In vitro maturation of immature oocytes for fertility preservation in cancer patients compared to control patients with fertility problems in an in vitro fertilization program

Background The aim of this study was to determine whether in vitro maturation (IVM) of immature oocytes after controlled hormonal stimulation of the ovaries could be important in cancer patients to improve their chances of conception in the future. Patients and methods After ovarian stimulation in cancer patients, the number of oocytes and their quality and maturity were compared to control patients with fertility problems in the in vitro fertilization (IVF) program. In both groups of patients, immature oocytes at the developmental stage of germinal vesicle were matured in vitro and the proportion of oocytes that matured in vitro was compared between groups. In a subset of women with fertility problems, intracytoplasmic sperm injection (ICSI) was performed on IVM oocytes to assess their ability to be fertilized and develop into an embryo compared to vivo matured oocytes in the same cycles and consider the procedure in cancer patients. Results In patients with different cancers, the disease did not affect the number and quality of retrieved oocytes. In cancer patients, there was even a significantly lower proportion of immature oocytes than in patients with fertility problems (30.0% vs. 43.6%; P < 0.05). However, in patients with cancer, fewer oocytes per patient matured in vitro than in patients with fertility problems (1.39 ± 1.04 vs. 2.48 ± 1.83; P < 0.05). After ICSI, the proportions of fertilized oocytes and fertilized oocytes developing into an embryo did not differ between oocytes matured in vitro and in vivo in the same cycles. Conclusions Oocyte IVM is proving to be a reliable procedure for resolving immature oocytes after controlled ovarian stimulation in cancer patients.

ANALYSIS OF CHANGES IN ELECTROLYTE PARAMETERS IN WOMEN DURING IN VITRO FERTILIZATION PROGRAM

Aim of the research. To determine the concentration of basic plasma electrolytes in women in in vitro fertilization program who received more individualized medication correction on the basis of determination the clinical and pathogenetic role of disorders of the neuroendocrine regulation of water-salt metabolism, as well as to study data of the modern methods of prevention and correction of electrolyte disorders. Research materials. 110 patients in vitro fertilization program were examined. Conclusions. Thus, when using standard protocols for ovulation stimulation in in vitro fertilization program patients are more prone to have potassium and sodium imbalance. Ovarian hyperstimulation syndrome was detected only in patients of the main group with the standard ovulation induction protocols. This syndrome was not observed in patients receiving the combination therapy.

Seasonal changes of macronutrients concentration in olive trees grown in acid and in alkaline soils

Leaf samples from mature olive (Olea europaea L. cv. ‘Kalamon’) trees were collected monthly from April 2018 to March 2019 from two olive orchards, cultivated one in acid and one in alkaline soil, located in Western Greece. Nitrogen (N), phosphorus (P), potassium (K), calcium (Ca), and magnesium (Mg) concentrations in the leaves were determined and seasonal variation curves were calculated for each nutrient and orchard. The seasonal concentration patterns of N, P, K, Ca, and Mg nutrients were almost similar in both soils. Seasonal variation nutrient curves independently of soil acidity varied according to vegetation stages and no significant differences in nutrient concentrations were observed at different development stages between olives grown in the acid or the alkaline soils, with only one exception the leaf K concentration. The nutrient concentration measured in wintertime was at a sufficient level for optimum olive growth in both orchards. These concentrations could be used as reference values for leaf analysis interpretation and for developing an optimum fertilization program under Mediterranean climatic conditions.

THE RISK OF DEVELOPING GYNECOLOGICAL CANCER IN WOMEN AFTER AN IN VITRO FERTILIZATION PROGRAM

This article presents reviews of literature sources on the issue of assessing the risk of developing gynecological cancer in women after an in vitro fertilization program. Infertility and infertile marriages have now become quite a big problem of modern medicine. Against the background of the unfavorable demographic situation in the Russian Federation, this problem is becoming quite urgent. The main way to solve this situation is assisted reproductive technologies, among which the most common is in vitro fertilization. The in vitro fertilization program is accompanied by a hormonal ovulation stimulation procedure to obtain a female germ cell capable of fertilization. Against the background of the active use of the in vitro fertilization procedure, many patients had concerns related to the risk of developing gynecological cancer after the IVF procedure, which is due to the use of hormonal drugs to stimulate the ovaries. Also of concern is the fact that certain types of cancer, including ovarian cancer, endometrial cancer and breast cancer, are hormone-dependent. In this regard, multiple large-scale studies were conducted, which showed that the risk of developing gynecological cancer is really increased in patients after the in vitro fertilization program. In particular, breast cancer in women after the in vitro fertilization program is more common by 10%, and in women without a history of pregnancy and over the age of 40, it is more common by 31%. The increased risk may be due to age-related vulnerability to the effects of hormones or higher doses of hormones during the IVF procedure. Ovarian cancer and endometrial cancer are also more common in patients after IVF. According to the research results, it is suggested that it is not the IVF procedure itself that causes the development of cancer, but excessive hormonal load of the body, which leads to the launch of carcinogenesis.

Еffectiveness and safety of the in vitro fertilization program for HIV infection in men

Purpose of the study: to evaluate the effectiveness and safety of IVF/ICSI program for couples with HIV infected men.Research and methods. Prospective clinical study was applied to 169 infertile married couples. The main group of subjects was 94 couples with HIV infected men. The control group included 75 couples with HIV negative status for both partners. In the main group there were carried out 60 treatment IVF/ICSI cycles and 31 frozen protocols, in the control group 86 and 39 cycles respectively. Before the Assisted Reproductive Technology (ART) was applied to the HIV infected men they were tested for DNA HIV in purified spermatozoa by PCR method. To evaluate the seroconversion in 21 days following the embryo transfer the women were tested for the presence of an antigen/antibodies to the HIV virus.Results. Clinical pregnancy rate [6 (19,4%) and 17 (27%); p=0,41] as well as birth rate [5 (16,1%) and 11 (17,5%); p=0,87] in couples with HIV infected male was comparable to the control group. The testing of semen samples showed no RNA HIV in 100% cases. Evaluation of seroconversion showed absolutely no antibodies to HIV in the women’s blood in 100% cases.Conclusion. Implementation of the IVF/ICSI program for discordant married couples with HIV infected male showed the rate of pregnancy onset which is comparable to the HIV seronegative control. Ejaculate processing of HIV infected male using «double» gradient and swim up is turns to be the measure to prevent horizontal transmission of the virus. This method can be recommended when implementing ART for couples with HIV infected male, both in the case of infertility and according to epidemiological indications.

Assisted reproductive technologies and their impact on a woman's body

A review of the literature data is presented, which indicates the possible influence of assisted reproductive technologies (ART) on the formation of both systemic and retinal vascular pathology. Despite the fact that the overall incidence of thromboembolic complications as a result of the use of ART is low, nevertheless, in women included in the in vitro fertilization program, their risk increases by 10 times. Therefore, due to the adverse effect of these drugs on the hemostatic system of a woman, ophthalmologists should be more wary of them in order to detect vascular retinal pathology in a timely manner. Key words: assisted reproductive technologies, in vitro fertilization, hyperestrogenism, vascular retinal pathology.

THE USE OF THE PRP THERAPY TO ACTIVATE FOLLICULOGENESIS IN WOMEN OF THE LATE REPRODUCTIVE AGE IN PROGRAMS OF ASSISTED REPRODUCTIVE TECHNOLOGIES

The rate of infertility in married couples of reproductive age in this country makes up from 10 to 15%, in some regions this value is close to 20% - acritical level that has a negative impact on demographic figures. The rate of pregnancy depends directly on the women’s age and decreases by 3.3times starting from the age of 19 and by the age of 48. The decrease in the ability to conceive is accounted for by subtle mechanisms related to thedeterioration of the quality of oocytes. The patients who are prepared for an extracorporeal fertilization program (ECF) and do not respond tocontrolled ovarian hyperstimulation protocols are considered to be poor respondents. Many studies focused on the development of an optimaltreatment method. However, none of the approaches seems to be effective enough to guarantee a successful use. Platelet-rich plasma is a new andpromising method that is successfully used in the reproductive science to solve a number of medical problems. All the patients whose commonfeatures were low oocyte output and poor embryo quality as well as failed ECF attempts were offered a treatment method of autologous PRP therapyafter their written consent. Three months later, one obtained astonishing results, which by the markers of biochemical infertility alone could beclassified as a complete biological phenomenon and are also characterized by improved embryo quality. The results of hormonal homeostasis show adecrease in the level of the follicle-stimulating hormone by 67.33% while the level of the anti-muellerian hormone is 75.18% higher.Thus, the use of the PRP therapy in poor respondents helps them to overcome their problematic reproductive barrier.

Cultivar-rootstock interactions on growth, yield and mineral nutrition of newly planted peach trees in a pot experiment

Two peach cultivars, i.e. ‘Andross’ and ‘Mercil’ were budded onto four rootstocks of varying vigor (‘Garnem’, ‘GF 677’, ‘Rootpac R’ (RPR) and ‘Rootpac 20’ (RP20)) and planted in pots. The plants were grown for three years, and each year the growth of the trees (in terms of trunk cross sectional area, tree height, and shoot length), fruit production and leaf nutrient concentration were assessed. The rootstock exerted a significant effect on the above-measured variables, as the lowest tree height in both cultivars was recorded when these were grafted on RP20 (the most dwarfing rootstock of all four used). The yield per tree was highest when the most vigorous rootstocks. ‘Garnem’ resulted in the highest upper plant dry weight, while ‘RP20’ in the lowest. Cultivar exhibited a significant effect regarding leaf nutrient concentration, as ‘Andross’ presented higher concentrations of N, K, Ca and Fe in most combinations and lower concentrations of P and Cu. The discriminant analysis, using all growth and nutrient data from the last two years, revealed that irrespective of the cultivar budded, ‘RP20’ and ‘GF 677’ were clearly distinguished from each other and from ‘RPR’ and ‘Garnem’. On the other hand, the hierarchical agglomerative analysis pointed out the crucial role of ‘RP20’ and ‘Garnem’ on tree growth and leaf nutrient concentration, with the cultivar budded on them playing a minor role. In conclusion, the fertilization program of a young, newly established orchard, should take into account the singularity of each scion-rootstock combination, to achieve the optimum tree performance.