scholarly journals Chronic Niche Inflammation in Endometriosis-Associated Infertility: Current Understanding and Future Therapeutic Strategies

2018 ◽  
Vol 19 (8) ◽  
pp. 2385 ◽  
Author(s):  
Yi-Heng Lin ◽  
Ya-Hsin Chen ◽  
Heng-Yu Chang ◽  
Heng-Kien Au ◽  
Chii-Ruey Tzeng ◽  
...  

Endometriosis is an estrogen-dependent inflammatory disease that affects up to 10% of women of reproductive age and accounts for up to 50% of female infertility cases. It has been highly associated with poorer outcomes of assisted reproductive technology (ART), including decreased oocyte retrieval, lower implantation, and pregnancy rates. A better understanding of the pathogenesis of endometriosis-associated infertility is crucial for improving infertility treatment outcomes. Current theories regarding how endometriosis reduces fertility include anatomical distortion, ovulatory dysfunction, and niche inflammation-associated peritoneal or implantation defects. This review will survey the latest evidence on the role of inflammatory niche in the peritoneal cavity, ovaries, and uterus of endometriosis patients. Nonhormone treatment strategies that target these inflammation processes are also included. Furthermore, mesenchymal stem cell-based therapies are highlighted for potential endometriosis treatment because of their immunomodulatory effects and tropism toward inflamed lesion foci. Potential applications of stem cell therapy in treatment of endometriosis-associated infertility in particular for safety and efficacy are discussed.

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (1) ◽  
pp. 50-54
Author(s):  
Zukhra Kh. Ebzieva ◽  
Svetlana V. Yureneva ◽  
Tatiana Yu. Ivanets

Aim. To conduct a comparative analysis of serum orexin A levels in women of different age periods with and without sleep disorder and vasomotor symptoms. To evaluate the dynamics of orexin A levels under menopausal hormone therapy. Materials and methods. The study included 50 postmenopausal women and 30 women of reproductive age with a regular menstrual cycle. Using block randomization, patients are divided into 3 groups: group 1 (main group), n=25, -STRAW+ 10 (+1b and +1c), patients with sleep disorder and vasomotor symptoms; group 2 (comparison group), n=25, STRAW+ 10 (+1b and +1c), patients with vasomotor symptoms without sleep disorder; group 3 (control group), n=30, STRAW+ 10 (-4), women of reproductive age without sleep disorder. Group 1 patients were given menopausal hormone therapy. A comparative analysis was carried out using the questionnaire for assessing menopausal symptoms severity by the Greene Scale (the Greene Climacteric Scale) and Rating Scale for subjective sleep characteristics. After 12 weeks of treatment, a control examination was performed. Results. In group 1 women, the serum orexin A levels were significantly higher compared to the women without the symptoms. The link between the orexin A levels and menopause syndrome severity was established. A significant decrease in the menopausal symptoms severity after 12 weeks of menopausal hormone therapy was shown. It was accompanied by a 1,3-fold decrease in orexin A levels. Conclusions. The obtained data indicate the possible role of orexin A and the orexin neuropeptide system in the pathogenesis of sleep disorder and vasomotor symptoms in postmenopausal women.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Muhammad Farhan Asif ◽  
Zahid Pervaiz ◽  
Jawad Rahim Afridi ◽  
Ghulam Abid ◽  
Zohra S. Lassi

Abstract Background Family planning services deliver a wide range of benefits to the well-being of females and the community. It can curtail the risk of maternal and neonatal mortality through the reduction in abortions and pregnancies. The government of Pakistan has been struggling to convince people about the usefulness of family planning programs. However, different factors related to social norms, values, and culture are important to determine the success of these programs. One such factor is the patriarchal structure of Pakistani society where most of the household decisions are made by men. The objective of this research is to examine the role of the husband’s attitude towards the usage of contraceptives for the unmet need of family planning (UMNFP) among married women of reproductive age (MWRA) in Pakistan. Method The dataset of Pakistan Demographic and Health Survey 2017–18 is utilized to examine the role of the husband’s attitude towards the usage of contraceptives in UMNFP among MWRA in Pakistan. Results The UMNFP was considerably lower among MWRA between 40 years and above compared to women 15–19 years. The odds of UMNFP were higher among women and men who were educated up to the primary level compared to those with no education. Odds of UMNFP were higher among women from the poor wealth quintile compared to the poorest wealth quintile; similarly, it was significantly lower among women who were from the richer and the richest wealth quintile compared to the poorest wealth quintile. The odds of UMNFP were lower among women who were employed compared to those who were not employed. Lastly, the odds of UMNFP were higher among women whose husbands opposed to using contraceptives, who perceived that there was a religious prohibition for such use and when a decision on the contraception use was solely made by the husband. Conclusions Husband’s attitude towards the usage of contraceptives is an important predictor of UMNFP. Liaising with the community and religious leaders to persuade people particularly men about the usefulness of family planning programs and encouraging men to understand their women’s say in using contraceptives should be encouraged.


2021 ◽  
Vol 68 (1) ◽  
pp. 40-47
Author(s):  
Catalina Diana Stanica ◽  
◽  
Adrian , Neacsu ◽  
Romina Marina Sima ◽  
Raluca Gabriela Ioan ◽  
...  

Endometriosis is a benign, chronic, estrogen-dependent condition, present in 10% of women of reproductive age. The condition is associated with chronic pelvic pain and infertility that influence their quality of life, as well as married life and has important socio-economic consequences. Despite its high morbidity, its etiopathogenesis is incompletely known. A large number of studies suggest that the ability of endometrial implants to grow in ectopic locations may be correlated with the altered immune response towards the endometriotic tissue. There are enough data to show that immune system mediators, such as cytokines and chemokines, are playing key roles in the onset and olso on progression of endometriosis. There are studies that prove the association between endometriosis and autoimmune diseases. The present paper aims to investigate the implications of the immune response in the etiopathogenesis of endometriosis. The study of cellular or humoral immunity deficits, the presence of autoantibodies associated with this condition, can facilitate the understanding of the mechanisms that lead to the appearance and spread of endometriosis. We hope that this information will ultimately provide the basis for the development of new effective approaches in endometriosis management.


2018 ◽  
Author(s):  
Bri Anne McKeon ◽  
Sarah Lambeth

The ability to diagnose early pregnancy and manage normal and abnormal findings associated with early pregnancy is important and commonly used in the medical care of women of reproductive age. The purpose of this review is to describe the evaluation of early pregnancy, discuss indications for early evaluation of pregnancy location, delineate diagnostic strategies to further evaluate pregnancy of unknown location, and review current treatment strategies for ectopic pregnancies, both tubal and nontubal in location.   This review contains 11 figures, 4 tables and 39 references Key words: early pregnancy, ectopic, human chorionic gonadotropin, methotrexate, pregnancy of unknown location, salpingectomy, salpingostomy, ultrasound criteria, vaginal bleeding


2021 ◽  
pp. 590-593
Author(s):  
Anton Iu. Tsukanov ◽  

Recurrent lower urinary tract infections are common among women. One of the important factors of their genesis is sexual activity: there is a positive correlation between sexual intercourse frequency and recurrences of lower urinary tract infections. Post coital cystitis accounts for 30–40% of all chronic recurrent cystitis and occurs in about 25–30% of women of reproductive age. One of the methods for the prevention of post coital cystitis is the use of D-mannose, the effectiveness of which was demonstrated with a clinical example.


Author(s):  
Najma Malik ◽  
Navneet Dubey

Background: PCOS is one of the most common endocrine disorder in women of reproductive age, it affects about 5-10% of women of reproductive age. It is characterized by chronic anovulation, hyperandrogenism, and insulin resistance. 30-40% of PCOS women have impaired glucose tolerance.Methods: This was prospective observational study carried out on 100 patients of PCOS visiting outpatient Department of Obstetrics and Gynecology, BRD Medical College, Gorakhpur from 1st July 2018 to 30th June 2019. Patients were diagnosed as PCOS on basis of Rotterdam criteria. In these 100 patients, oral inositol 2 gm twice daily was given for 3 months to 6 months depending upon the response of the patient and patients were examined every 4 week for menstrual regularity, acne improvement, hirsutism, spontaneous ovulation and pregnancy.Results: With inositol supplementation, menstrual abnormality corrected in 80% cases, 45% cases having acne improved. Ovulation occurred in 75.5% cases and 66.6% cases conceived with inositol supplementation.Conclusions: Insulin resistance is the basic pathophysiology for PCOS hence inositol supplementation is supposed to be very good medicine for management of PCOS to improve insulin sensitivity. Inositol leads to improvement in regularity of menstrual cycle, insulin resistance, hyperandrogenic features like hirsutism, acne, restores ovulation and improves oocyte quality.


Author(s):  
Kusum V Shah ◽  
Sonal Goyal ◽  
Saket Kumar ◽  
Arti D Shah ◽  
Yash Rana

Pulmonary Lymphangioleiomyomatosis (LAM) is a rare disease, mostly seen in women of reproductive age group. Most common presentation is dyspnoea on exertion, may be associated with haemoptysis and chest pain. LAM is a cystic lung disease, with a poor prognosis and is difficult to treat. In this case reports, we discussed two patients who presented with dyspnoea and chest pain due to pneumothorax and were later diagnosed as case of LAM on clinical and radiological basis. Intercostal Chest tube Drainage (ICD) was inserted for resolution of pneumothorax and subsequently pleurodesis was done to prevent recurrent pneumothorax. In case of recurrent pneumothorax, LAM should be considered as a differential diagnosis. Pleurodesis can be considered to prevent recurrent pneumothorax.


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