scholarly journals ESTIMATION TO EFFICIENCY OF THE MULTIFUNCTION METHOD ОF ENDOMETRIOSIS OVARIЕS TREATMENT

2020 ◽  
Vol 73 (5) ◽  
pp. 868-872
Author(s):  
Iryna M. Nikitina ◽  
Volodymyr I. Boiko ◽  
Svitlana A. Smiian ◽  
Tetiana V. Babar ◽  
Natalia V. Kalashnyk ◽  
...  
Keyword(s):  
Gonadotropin Releasing Hormone ◽  
Inhibin B ◽  
Reproductive Age ◽  
Sexual Life ◽  
Control Group ◽  
Women Of Reproductive Age ◽  
Releasing Hormone ◽  
Antral Follicles ◽  
Group I ◽  
Laparoscopic Removal

The aim: The aim of the study was to improve the results of treatment of patients with endometriosis by using a combination method of therapy. Materials and methods: For two years, 136 women of reproductive age who underwent laparoscopic surgeries for ovarian endometriosis were monitored: Group I (n = 24) did not receive any hormonal treatment in the perioperative period; Group II (n = 32) – received gonadotropin-releasing hormone agonists within 3 months after surgery; Group III (n = 80) prior to laparoscopic removal of the ovarian cyst used gonadotropin-releasing hormone agonists – Triptorelin 3.75 mg intramuscularly for 2 months, as well as three months after surgery. The control group consisted of 30 healthy women of reproductive age with regular menstrual periods. All patients underwent transvaginal ultrasound, counting the number of antral follicles before and after treatment. Serum hormone levels (FSH, prolactin, thyrotropic hormone, anti-Mullerian hormone, inhibin B) were determined by enzyme-linked immunosorbent assay on Cobas e-411 analyzer (Roche Diagnostics, Switzerland) on day 2-3 of the menstrual cycle and on day 2–3 of the first menstrual period after the end of treatment. Laparoscopic removal of the cyst was performed with exfoliation of the cyst, hemostasis on the wound surface of the bed of the cyst was performed with a bipolar electrocoagulator. Bipolar coagulation and resection of the ovarian tissue with no potential was used during surgical treatment of the ovaries, which made it possible to preserve the intact portion of the ovary as much as possible. Results: Analysis of ovarian reserve indices, namely number of antral foliculs, number of antral follicles, AMG, and inhibin B levels in all examined patients with ovarian endometriomas were significantly lower than those of the control group before the start of treatment: in the ovarian endometrial group group 1.26 times (p <0.01), inhibin B – 1.5 times (p <0.01), the number of antral follicles – 1.2 times (p <0.01), due to the development dystrophic changes of the follicular apparatus due to prolonged compression, hypoxia, fibrosis in the ovaries. Patients who planned pregnancy were advised to have an active sexual life before menstruation was restored. In 23 (46.9%) of 49 patients who had reproductive plans, pregnancy occurred without first menstruation after a course of gonadotropin-releasing hormone agonists, 12 (24.5%) women became pregnant during the first three menstrual cycles. Extracorporeal fertilization was recommended for women who did not have pregnancy within 6 months of surgery. For two years in women who did not plan pregnancy, recurrence of endometriosis was not observed. Conclusions: The combination of laparoscopic treatment with gonadotropin-releasing hormone agonists in patients with endometriosis with infertility allowed to restore reproductive function in 71.4% of women, which indicates the effectiveness of the treatment method used. In addition, it helps to achieve lasting remission and addresses the socio-social problems of women’s health and maternity.

Features of the cervix uteri in women of reproductive age with endometrial polyps and micropolyps

2016 ◽  
pp. 108-111
Author(s):  
T.F. Tatarchuk ◽  
◽  
D.G. German ◽  
Keyword(s):  
Reproductive Age ◽  
Cervix Uteri ◽  
Control Group ◽  
Women Of Reproductive Age ◽  
Endometrial Polyps ◽  
Group Iii ◽  
Aggressive Form ◽  
Group I ◽  
Group Ii ◽  
Control Group Group

The article presents the comparative analysis of the state of the cervix in women with endometrial polyps and micropolyps. Patients and methods. The study involved 130 patients aged 18-35 years: 70 patients with endometrial polyps (group I), 30 patients with micropolyps (group II) and 30 patients of the control group (group III). Results. According to the anamnesis of women in the I group were significantly more frequent diseases of the cervix, which corrected physical surgery methods, in particular cryodestruction. In group II, the representatives of these indicators were similar to healthy. Normal colposcopic picture met significantly less frequently in patients and I, and II group. The differences in the incidence of HPV high oncogenic risk in all groups were not statistically significant. Conclusion. Destructive methods used in the detection of any changes in the cervix are often overly aggressive, form scars and contributing to inflamaciones process. In the chain of events leading to the formation of PE, cervical pathology and its correction can take the basic place. Key words: endometrial polyp, micropolyps, chronic endometritis, uterine cervix, colposcopy.

scholarly journals Μελέτη των επιπέδων της ινχιμπίνης Β στον ορό εφήβων με κιρσοκήλη για την διερεύνηση της σημασίας αυτής ως προγνωστικού παράγοντα υπογονιμότητας

2015 ◽  
Author(s):  
Ευάγγελος Μπλευράκης
Keyword(s):  
Luteinizing Hormone ◽  
Gonadotropin Releasing Hormone ◽  
Inhibin B ◽  
Testicular Volume ◽  
Maximal Response ◽  
Control Group ◽  
P Value ◽  
Testicular Damage ◽  
Releasing Hormone ◽  
Relationship Of

Purpose: Varicocele represents a frequent cause of male infertility. Early identification and treatment of varicocele during adolescence may reduce the risk of infertility. The relationship of varicocele and its effect on semen quality and healthy male reproduction has been investigated. However obtainement of semen samples in adolescents is a sensitive topic. Alternatively blood samples are easier to obtain compared to ejaculates. Therefore, serum biomarkers of spermatogenesis are of major interest for population studies. Inhibins are glycoproteins predominantly produced in the gonads. Inhibin B, composed of α and β subunits, is the phsiologiacally relevant form on inhibin in males. Both subunits are produced by Sertoli cells, regulated by FSH and unidentified factors related to germ cells. The aim of this study was to evaluate hormonal parameters in a group of adolescents with varicocele in order to identify prognostic factors for testicular damage.Patients and Methods: Twenty adolescents at Taner stage 4-5 with left varicocele were studied and compared with a control group of twenty healty adolescents. All patients underwent ultrasonographic testicular volumetry as well as hormonal evaluation of inhibin B, testosterone, baseline and gonadotropin-releasing hormone, follicle-stimulating hormone as well as luteinizing hormone. Statistical analysis was performed using Mann - Whitney U test with p value < 0,05 taken as statistical significant. The same tests of endocrine function and testicular volume were repeated 6 months surgery following. Statistical analysis was performed using the Wilcoxon signed rank test with p value < 0,05 taken as statistical significant.Results: Patients with varicocele showed reduced levels of inhibin B compared to controls and a significant reduction in the testicular volume on the affected side. The response of luteinizing hormone to gonadotropin-releasing hormone stimulation was significantly higher in the varicocele group compared to the control group. No statistically significant differences in basal FSH, LH, testosterone and the maximal response of FSH were identified between subjects with varicocele group and the control group. Furthermore a significant inverse relationship of inhibin B compared to follicle-stimulating hormone was noted.Inhibin B levels were significantly higher following surgery in the same population. The left testis volume showed a significant increase 6 months postoperatively. Baseline FSH levels were significantly higher after surgery compared to preoperative levels. No statistically significant differences in basal LH, testosterone and the maximal response of LH were found between subjects with varicocele before and after surgery. A postoperative decrease of luteinizing hormone maximal serum levels following gonadotropin releasing hormone stimulation was noted but it was not statistically significant. Furthermore inhibin B levels in varicocele patients after surgery positively correlated with bilateral testicular volume and the correlation coefficient of inhibin B compared with baseline FSH was negative and statistical significant.Conclusion: In the light of these findings inhibin B might be a useful diagnostic marker of testicular damage caused by varicocele in adolescents. Inhibin B values could assist in the selection of adolescents for surgical treatment in order to prevent future infertility problems in these subset of patients.All of these observations suggest that the deterioration of the testicular function in adolescents with varicocele is a progressive phenomenon that requires extensive work up follow up to indentify early signs of testicular dysfunction. Early identification and treatment of varicocele during adolescence may prevent further testicular damage and reduce the risk of infertility.

Relationship of the ovarian reserve with autoimmune thyroid diseases in the reproductive period

2019 ◽  
Vol 91 (10) ◽  
pp. 14-18
Author(s):  
O R Grigoryan ◽  
N S Krasnovskaya ◽  
R K Mikheev ◽  
I S Yarovaia ◽  
E N Andreeva ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Inhibin B ◽  
Reproductive Age ◽  
Fmr1 Gene ◽  
Normal Range ◽  
Women Of Reproductive Age ◽  
Antral Follicles ◽  
Antithyroid Antibodies ◽  
Healthy Women ◽  
The Status

Aim. To compare ovarian reserve in healthy women of reproductive age - carriers of antithyroid antibodies (ATA) and in healthy women of reproductive age negative for ATA. Materials and methods. 70 healthy women of young reproductive age in the state of euthyroidism (from 18 to 38 years old) were examined. Participants were divided into equal groups (n=35) depending on the status of the presence of antithyroid antibodies (AT-TPO, AT-TG). On the 2nd-4th days of the menstrual cycle, the following markers of the ovarian reserve were determined: serum levels of anti-Müllerian hormone (AMG), inhibin B, FSH, LH, estradiol, testosterone and progesterone, as well as ultrasound parameters - the number of antral follicles and the volume of the ovaries. In addition, to determine the predisposition to premature ovarian failure, an analysis was performed to the number of CGG repeats in the FMR1 gene. Results and discussion. Statistically significantly differs such parameters as the level of estradiol and testosterone, while the differences were not clinically significant. All the parameters evaluated were within the normal range, the main predictors of the ovarian reserve (levels of AMG and inhibin B, the number of antral follicles) remained in the normal range. An increase in the number of repeats of CGG in the FMR1 gene was not detected in any of the participants in the study. Conclusion. In healthy young reproductive age women, the status of ATA does not have a direct effect on the ovarian reserve.

scholarly journals Features of reproductive function in infertile women with hyperthyroidism

2021 ◽  
Vol 38 (1) ◽  
pp. 64-71
Author(s):  
L. M. Rzakulieva ◽  
A. E. Hajizade
Keyword(s):  
Thyroid Gland ◽  
Reproductive Function ◽  
Reproductive Age ◽  
Control Group ◽  
Women Of Reproductive Age ◽  
Early Menopause ◽  
Ovarian Volume ◽  
Infertile Women ◽  
Group I ◽  
Toxic Goiter

Objective. The aim was to study the characteristics of reproductive function in women of fertile age with infertility and hyperfunction of the thyroid gland. Materials and methods. The object of the study was 148 women of fertile age. To compare the indicators obtained by special methods, the control group included the indicators of laboratory and instrumental examination of 30 non-pregnant women of reproductive age. Reproductive function was evaluated in 118 women with hyperthyroidism: 58 retrospectively (group I) and 60 prospectively (group II); the control group consisted of 30 healthy women of reproductive age. Hormonal studies were performed by radioimmune and enzyme immunoassay methods using the automatic analyzer "Cobb" ("Hoffmann La Roche", Switzerland), as well as DPS test systems the analyzer Immulite (USA). Ultrasound of the thyroid gland was performed by a linear sensor with a frequency of 7.5 MHz. The volume of the thyroid gland was calculated according to the Bruno formula. Results. For women of fertile age with hyperthyroidism, a decrease in ovarian reserve is characteristic that is manifested by a significant increase in FSH level (14.1 3.1 IU / L, p 0.05), and a decrease in inhibin B level (35.9 12,7 pg / ml, p 0.05). In 47.7 % of women of fertile age with hyperthyroidism, there is a decrease in ovarian volume and a significant reduction in the average number of antral follicles of normal size (4.34 1.56, p 0.05). Conclusions. Based on the results obtained, it can be assumed that in diffuse toxic goiter there are not only functional disorders (metabolism of hormones of the reproductive system), but also deep organic changes in the structure of the ovaries that leads to a rapid suppression of their functions. In cases of thyroid diseases, the clinical manifestation of these changes is premature and early menopause.

scholarly journals Ovarian aromatase activity in endometriosis

2013 ◽  
Vol 62 (2) ◽  
pp. 17-22 ◽  
Author(s):  
Valentina Mikhaylovna Denisova ◽  
Vladimir Vsevolodovich Potin ◽  
Mariya Igorevna Yarmolinskaya ◽  
Yekaterina Mikhaylovna Timofeyeva
Keyword(s):  
Antral Follicle ◽  
Reproductive Age ◽  
Control Group ◽  
Aromatase Activity ◽  
Women Of Reproductive Age ◽  
Antral Follicles ◽  
Gonadotropin Releasing Hormone Agonist ◽  
Healthy Women ◽  
Key Enzyme

Aromatase is the key enzyme, which converts androgens into estrogens. To study the role of aromatase in pathogenesis of endometriosis 57 patients and 15 healthy women of reproductive age were examined. Aromatase activity was detected by reaction of estrogens on aromatase inhibitor letrozol intake. Ovarian source of detected aromatase activity was proved by suppression of reaction on letrozole intake during therapy with gonadotropin- releasing hormone agonist. Aromatase activity in recalculation on antral follicle in endometriosis patients withII–IV stages was higher than in healthy women, though total ovarian aromatase activity was not differed from control group because of low number of antral follicles in endometriosis patients. The disturbance of folliculogenesis in endometriosis is connected probably with hyperestronaemia, which has ovarian and extragonandal origin.

Clinical-morphological parallels in the pathogenesis of chronic inflammatory processes of internal genital organs in women with varicose veins of the small pelvis

2018 ◽  
pp. 118-122
Author(s):  
N.V. Drohomyretska ◽  
Keyword(s):  
Inflammatory Diseases ◽  
Varicose Veins ◽  
The State ◽  
Reproductive Age ◽  
Control Group ◽  
Bulbar Conjunctiva ◽  
Women Of Reproductive Age ◽  
Vein Wall ◽  
Group I ◽  
Inflammatory Processes

Violation of hemomicrocirculatory processes is in the basis of the development of diseases of various organs and systems. The study of hemomicrocirculation at all levels allows us to understand the complexity and universality of these processes, as well as opens up new perspectives in the pathogenetic approach to the treatment and prevention of the diseases. The homogeneity of the reaction of all parts of the hemomicrocirculatory bed in various diseases has been proved on the basis of clinico-morphological comparisons. Study of some areas allows us to judge the state of hemomicrocirculation as an integral system. The objective: to study and compare the changes of the hemomicrocirculatory bed (HMCB) of the conjunctiva of the eyeball and adventitia of varicose veins of the small pelvis (VVSP) in women with chronic inflammatory processes of the internal genital organs (CIPIGO). Materials and methods. There were examined 54 women with chronic inflammatory processes of internal genital organs against the background of varicose veins of the small pelvis (group I); 30 – practically healthy women (control group). The age of women was between 18 and 45 years old. Bulbar microscopy was performed using the SHL-2B slit lamp. The results of microscopy were evaluated according to the system of V.S.Volkov et al. To evaluate the restructuring of the HMCB of adventitia of VVSP, the operating material of 12 women of reproductive age was used. Mainly, these were pieces of the ovarian vein. The study of 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 state of the HMCB of venous wall adventitia was studied in norm in 5 women of reproductive age, who died as a result of various injuries. Results. Clinical-morphological parallels between changes in the HMCB of the conjunctiva of the eyeball and adventitia of the varicose veins of the small pelvis were revealed after the performed research. The arteriols’ architectonics was almost unchanged. Venules were dilated, twisted, somewhere varicose-enlarged, filled with formed elements. The structure of capillaries was polymorphic. The capillary net was localized and concentrated or shaped in the form of a thick planar net, the capillaries were expanded. In the micropreparations of the adventitia, there were arterio-venular anastomosis. The nuclei of the endothelial cells were shortened. In some preparations, the diameter of the arterioles corresponded to the diameter of the collection venules. Conclusions. 1. Our studies confirm both clinically and pathomorphologically that one of the links of the pathogenesis of CIPIGO, which occur against the background of VVSP, is a violation of HMCB. 2. Firstly, changes in the HMCB of the conjunctiva of the eyeball and adventitia of the varicose veins of the small pelvis in women with CIPIGO show that they are systemic. 3. The results obtained by us prove the necessity of the use of medicines that improve hemomicrocirculation in the treatment of CIPIGO against the background of VVSP. Key words: hemomicrocirculatory bed, bulbar conjunctiva, adventitia, varicose veins of the small pelvis, chronic inflammatory diseases of the small pelvic organs.

Functional state of the vaginal mucosa in bacterial vaginosis and its correction

2017 ◽  
pp. 77-82
Author(s):  
V.O. Beyuk ◽  
◽  
O.A. Shcherba ◽  
L.D. Lastovetska ◽  
◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Anaerobic Bacteria ◽  
Reproductive Age ◽  
High Rate ◽  
Control Group ◽  
Vaginal Mucosa ◽  
Women Of Reproductive Age ◽  
Results Of Treatment ◽  
Group I ◽  
Group Ii

Bacterial vaginosis is the most common cause of the treatment of women of reproductive age to the gynecologist. It accounts for up to 50% of cases of pathological discharge from the genital organs. In 50-75% of cases, bacterial vaginosis is asymptomatic. The examination of the patient occupies one of the key positions in the effective treatment of the patient. Nitrosamines, which are metabolites of obligate anaerobic bacteria and coenzymes of carcinogenesis, and may be one of the cause for the genesis of cervical cancer. The objective: assess the condition of the mucous membrane of the vagina and cervix in bacterial vaginosis, the effectiveness of its treatment in women of reproductive age. Materials and methods. Оf investigation 64 women of reproductive age with bacterial vaginosis were examined and treated, of which 34 patients (group I of the study) conducted our therapy which received the Tyloron and the local combined preparation of dexpanthenol and chlorhexidine bigluconate, followed by the introduction of lactobacilli in standard doses. 30 patients (group II of the study) received standard treatment. The control group consisted of 27 healthy women. Results. Results of treatment of bacterial vaginosis in women of reproductive age are presented. In 94.1% and a group of cases, we achieved a clinically significant effect, compared with group II (76.7%) of 10 days of treatment. Three months after the end of treatment, 97.1% of the patients in the main group recovered (group II – 86.6%). Conclusions. The use of the complex therapy of bacterial vaginosis proposed by us showed a high rate of recovery, and a low rate of recurrence in women of reproductive age. Key words: bacterial vaginosis, diagnosis, treatment, tyrolon, dexpanthenol, chlorhexidine.

scholarly journals THE SPECIFICITY OF THE OVARIAN RESERVE OF WOMEN WITH CHRONIC SALPINGOOPHORITIS

2018 ◽  
Vol 25 (6) ◽  
pp. 119-126
Author(s):  
V. A. Novikova ◽  
F. R. Autleva ◽  
A. A. Sorochenko ◽  
D. I. Fayzullina ◽  
E. V. Nurgalieva
Keyword(s):  
Ovarian Reserve ◽  
Reproductive Period ◽  
Main Group ◽  
Reproductive Age ◽  
Control Group ◽  
Regression Equations ◽  
Women Of Reproductive Age ◽  
Antral Follicles ◽  
Preconception Consultation ◽  
The Impact

Aim. The research was conducted for the assessment of the impact of chronic salpingoophoritis on the ovarian reserve of women in various phases of reproductive age.Materials and methods. A prospective, controlled and open cohort study was performed in 2013-2018 (n=202). The main group consisted of women with chronic salpingoophoritis (ChrSO) who applied for preconception consultation (n=138). In accordance with the reproductive age phase, the main group was divided into subgroups: the early reproductive age period (ERP, n=44), the peak reproductive age period (PRP, n=56), the late reproductive period (LRP, n=38). The control group consisted of conditionally healthy women of reproductive age (n=64). The ovarian reserve (OR) was estimated on the basis of the serum level of antimullerian hormone (AMH), inhibin B, estradiol, follicle stimulating hormone (FSH), an ultrasoundbased assessment of the number of antral follicles (AF), and the ovarian volume. Results. The age of women ranged from 18 to 40 years. Based on the discriminant analysis, it was found that the main indicators determining the specificity of the OR in ChrSO, depending on the phase of reproductive age, are the number of antral follicles, estradiol level and AMH (Wilks’ lambda = 0.35503, p<0.0001). The specificity of the OR of women with ChrSO (difference from the control group), regardless of the phase of reproductive age, initially and when evaluated after 6 months, is determined by the number of AF and the level of estradiol and AMH; the number of AF and AMH is determined with a similar estimate after 12 months. The specificity of the OR in ChrSO, which is dependent on the reproductive age phase, has been proved through the analysis with the neural networks training(the proportion of correct answers is more than 80%). The linear relationships were established between the values of each OR parameter in women with ChrSO. Initially, when estimating after 6 and 12 months, linear regression equations were calculated, allowing the values of individual OR parameters to be calculated over 6 and 12 months.Conclusion. Chronic salpingoophoritis (ChrSO) is associated with a decrease in ovarian reserve in women of reproductive age. The effect of ChrSO on some parameters of the ovarian reserve depends on the age phase of the reproductive period, which increases with time (after 6, 12 months). The presence of ChrSO in women planning future pregnancies requires preventive and therapeutic measures aimed at preserving the ovarian reserve and the preferred implementation of fertility in early reproductive age before the ovarian reserve starts to decline.

scholarly journals VULVOVAGINAL CANDIDIASIS IN COMBINATION WITH BACTERIAL VAGINOSIS IN WOMEN OF REPRODUCTIVE AGE: FEATURES OF PATHOGENESIS AND TREATMENT

2021 ◽  
pp. 12-17
Author(s):  
Svitlana Pandei ◽  
Dmytro Ledin ◽  
Oleksandra Lubkovska
Keyword(s):  
Bacterial Vaginosis ◽  
Adhesion Molecules ◽  
Vulvovaginal Candidiasis ◽  
Reproductive Age ◽  
Control Group ◽  
Women Of Reproductive Age ◽  
Combination Drug ◽  
Group I ◽  
Tnf Α ◽  
Topical Metronidazole

The aim. Reducing the recurrence of vulvovaginal candidiasis (VVC) in combination with bacterial vaginosis (BV) in women of reproductive age by studying the pathogenesis and improving the algorithm of treatment and prevention measures. Materials and methods. During the study, 150 women of reproductive age who had the same clinical manifestations of VVC and BV were selected and divided into 3 groups of 50 women: Group I was treated with an antimicrobial combination drug (miconazole with topical metronidazole), group II – the same drug in combination with probiotic (lactobacilli) in candles, group III – according to the algorithm improved by the authors. In addition, a control group was formed, which included healthy women of reproductive age.  To establish the pathogenesis of VVC in combination with BV in the studied women, the concentration of cytokines and adhesion molecules in the blood before and after treatment was determined and compared with the control group. The clinical effect of different treatments was assessed at 3, 7, 10, 14 days, and the presence of relapses – 1, 3, 6 months after treatment. Results. The occurrence of a combination of VVC and BV in women of reproductive age is accompanied by a significant increase in the level of intercellular adhesion molecules (ICAM-1) and vascular cell adhesion molecules (VCAM-1) along with a statistically significant increase in proinflammatory cytokines (interleukin-6) (IL-6), interleukin-8 (IL-8)) and tumor necrosis factor (TNF) - TNF-α. As a result of the application of the algorithm improved by the authors, higher clinical efficiency and the ability to avoid recurrence of VVC in combination with BV in women of reproductive age were obtained. Conclusions. The authors' substantiated improvement of the algorithm of VVC treatment in combination with BV in women of reproductive age makes it possible to reduce the frequency of their recurrence and restore the biocenosis of the vagina to normal. In the case of this pathology there is an increase in the level of pro-inflammatory cytokines (IL-6, IL-8), TNF-α and ICAM-1 and VCAM-1.

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