EVALUATION OF HORMONAL FUNCTION IN WOMEN WITH CERVICAL INSUFFICIENCY AND INFERTILITY IN THE HISTORY

2021 ◽  
Vol 74 (10) ◽  
pp. 2412-2416
Author(s):  
Oksana M. Perkhulyn ◽  
Lyudmyla V. Pakharenko ◽  
Vladyslav S. Sukhin ◽  
Oleksiy V. Saltovskiy ◽  
Viktoriia M. Kovalchuk ◽  
...  
Keyword(s):  
Blood Serum ◽  
Pregnant Women ◽  
Hormonal Treatment ◽  
Placental Lactogen ◽  
Cervical Insufficiency ◽  
Vitro Fertilization ◽  
Healthy Women ◽  
History Of ◽  
Anovulatory Infertility

The aim: To assess the levels of hormones in women with cervical insufficiency and infertility in the history in the II trimester of gestation. Materials and methods: 120 pregnant women with cervical insufficiency and anovulatory infertility in the history were examined in the II trimester of gestation: in the I group (60 persons) pregnancy occurred after hormonal treatment of infertility, in the II group (60 individuals) – after in vitro fertilization. 30 pregnant women without cervical insufficiency and a history of infertility were controls. The levels of estradiol, progesterone, placental lactogen, prolactin and cortisol were determined in the blood serum. Results: The concentration of maternal progesterone was lower in the persons in the I group on 12.36 %, in the II group – on the 15.37 % (p=0.03) compared to the healthy women. Cortisol and prolactin amounts were statistically higher in I and II groups (p<0.001) than in controls. While the levels of estradiol and placental lactogen were slightly less in the subjects with cervical insufficiency and a history of anovulatory infertility compared to the healthy women. Conclusions: In pregnant women with cervical insufficiency and a history of anovulatory infertility in the II trimester of gestation there are decrease progesterone level and high prolactin and cortisol concentrations in blood serum. The changes in estradiol and placental lactogen amounts are not significant compared to healthy women.

scholarly journals Assessment of the hormonal levels in different management strategies for women with cervical insufficiency and a history of anovulatory infertility

2021 ◽  
Vol 23 (1) ◽  
pp. 98-104
Author(s):  
L. V. Pakharenko ◽  
O. M. Perkhulyn
Keyword(s):  
In Vitro Fertilization ◽  
Management Strategies ◽  
Placental Lactogen ◽  
Cervical Insufficiency ◽  
Cervical Cerclage ◽  
Vitro Fertilization ◽  
Vaginal Progesterone ◽  
History Of ◽  
Anovulatory Infertility

Cervical insufficiency (CI) is one of the causes of preterm birth. The rate of CI is higher in women after in vitro fertilization treatment for infertility compared to the general population. The aim. To assess the hormonal level in women with CI and a history of anovulatory infertility in the second and third trimesters of pregnancy in different management strategies for CI. Materials and methods. 60 pregnant women with CI who conceived through in vitro fertilization treatment for anovulatory infertility were divided into two groups: in the I group (30 women), CI was corrected only with cervical cerclage / pessary in the II trimester of pregnancy, in the II group (30 persons), cervical cerclage / pessary was combined with vaginal progesterone 200 mg ones a day until 34 full weeks of gestation. 30 pregnant women without СІ or infertility with the physiological course of pregnancy were controls. The concentrations of estradiol, progesterone, placental lactogen, prolactin and cortisol were determined in the terms of 19–22 and 30–32 weeks of gestation in the maternal blood serum. Results. In the patients with CI at 19–22 gestational weeks, the estradiol and placental lactogen concentrations were slightly lower in the I and II groups than those in the control women, the level of progesterone was less in the I group by 13.44 %, in the II group – by 17.30 % (P < 0.05) compared to the controls; the levels of prolactin and cortisol in the I and II groups were increased significantly (P < 0.001). At 30–32 gestational weeks, the levels of estradiol (P < 0.05), progesterone (a decrease of 23.10 %, P < 0.001) and placental lactogen (a decrease of 10.74 %, P < 0.05) were significantly less as compared to the physiological ranges, while these parameters in the II group patients were on the lower limit of normal. In the I group, the concentrations of prolactin and cortisol were higher by 41.70 % (P < 0.001) and 27.36 % (P < 0.001), respectively, than the controls, in the II group – only by 24.10 % (P < 0.05) and 13.70 % (P < 0.05), respectively. Conclusions. In the women with cervical insufficiency after in vitro fertilization treatment for anovulatory infertility, the levels of estradiol, progesterone and placental lactogen are not significantly different from physiological indices, but the prolactin and cortisol concentrations are much higher. Adjunctive vaginal progesterone treatment to cervical cerclage/pessary in the third trimester of pregnancy promotes the normalization of progesterone, estradiol and placental lactogen levels, the decrease in prolactin and cortisol indices at 30–32 gestational weeks compared to the women with cervical cerclage/pessary alone.

scholarly journals Cervical elastograhy in patients with cervical insufficiency and a history of anovulatory infertility

2021 ◽  
Vol 3 ◽  
pp. 34-36
Author(s):  
O.M. Perkhulyn ◽  
L.V. Pakharenko
Keyword(s):  
Reproductive Technologies ◽  
Cervical Canal ◽  
Blue Color ◽  
Cervical Insufficiency ◽  
Cervical Tissue ◽  
Vitro Fertilization ◽  
Yellow Color ◽  
History Of ◽  
Anovulatory Infertility

Cervical insufficiency is one of the most frequent reasons for late miscarriage and preterm birth. Its rate is increased in women who conceived after the use of additional reproductive technologies. The objective: to assess the parameters of cervical elastography in women with cervical insufficiency and anovulatory infertility in a history. Materials and methods. 40 pregnant women with cervical insufficiency who conceived after treatment of infertility associated with anovulation were examined in the term of 16–20 weeks: in the I group (20 persons) pregnancy conceived after conservative treatment of infertility, in the II (20 patients) – after in vitro fertilization. 20 women with the physiological course of pregnancy without cervical insufficiency and with spontaneous gestation were controls. Cervical elastography index was used to assess the strain of cervical tissue. Results. According to the results of compression elastography all patients in the I and II groups had red or yellow color of the internal cervical os and cervical canal. In the persons without cervical insufficiency the cervical tissue was firm (purple and blue color). The number of women with purple color of the anterior labia of the cervix in the I and II groups was in 4.67 (р=0.001) and 2.33 (р=0.03) times less compared to the controls, of the posterior labia – in 3,2 times (р=0.001) in both groups. Conclusion. In women with cervical insufficiency and a history of anovulatory infertility there are considerable changes of strain in internal os and cervical canal of the cervix.

scholarly journals Fetal Echocardiography:Short Term Profile from Shahid Gangalal National Heart Centre, Kathmandu, Nepal

2016 ◽  
Vol 13 (1) ◽  
pp. 9-12
Author(s):  
Sudhir Regmi ◽  
Deewakar Sharma
Keyword(s):  
Pregnant Women ◽  
Congenital Heart ◽  
Fetal Echocardiography ◽  
Tertiary Care ◽  
Outcome Data ◽  
Cross Sectional ◽  
Vitro Fertilization ◽  
History Of ◽  
Sectional Analysis

Background and Aims: Fetal echocardiography is helpful in early detection of Congenital Heart Disease. Our study was conducted to evaluate the most common indications of referral and outcome in a tertiary-care fetal echocardiography practice.Methods: A Cross-sectional analysis of all pregnant women referred by obstetricians to cardiology unit for fetal echocardiography over a 1-year period (July 2014 and July 2015) was performed. The primary indications for referral for fetal echocardiography were obtained from the obstetric referral forms. Outcome data were extracted from performa containing client’s demographic, physical examination and the fetal echocardiograhic data. Postnatal Echocardiography was advised to all cases having positive echocardiographic finding.Results: A series of 251 fetal cardiac studies were reviewed. Average gestational age was 25.6 weeks (range, 18 to 38 weeks). Thirty-eight (15.1%) pregnant women had abnormal fetal cardiac findings. The most common referral for fetal cardiac scan was related to maternal indications (48.6%). Other indications were abnormal prenatal fetal findings in ultrasonography (23.1%), family history of CHD (12%), general screening (15.5%), and follow up of IVF (In-vitro fertilization) (0.8%). The highest yield of significant abnormal findings was there among patients referred with abnormal prenatal fetal finding in ultrasonography (47%).Conclusion: Majority of referral were for abnormal prenatal ultrasonographic findings. So, fetal Echocardiography is an important part of overall management of the pregnancy at risk for producing an infant with congenital heart disease.Nepalese Heart Journal 2016; 13(1): 9-12

scholarly journals Features of establishment of early lactation in women who gave birth after in vitro fertilization

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
P Samchuk ◽  
Y Rozalieva ◽  
A Gil
Keyword(s):  
Medical Personnel ◽  
Placental Lactogen ◽  
Control Group ◽  
Early Lactation ◽  
Vitro Fertilization ◽  
Hormonal Function ◽  
History Of ◽  
Placental Hormone ◽  
And Control

Abstract Background Breastfeeding gives babies the best possible start in life and breastmilk works like a baby’s first vaccine. Pregnancy resulting from IVF is often associated with placental insufficiency in which the hormone-producing function of placenta can be compromised that may result in reduced lactogenesis. The aim was to study the emergence of early lactation after IVF in women with a history of infertility. Methods The study involved 34 women after IVF with a singleton full-term pregnancy with a history of tubal-peritoneal infertility. Control group comprised of 47 women with naturally occurred pregnancy. Delivery occurred naturally. All women were assessed for hormonal function of placenta for a period of 16-18, 28-32, and 37-38 weeks of pregnancy. The average daily amount of milk on a 5th day after delivery was measured. Results In the IVF group vs. control group there was a decrease in the production of hormones by the placenta (progesterone, estriol, placental lactogen) preparing the mammary glands for lactation (p &lt; 0.05). At gestational age of 16-18 weeks progesterone level in IVF group was 172.2±10.72 nmol/l; 28-32: 274.2±8.45 nmol/l; 37-38 weeks: 343.2±9,1 nmol/l. The level of estriol at 16-18 weeks was 2.87±1.42 ng/ml; 28-32: 10.94±0.6 ng/ml; 37-38 weeks: 25.21±0.22 ng/ml. Placental lactogen at16-18 weeks: 1.15±0.2 nmol/l; 28-32: 6.39±0.69 nmol/l; 37-38 weeks: 7.23±0.59 nmol/l. On day 5 normal lactation was observed in 21(62%) and 43(91.5%) women in IVF and control group, respectively (p &lt; 0.05). Conclusions Increased number of cases of hypolactation was observed in women after IVF, which was associated with decrease in the hormonal function of placenta. Women who have given birth to children after IVF require special attention from the side of medical personnel and from loved ones in the early stages of establishment of breastfeeding. Key messages IVF is a risk factor for hypolactation, which is associated with placental hormone-producing insufficiency. Women who have given birth after IVF require support aimed at promotion of early lactation and breastfeeding.

scholarly journals EVALUATION OF HORMONAL ASPECTS BY CERVICAL INSUFFICIENCY IN WOMEN WITH HISTORY OF INFERTILITY

2020 ◽  
Vol 20 (2) ◽  
pp. 76-79
Author(s):  
O.M. Perkhulyn
Keyword(s):  
Blood Serum ◽  
Pregnant Women ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Main Group ◽  
The Body ◽  
Control Group ◽  
Cervical Insufficiency ◽  
The Past ◽  
History Of

Introduction. Today, the frequency of infertility is increasing worldwide. Infertility, associated with anovulation, is especially challenging for the medical correction especially. The leading aspect of this problem is hormonal disorders in the body of a woman. The aim of this study was to assess the level of estradiol and progesterone in the blood serum of pregnant women with cervical insufficiency and infertility associated with anovulation in the history. Materials and methods. The main group included 30 pregnant women with the II trimester of pregnancy, who had cervical insufficiency and infertility associated with anovulation in the past medical history. They got pregnant after assisted reproductive technologies. The control group included 30 pregnant women without cervical insufficiency and with physiological gestation. Estradiol and progesterone levels in blood serum were determined at 20-22 and 30-32 weeks of gestation. Results. The average age of the women in the basic group was statistically higher relative to the control one – 31.30±1.16 and 27.30±0.92 years, respectively (p=0.02). There was no difference in the number of pregnancies in women between both groups. In the main group, 73.33% of the persons were primagravida, 10.00 % of patients had two pregnancies, and 16.67 % - three pregnancies. 56.67 % of the women in the control group were primagravida, 26.67 % had two pregnancies, 16.66 % - three pregnancies. Although primaparas predominated in both groups, the number of such women was in 1.47 times higher in the main group (93.33 %) than in control (63.33 % of patients; χ2=6.28, p=0.01); 6.67 % and 26.67 % women had two labors respectively and 10.00 % of healthy patients - three labors. The concentration of estradiol at the 20-22 and 30-32 weeks of pregnancy in women of the main group almost corresponded to physiological parameters. However, the progesterone level in women with cervical insufficiency and a history of infertility was by 13.44 % lower than in healthy pregnant women at 20-22 weeks, and by 17.02% at 30-32 weeks (p=0.003). Conclusions. In pregnant women with cervical insufficiency and infertility associated with anovulation, the level of estradiol in the II and III trimesters of gestation mainly corresponds to the level of physiological pregnancy. However, they have the decrease in progesterone concentration in the III trimester of pregnancy relative to healthy pregnant women (p<0.003).

scholarly journals Impact of the Vaginal and Endometrial Microbiome Pattern on Assisted Reproduction Outcomes

2021 ◽  
Vol 10 (18) ◽  
pp. 4063
Author(s):  
María del Carmen Diaz-Martínez ◽  
Andrea Bernabeu ◽  
Belén Lledó ◽  
Concepción Carratalá-Munuera ◽  
Jose A. Quesada ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Relative Abundance ◽  
Diversity Index ◽  
Alpha Diversity ◽  
Vitro Fertilization ◽  
Alpha And Beta Diversity ◽  
History Of ◽  
Health And Disease ◽  
Lactobacillus Spp

Uterine microbiota may be involved in reproductive health and disease. This study aims to describe and compare the vaginal and endometrial microbiome patterns between women who became pregnant and women who did not after in vitro fertilization. We also compared the vaginal and endometrial microbiome patterns between women with and without a history of repeated implantation failures (RIF). This pilot prospective cohort study included 48 women presenting to the fertility clinic for IVF from May 2017 to May 2019. Women who achieved clinical pregnancy presented a greater relative abundance of Lactobacillus spp. in their vaginal samples than those who did not (97.69% versus 94.63%; p = 0.027. The alpha and beta diversity of vaginal and endometrial samples were not statistically different between pregnant and non-pregnant women. The Faith alpha diversity index in vaginal samples was lower in women with RIF than those without RIF (p = 0.027). The alpha diversity of the endometrial microbiome was significantly higher in women without RIF (p = 0.021). There were no significant differences in the vaginal and endometrial microbiomes between pregnant and non-pregnant women. The relative abundance of the genera in women with RIF was different from those without RIF. Statistically significant differences in the endometrial microbiome were found between women with and without RIF.

Peculiarities of pregnancy and delivery course in women after the application of assisted reproductive technologies against obesity (Based on the retrospective analysis)

2018 ◽  
pp. 122-126
Author(s):  
I.A. Zhabchenko ◽  
◽  
O.R. Sudmak ◽  
Keyword(s):  
In Vitro Fertilization ◽  
Pregnant Women ◽  
Retrospective Analysis ◽  
Perinatal Outcomes ◽  
Reproductive Technologies ◽  
Ischemic Lesion ◽  
Vitro Fertilization ◽  
Pregnancy And Delivery

The objective: to study the structure and frequency of complications of pregnancy, deliveries and perinatal outcomes in three groups of women: women with infertility and obesity, treated by application of in vitro fertilization (hereinafter IVF), pregnant women after IVF application with normal body weight, and pregnant women on the background of obesity which did not have an infertility in past history. Materials and methods. A retrospective analysis of 221 case histories of pregnancies and labors in women who were treated and gave birth in the Pregnancy and delivery pathology Department of SI «Institute of Pediatrics, Obstetrics and Gynecology named after Acad. O. M. Lukyanova of NAMS of Ukraine» for 2012 – 2016 years was carried out. Results. The overwhelming majority of pregnant women after IVF on the background of obesity are primaparas, who have a complicated obstetric history, hormonal changes in the form of progesterone deficiency predominantly and chronic inflammatory processes. Pregnancy with a combination of infertility, treated by the means of IVF application, and obesity, in most cases is accompanied by a long-term threat of termination of pregnancy (48.8%), threatening preterm deliveries (56%), placental dysfunction (41.5%), premature rupture of the amniotic membranes (41.5%), other problems during pregnancy, at the same time, every second woman (58.5%) had a combination of several complications, and required a long-term and repeated inpatient treatment (53.7%). The specific gravity of surgical delivery was 90%, and 16.2% of such deliveries were complicated by pathological blood loss. The number of preterm deliveries was 17.1%, with perinatal losses up to 11.3‰. Among full-term newborns 21.3% of newborns had malnutrition of the I degree and 17% of them had hypoxic-ischemic lesion of CNS. Conclusion. The course of pregnancy, delivery and the postpartum period in the studied contingent of women has a significant frequency of complications, mainly the coinciding ones, which affects on the consequences of perinatal outcomes and requires further study of this problem and the development of differentiated algorithms for antenatal observation. Key words: pregnancy, obesity, in vitro fertilization, complications, delivery, newborn.

Achieving pregnancy at a late reproductive age in a patient with a history of multiple failed in vitro fertilization attempts

2021 ◽  
Vol 7_2021 ◽  
pp. 202-209
Author(s):  
Kirienko K.V. Kirienko ◽  
Osina E.A. Osina ◽  
Apryshko V.P. Apryshko ◽  
Voloshanenko V.V. Voloshanenko V ◽  
Yakovenko S.A. Yakovenko S ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Reproductive Age ◽  
Vitro Fertilization ◽  
History Of

Features hormonal status in pregnant women with benign cervical pathology in anamnesis

2017 ◽  
pp. 71-73
Author(s):  
N.Yu. Bysaha ◽  
Keyword(s):  
Statistical Analysis ◽  
Pregnant Women ◽  
Placental Lactogen ◽  
Control Group ◽  
Hormonal Status ◽  
Hormonal Changes ◽  
Fetoplacental Complex ◽  
History Of ◽  
Objective Study ◽  
Stimulation Of

The objective: study of hormonal status in pregnant women with benign cervical pathology (CP) in anamnesis. Patients and methods. Clinical and statistical analysis of the hormonal status of 100 women with a history of benign CP pathology has been performed. According to the revealed symptoms of CP during colposcopic examination, women were divided into two groups: 100 pregnant women, in whom colposcopic and cytologically signs of CP pathology were not detected, were included in the control group; and 100 women who had a pathology of CP, entered the main group. Results. The study examined hormonal relationships in the system mother–placenta–fetus, namely the level of hormones such as estriol, progesterone, human chorionic gonadotropin, placental lactogen. Hormonal changes in pregnant women and contribute to reducing the immunoreactivity unwanted stimulation of existing benign hyperplastic background processes in the cervix. Conclusion. Determining functional state placenta is an important factor in the timely diagnosis of disorders in the functioning of the system mother–placenta–fetus. Key words: hormonal status, placenta, uterine cervix, fetoplacental complex.

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