. In addition, conditions of work with considerable physical activity can indirectly have a negative effect on venous hemodynamics in the small pelvis. Women with functional infertility and ovaricovaricocele had a high incidence of infectious diseases in childhood — 83.9%. It is precisely at the stage of formation of reproductive function that the action of an infectious factor can be significant in the occurrence of violations of complete oogenesis in the subsequent reproductive life of patients. Attention is drawn to the large number of inflammatory diseases of the internal organs in women as the main group and the comparison group in the study of the somatic anamnesis: from the otolaryngologic organs — 48.3%, respiratory organs – 54.7%, genitourinary system — 43.5% and in the structure of gynecological diseases: inflammation of ovaries — 43.5%, vagina and cervix — 25.8%, suggesting that factors of violations of folliculogenesis in active reproductive age may be inflammatory diseases of the genitals. There is a significant percentage of dyshormonal abnormalities in the form of abnormal uterine bleeding in the structure of gynecological pathology in women with functional infertility and ovaricovaricocele (30.6%) against patients with infertility without structural changes in ovarian veins. Patients with infertility are more likely to point out dysgharmony of sexual life (58.1%), which in patients with varicose veins in the pelvic organs was accompanied by dyspareunia (32.2%), suggesting the role of chronic stress as a risk factor for ovarian dysfunction, which is also exacerbated by the presence pain of syndrome in the lower abdomen in women of the main group (77,4%). The more significant percentage of gynecological pathology of endocrine genesis in women with functional infertility and ovaricovaricocele and the presence of certain extragenital pathology, which affects the formation of pelvic pelvic flooring in comparison with patients with infertility without structural changes in ovarian veins, is established during the analysis of the clinical characteristics of the significant percentage of venous hemodynamics in the functional properties of the ovary and induces further investigation of the role of varicose veins of the pelvic reservoirs, in particular ovariсovariсocele, in the pathogenesis of ovarian dysfunction in order to further develop the methods of therapeutic correction.

2017 ◽  
Vol 23 (2) ◽  
Author(s):  
Natalya Drohomyretska

Hemomicrocirculatory system – is a complex structure that reacts in every pathological process even before the clinical period and takes the first blow. The study of microhemocirculation will provide an opportunity to solve the important for practical medicine questions of pathogenesis of many diseases, as for the prevention and treatment of regional disorders of blood circulation.The objective of the research is to study the state of the hemomicrocirculatory bed (HMCB) of adventitia of varicose veins of the small pelvis (VVSP) in women with chronic inflammatory processes of the organs of the small pelvis (CIPOSP).Materials and methods of research. To evaluate the restructuring of the HMCB of adventitia of VVSP, the operating material of 12 women of reproductive age was used. Mainly, there were pieces of the ovarian vein. The study of the HMCB in the vein wall was performed by the non-injecting method of silver impregnation according to V.V. Kupriyanov. To standardize the results, the condition of the HMCB of adventitia of the venous wall in norm was studied in 5 women of reproductive age, who died as a result of various traumas.Results of the research. After the performed studies, the structural-morphological changes of the HMCB of the adventitia of the small pelvis veins were revealed. The dilation of capillaries, postcapillaries, postcapillary venules was observed. The diameter of the vessels of the HMCB of the ovarian vein adventitia was: venule – 94.21 ± 1.38 μM in comparison with the norm – 48.78 ± 1.60 μM (p<0.001); post-capillary venules – 46.76 ± 1.04 μM in comparison with the norm – 28.29 ± 1.1.01 μM (p<0.001); the capillaries were 11.22 ± 0.14 μM in comparison with the norm – 8.24 ± 0.16 μM (p<0.05), arterioles – 29.02 ± 0.76 μM in comparison with the norm – 25.19 ± 1.15 μM (p<0.01). The architectonics of the arterioles is almost unchanged. Lumen of venules is filled with formed elements. The structure of capillaries is polymorphic. The capillary net was localized and concentrated or was formed as a thick planar net, the capillaries were expanded. There were arterio-venulous anastomoses. Endothelial nuclei are shortened. In some preparations, the diameter of the arterioles corresponded to the diameter of the collection venules.  Conclusions:1. The first discovered by us changes in HMCB of adventitia of varicose veins of the small pelvis in women with CIPOSP can be one of the pathogenetic links of the development and progression of the varicose vein itself, which in turn aggravates the course of chronic inflammation.      2. The timely appointment of drugs that improve microcirculation will enable to prevent the development of dystrophic changes in the vein wall, improve the course of chronic inflammatory processes and reduce or completely eliminate the syndrome of “chronic pelvic pain”.


2018 ◽  
Vol 22 (4) ◽  
pp. 660-665
Author(s):  
O.V. Astakhova ◽  
O.B. Malinina ◽  
A.M. Grigorenko

The problem of reproductive health in Ukraine over the last decade has become very important. The greatest clinical interest is infertility, which is accompanied by a violation of the ovulatory function of the ovaries due to hypothalamic-pituitary-ovarian failure. Sustained anovulation for a long time, as well as the lack of adequate correction of menstrual disorders, lead to the development of endocrine-dependent gynecological diseases, the manifestation of which is primary or secondary infertility. Increased flow of venous blood through the ovarian veins is accompanied by phlebostasis and phlebohypertension in the venous sector of the internal genital organs. Increasing the viscosity and rheological properties of blood that occurs at the same time leads to a deterioration of transcapillary metabolism and transport of oxygen to tissues. In the ischemic ovary, degenerative changes in the follicular apparatus, yellow bodies, followed by spreading to all the ovarian structural elements, which leads to its atrophy and reduced functional properties. Considering the importance of venous blood flow in the development of hormonal imbalance as a result of a violation of the endocrine function of the ovaries, the purpose of our study was to assess the menstrual and reproductive function of infertile women against the background of varicose veins. The reproductive function of women with infertility and varicose changes in ovarian veins is represented by a significant percentage of unauthorized miscarriages (41.9%) in the period of pregnancy after 6 weeks (30.6%). In patients with varicose veins in the ovaries, there was a tendency to increase the duration of infertility compared with patients without varicose dilatation of ovarian veins, which may indirectly indicate more significant functional and structural changes in the reproductive organs. In women, both the primary and the comparator groups are predominantly the late and early menarche, but the rates in groups differ slightly in their direction in women with infertility and varicose veins in the ovaries, although they do not reach statistically significant values. The menstrual function of women in the main group is characterized by a regular menstrual cycle (77.5%), regular duration (43.6%) with excessive blood loss during menstruation (54.8%) and a duration of more than 6 days (50.1%) with acyclic uterine bleeding (37.1%), dysmenorrhea (56.4%) and premenstrual disorders (51.6%), which significantly impairs the quality of life of women. At the same time, the violation of the menstrual cycle in the form of its shortening of 16,1% and acyclic uterine bleeding — 6,5%, was gradually increasing with age and was statistically significant against women from the comparison group. Conclusion in the analysis of clinical characteristics, the more significant percentage of changes in the menstrual cycle, reproductive function in women with functional infertility and varicose veins of the ovary compared with patients with infertility without structural changes in ovarian veins indicates the significant importance of venous hemodynamics in the functional properties of the ovary.


2016 ◽  
Vol 65 (3) ◽  
pp. 18-24
Author(s):  
Ekaterina М Riazantceva

Actuality. Ovarian insufficiency can be diagnosed in more than 30% of reproductive age women with obesity. The role of leptin in the pathogenesis of ovarian insufficiency in obesity is not well understood and needs to be detalised. The aim of the study: to ivestigate the role of leptin in the pathogenesis of ovarian insufficiency in obesity. Materials and methods. 50 reproductive age females with BMI > 26.5 kg/m2 were studied. 10 healthy reproductive age females were used as control. Blood levels of leptin, gonadotropins, prolactin, sex steroid hormones were measured by immunoenzymatic assay and pelvic echoscopy were performed in all studied patients and co ntrols. Results. 72% of obese women had signs of ovarian insufficiency, such as ovarian enlargement and increased antral follicular count. The level of leptin did not correlate with the presence or absence of ovarian insufficiency in our patient group. The positive correlation between leptin level and BMI, luteinizing hormone (LG) and oestradiol and negative correlation between leptin level and follicular stimulating hormone (FSH) were revealed. Conclusion. The results of our study do not support the hyperleptinemia as the main cause of ovarian dysfunction in alimentary obesity. The most potential reason of ovarian dysfunction in these women could be ovarian or non-ovarian origin hyperoestrogenia leading to premature LG piques, and, thus, disturbing folliculogenesis in ovaria.


2018 ◽  
pp. 42-49
Author(s):  
V.I. Pyrohova ◽  
◽  
S.O. Shurpyak ◽  
Yu.R. Fayta ◽  
M.Y. Malachinska ◽  
...  

The objective: to increase the effectiveness of local therapy for recurrent nonspecific vaginitis associated with cervicitis in women of reproductive age on the basis of a comparative evaluation of combined drugs Terzhinan and Neo Penotran Forte. Materials and methods. A prospective, open comparative study included 56 women aged 27.5±2.8 years with recurrent nonspecific vaginitis and cervicitis who were randomized to the main group and comparison group. Patients of the main group (n=28) received the drug Terzhinan® (1 vaginal tablet in the evening, before bed, for 10 days). The comparison group included 28 patients who received Neo-Pentran Forte (1 vaginal suppository in the evening, before bedtime, for 10 days), one vaginal suppository containing 750 mg of metronidazole and 200 mg of miconazole nitrate. The complex clinical-paraclinical examination included the determination of the state of the vaginal microbiota using several methods in parallel: a bacterioscopy of vaginal smears stained by Gram, a bacteriological rapid method using AFGENITAL SYSTEM (Liofilchem®, Italy), real-time PCR (Florocenosis) with detection antigens of chlamydia, herpes simplex virus, human papillomavirus, trichomonads. Results. The main reason for the treatment of patients were abundant pathological discharge from the genital tract (73.2%), pruritus (37.5%) and burning (23.2%) in the vulva, pain during sexual intercourse (8.9%), while 33.9% of women expressed combined complaints. Attention was drawn to the significant frequency of dyshormonal pathology among women with recurrent cervico-vaginal infections. In the examined women, uterine leiomyoma was diagnosed (28.6%), genital endometriosis (19.6%), fibrocystic breast disease (37.5%), combined benign dyshormonal diseases of the genital organs (14.3%). About 21.4% of patients treatment of thyroid gland dysfunction (hypothyroidism). According to the comprehensive examination, in all patients of clinical groups, decompensated vaginal dysbiosis was diagnosed, which was manifested by a sharp decrease in the absence of Lactobacillus spp strains in 39.3% of patients and an increase in the number of isolated opportunistic and pathogenic microorganisms to 1011 CFU/ml with an increase in the number of microorganisms in microbial associations (from 2–3 to 5–6 conditionally pathogenic and pathogenic pathogens) in all the cases analyzed. When using the genital express system in vaginal contents, women of the main group identified Escherichia coli (17.9%), Pseudomonas spp. (10.7%), Gardnerella vaginalis (39.3%), Staphylococcus aureus (17 9%), Enterococcus faecalis (25.0%), Streptococcus Group B (10.7%), Candida spp. (46.4%), Mycoplasma spp./Ureaplasma ur. in the title > 105 (14.0%). In the comparison group, the spectrum of detected pathogenic and conditionally pathogenic microorganisms did not differ significantly from the data of the main group. 92.6% of patients in the main group had a pronounced positive clinical effect, and a positive microbiological effect was achieved in 96.4% of cases that persisted during the next two months of follow-up. Without additional prescription of antifungal agents, a positive effect was achieved in 84.6% of patients in the main group with mixed bacterial-candidiasis vaginitis at 54.5% in the comparison group. The independent recovery of the lactobacilli pool to a titer of 107–109 CFU/ml in 17.9% of patients with a lack of detection of lactobacilli before treatment. A similar effect was not observed in the comparison group. Сonclusion. In a comparative study of the results of the use of Terzhinan and Neo-Penotran Forte in monotherapy in patients with inflammatory diseases of the lower genitalia (nonspecific recurrent vaginitis and cervicitis), the high clinical and microbiological efficacy of Terzhinan has been demonstrated. Key words: mixed vaginitis, cervicitis, Terzhinan, Neo-Penotran Forte.


2020 ◽  
pp. 37-38
Author(s):  
M.Ya. Kamilova ◽  
N. Amin-Zade

Objective. To evaluate the effectiveness of a tranexamic acid for the prevention of critical bleeding in women with preeclampsia. Materials and methods. 31 puerperas with postpartum hypotonic bleeding. Inclusion criteria: reproductive age, severe preeclampsia, postpartum hemorrhage, volume of blood loss – 700 ml, voluntary consent to the administration of the tranexamic acid. Exclusion criteria: delivery by the caesarean section. When providing emergency care, along with other standard measures, 14 women (the main group) were injected with the tranexamic acid when blood loss reached 700 ml, 17 women (the comparison group) did not receive the tranexamic acid. Research methods: measurement of the volume of blood loss (by the calculation method and by the method of measuring blood loss), statistical analysis – comparison of populations by qualitative characteristics. Results and discussion. A bleeding with a blood loss of 700-800 ml was registered in 7 women of the main group and in 6 women of the comparison group, with a blood loss of 800-900 ml – in 6 and 4 women, with the blood loss 900-1000 ml – in 1 and 7 women, respectively. There was a significant difference in outcomes (blood loss – 900-1000 ml) depending on the use of the tranexamic acid (Fisher’s exact test – 0.04537; p<0.05). Evaluation of the strength of the relationship between the frequency of aggravation of bleeding and the use of the tranexamic acid for the prevention of massive bleeding established a relationship of average strength (Cramer’s criterion – 0.387). Pregnant women with severe preeclampsia are at risk of the developing obstetric bleeding, which is associated with secondary changes in the hemostatic system in women with preeclampsia. With obstetric bleeding in women with preeclampsia, the balance between the coagulation, anti-coagulation and fibrinolytic systems is disturbed faster. Fibrinolysis is activated faster due to the limitation of thrombus formation due to the breakdown of fibrin in thrombi and the fibrinolytic properties of the fibrin breakdown products themselves. The use of the tranexamic acid in the obstetric bleeding is justified by the antifibrinolysis effect of the drug. Further research on the use of the tranexamic acid for the prevention of massive bleeding, confirmed by laboratory data, is highly relevant. Conclusions. The use of tranexamic acid with the onset of obstetric bleeding in women with risk factors for the secondary thrombocytopathy will prevent the aggravation of coagulopathy and reduce the incidence of massive obstetric bleeding caused by a disseminated intravascular coagulation.


2012 ◽  
Vol 93 (1) ◽  
pp. 61-67 ◽  
Author(s):  
N V Moskovenko

Aim. To improve the results of treatment of chronic pelvic pain in women secondary to chronic nonspecific salpingoophoritis and chronic cystitis. Methods. Examined were 91 women of reproductive age suffering from pelvic pain. The patients comprised two groups. The first group included 68 women in the treatment of which physical exercise therapy, electromagnetic resonance radiation and laser treatment were used. The comparison group included 23 women who received conventional therapy. Used were the generally accepted clinical and special methods of investigation: determined was the content of gonadotropic and steroid hormones, conducted were sonographic, urodynamic studies, laser Doppler flowmetry, assessed was the heart rate variability by the R.M. Baevskiy technique. The medical and psychological examination of women included a study of a women’s personality traits with the help of classical psycho-diagnostic methods. Results. Chronic pelvic pain in women is accompanied by a disturbance of the autonomic balance, increase in the activity of the regulatory systems and psychoemotional disorders, in the structure of which anxiety and depression conditions dominate. The influence of these disturbances on the major categories of quality of life has been established. After treatment was completed marked improvement was observed in the women of the main group; herein the disappearance of major symptoms, normalization of laboratory data, ultrasound investigation data, indicators of microcirculation occurred in a shorter time; the duration of treatment decreased. In the long-time registered was a decrease of the frequency of exacerbations of the disease in the main group of women by 2.6 times relative to the comparison group of patients. The economic effectiveness of the proposed methods of treatment was 40.2%. Conclusion. The usage of physiotherapy techniques in the treatment of pelvic pain made it possible to reduce the treatment time, reduce the frequency of exacerbations of the disease, to establish an economic effect.


Author(s):  
Grigorieva N.A. ◽  
Glukhova T.N.

The only effective method of treating pregnant women with developed preeclampsia is timely delivery, so it is an urgent task to establish predictors of preeclampsia in order to predict its development.The aim of the work is to evaluate the platelet link of the hemostasis system in the 2nd trimester of pregnancy in patients with preeclampsia that developed after 34 weeks of pregnancy, to establish informative markers for predicting the development of preeclampsia after 34 weeks of pregnancy A survey of 210 apparently healthy women of active reproductive age (18-34 years) was carried out. Patients with multiple pregnancies, autoimmune pathology, arterial hypertension, heart defects, varicose veins, diabetes mellitus, hereditary thrombophilia were excluded from the study. All patients received voluntary informed consent to use the survey data for scientific purposes. In 20 patients, the course of pregnancy was complicated by the development of moderate preeclampsia after 34 weeks of pregnancy, these patients constituted the main group. 190 women with physiological pregnancy made up the comparison group. The study of the state of the platelet link of the hemostasis system was carried out using a VS-3000 + hematological analyzer, the number of platelets, their average volume, the root-mean-square value of the spread of platelet sizes, and the percentage of megalothrombocytes were determined. At the preclinical stage of development of preeclampsia (at 20-22 weeks), a decrease in the number of platelets and an increase in functional activity in the form of an increase in the rate of platelet anisocytosis, the average volume of platelets and the number of megalothrombocytes were found in pregnant women of the main group. Determination of indicators of the state of the platelet hemostasis at 20-22 weeks of gestation can be used to predict the development of moderate preeclampsia after 34 weeks of gestation.


Cervical cancer is one of the widespread diseases that have a negative impact on the reproductive health. However, medical-social risk factors which provoke this pathology aren't studied sufficiently yet. We have identified the most significant medical-social risk factors of cervical cancer's development and progression based on data analysis of a sociological study. Thus, it was found that cervical cancer can't be associated with predominantly late reproductive age of women in conditions of the Republic of Belarus: most of the patients with this pathology (more than 53%) were under the age of 35 years old. The group of patients suffered from cervical cancer was quite homogeneous in their social status, which was average and relatively stable in a large majority of them (more than 90%), despite employment in various sectors of the national economy. Social functioning of these patients wasn't significantly different from the main population of women in reproductive age. Thus, early sexual activity and random early sexual relations weren't characteristic for the majority of them: 86.1±4.46% (the control group – 87.3±5.51%, the comparison group – 78.2±3.96%) and 83.5±4.72% (the control group – 89.1±4.28%, the comparison group – 75.2±2.36%). Moreover, the married patients of the main group had the most ordered sexual behavior (p<0.01; tau=0.572) which determined the low prevalence of artificial abortions among them, including menstrual cycle regulation (less than 8%). However, the revealed different defects of health-saving behavior in the main group of patients (more than 70%), including an insufficient level of valeological knowledge, the presence of common harmful habits and low medical activity, indicate that there are significant reserves for improvement of the preventive activities of medical stuff in the field of primary medical care for the development of a healthy lifestyle among female population of reproductive age and providing clinical examination among this contingent of females in reproductive age with the purpose of cervical cancer prevention.


2017 ◽  
Vol 24 (3) ◽  
Author(s):  
Oksana Makarchuk ◽  
Volodymyr Dziombak

Obstetric complications in women of reproductive age are often the result of puberty disorders which remain underestimated and not taken into account in pregnancy monitoring programs in such patients, leading to an increase of habitual non-carrying of pregnancy and negative obstetric effects.The objective of the research is to carry out a comprehensive multivariate assessment of the disturbances of the body adaptive processes in teenage girls, taking into account the data of anamnesis regarding the specifics of menstrual function regularization during puberty, and to determine the main factors of complicated pregnancy in this category of patients.Materials and methods. To carry out the task, 110 pregnant women with a disorder of menstrual function regularizationhave been prospectively examined (the main group); the examination was performed at the preconception stage and in the periods of 6-12, 22-24 and 32-36 weeks of pregnancy. The comparison group consisted of 30 patients with a normal menstrual cycle. In order to identify risk factors and predict complications, the odds ratio (OR) and its 95% confidence interval were used.Results. Extragenital pathology plays a significant role in the formation of pathological course of puberty and obstetric complications; 87.27% ofsuch cases were demonstrated in our study. Among the disorders of the ovarian-menstrual cycle, the structural significance is characteristic to the failure of the luteal phase and anovulatory disorders (78.18% of cases). Gynaecologic pathology includes inflammatory diseases of the pelvic organs (35.45%), cervical background processes (41.66%), ovarian tumour lesions (21.81), and primary infertility(14.54%). The obtained results of the structure of pregnancy complications in patients of the main group show reproductive losses in early pregnancy (11.8%), subchorionic hematoma (28.18%) and the threat of late spontaneous abortion; these data are notedthree times more often than in the comparison group. Many cases of preeclampsia (28.18%), gestational anaemia in more than half of the observations, fetal distress during pregnancy (32.72%) and birth of children with a low weight (17.27%) are associated with the development of the primary placental dysfunction and pathology of vascular and thrombocytic component of haemostasis.Conclusions. Analysis of the obtained data confirmed that pregnant women with a disorder of menstrual function regularization in puberty are characterized by a significant number of complications during pregnancy and delivery, high rates of spontaneous abortions and missed miscarriages; all these factsshould be considered as potential risk factors. The key factors are the following: endocrine imbalance by type of oligomenorrhea and luteal phase deficiency (OR – 9.16; 2.21-23.24), inflammatory diseases of the genital tract, such as asymptomatic bacteriuria and bacterial vaginosis (OR – 14.26; 3.26-32.12), premature deliveryin past medical history, the risk of spontaneous miscarriages and subchorionic hematoma.


2019 ◽  
Vol 6 (1) ◽  
pp. 27-31
Author(s):  
Natalia A. Burova ◽  
S. V Serdyukov ◽  
K. A Sadovskaya ◽  
N. A Zharkin

Inflammatory diseases of the pelvic organs (IDPO) remain one of the most pressing and debatable problems of modern gynecology. Currently, IDPO acquired an erased course due to immune and vascular changes at the local and systemic level, leading to endothelial dysfunction, which, in the absence of acomprehensive, step-by-step treatment, causes chronicity and disrupts the fertility of women. We examined 184 patients with acute episodes of IDPO divided into 2 groups: the main group included 94 patients and the comparison group consisted of 90 patients. All patients started comprehensive drug anti-inflammatory therapy. Patients of the main group additionally received a vaginal laser-magnetopuncture from the 2nd to the 7th day of treatment. To assess the state of endothelial function, the enzyme-linked immunosorbent assay (ELISA) in the serum was used to determine the level of a metabolite of nitric oxide (NO) iNOS - inhibited endothelial NO synthase and endothelin-1. Similar markers were determined in the blood serum of 20 healthy women volunteers of the reproductive age. As a result of the study, in the acute phase of inflammation there was found an increase in both the vasodilator NO and the vasoconstrictor - endothelin-1, which was 2.5 times higher than in healthy women, which confirms the presence of endothelial dysfunction in IDPO patients, which cannot be stopped when carrying out traditional therapy. The use of improved complex treatment with the inclusion of preformed exposure factors contributed to the reduction in the production of NO and endothelin-1, the normalization of epithelial cells and the restoration of the vasomotor function of the endothelium. The use of laser-magnetic vaginal exposure in the early period of treatment and rehabilitation of IDPO patients may help prevent chronic inflammation and normalize the specific functions of the female body.


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