THE HYPERPROLACTINEMIA IN GYNECOLOGICAL PRACTICE: ETIOLOGY, PATHOGENESIS, CLINICAL PRESENTATION, DIAGNOSIS, TREATMENT
О.R. Grigoryan, А.А. Larina, E.N. Andreeva, G.A. Melnichenko
The hyperprolactinemia is often associated with different menstrual disorders and may be the cause of endocrine infertility in 25—40%. Pregnancy, lactation and stress as well as pituitary and parasellar tumors, some medications, renal failure, hepatic cirrhosis and hypothyroidism can lead to prolactin level elevation. The dopamine agonist therapy (cabergoline and bromocriptine) is recommended for management of hyperprolactinemia. They may be used during pregnancy. The patients with hyperprolactinaemia have a significant chance of normalizing their prolactin levels at menopause. The need of hyperprolactinaemia and microprolactinoma treatment in menopause should be reassessed.
Key words: hyperprolactinemia, pituitary tumors, dopamine agonists, pregnancy, menopause (page 14—20).
THE APOPTOSIS OF LYMPHOCYTES IN WOMEN WITH HISTORY OF MISSED ABORTION
G.N. Chistjakova, M.N. Tarasova, I.A. Gazieva, I.I. Remisova, D.V. Pogorelko
The immunological examination of 21 women with and 9 women without the history of missed abortion was made in order to evaluate the realization and regulation of apoptosis. The count of apoptotic lymphocytes in the endometrial tissue increased in women with history of missed abortion. The high count of proapoptotic factor TNF-α was accompanied by a decrease of expression of CD95, the marker of readiness to apoptosis.
Key words: missed abortion, apoptosis, regulation of apoptosis (page 27—30).
THE COMPARATIVE ANALYSIS OF EFFECTIVENESS OF DIENOGEST AND LEUPRORELIN IN THE COMPLEX TREATMENT OF GENITAL ENDOMETRIOSIS
L.V. Adamyan, M.M. Sonova, O.N. Loginova, E.S.Tikhonova, E.L. Yarotskaya, E.V. Zimina, Z.Kh. Murdalova, N.M. Shamugiya, A.V. Laskevich
The experience of dienogest 2 mg versus 3.75 mg leuprorelin usage in treatment of pain symptoms associated with endometriosis is presented. The efficiency of dienogest and leuprorelin was comparable regarding pain symptoms, clinical manifestations and the quality of life in patients with endometriosis. Toleration of endometriosis treatment with dienogest was better. Dienogest is an effective therapeutic alternative to GnRH agonists in the treatment of endometriosis.
Key words: endometriosis, dienogest, gonadotropin-releasing hormone analogs, pelvic pain (page 33—38).
MODERN LOOK ON ENDOMETRIAL RECEPTIVITY AND THIN ENDOMETRIUM IN ART CYCLES (A REVIEW)
C.Yu. Boyarsky, S.N. Gaidukov, N.A. Palchenko
There is no clear definition of the “thin” endometrium. Current researches show that the pregnancy rate in ovum donation cycles does not depend on the thickness of the endometrium and the 6—7 mm endometrium thickness may be considered as sufficient for embryo transfer. At the same time, the minimal endometrium thickness in IVF/ICSI cycles with ovarian stimulation is assessed should be 7—8 mm. Thickness of 5 mm or less is associated with a poor prognosis in cycles with embryo transfer. The proposed methods of endometrium thickness increasing should be confirmed with the use of evidence-based medicine.
Key words: endometrial receptivity, thin endometrium, ovum donation, IVF/ICSI (page 51—60).
THE COMPARISON OF PREPARATORY HORMONE THERAPY VERSUS MODIFIED NATURAL CYCLE FOR THE TRANSFER OF EMBRYOS CRYOPRESERVED BY DIFFERENT METHODS
Ya.N. Kravchuk, A.S. Kalugina
The efficiency of endometrial preparation for transfer of thawed embryos, cryopreserved by vitrification or low freezing method, with the help of HRT versus modified natural cycle is analyzed. It was established that vitrification method provides better embryo survival rate and results in a higher clinical pregnancy rate than slow freezing method. The impact of different endometrial preparation regimes on clinical pregnancy rate was not revealed.
Key words: vitrification, slow freezing, embryo transfer, natural cycle (page 61—66).
LH-CONTAINING RECOMBINANT AND URINARY GONADOTROPINS IN THE PREVENTION OF POOR OVARIAN RESPONSE IN IVF-ET
К.V. Кrasnopolskaya, Т.А. Nazarenko, А.N. Beketova, V.N. Ivakhnenko, D.I. Kabanova
The comparative data characterizing the ability of LH-containing preparations, urinary and recombinant gonadotrophins, to prevent suboptimal/poor response and their influence on IVF outcomes in women with prognosis of poor ovarian response are represented.
Key words: infertility, IVF, Menopur, Pergoveris (page 67—70).
LEGISLATIVE APPROACHES IN THE APPLICATION OF ASSISTED REPRODUCTIVE TECHNOLOGIES
S.SH. Murzabaeva, Yu.V. Pavlova
The article provides a comparative analysis of the existing legislation concerning the reproductive human rights to assisted reproductive technologies. The structural changes in legal rules governing the procedures of assisted reproductive technologies are marked. The required conditions for assisted reproduction techniques and gaps in the legal regulation in this area are discussed.
Key words: reproductive rights, reproductive health, population policy, family planning, assisted reproductive technology (page 71—74).
COMPACT MORULA STAGE BIOPSY IMPROVES THE DIAGNOSTIC RELIABILITY OF PREIMPLANTATION GENETIC SCREENING (PGS) AND PROVIDES A HIGH PREGNANCY RATE (OUTCOME OF 215 CYCLES OF IVF-ICSI-PGS)
E.E. Zakharova, V.V. Zаletova
The present study was the first to demonstrate that compact morula stage biopsy is possible to provide sufficient cellular material for preimplantation genetic diagnosis/screening. Mechanical cell damage is minimal, which considerably facilitates nuclear fixation for FISH. There is enough time after biopsy to obtain PGD/PGS results for embryo transfer on day-5 or 6 in the same IVF cycle. After biopsy almost all embryos examined can reach blastocyst stage and pregnancy rate is comparable with that of IVF program without PGD. It means no negative effect of compact stage biopsy on further human embryo development both in vitro and in vivo.
Key words: Day 4 biopsy, compact morula stage, PGD, PGS, FISH (page 75—81).
THE INFLUENCE OF CONTROLLED OVARIAN STIMULATION ON MORPHOLOGICAL PARAMETERS OF PREIMPLANTATION EMBRYOS
N.V. Leonov, L.L. Tikhonova
The article presents a comparative analysis of the gonadotropin (highly purified and recombinant) influence on the morphology of embryos at early cleavage stages. The research revealed that the usage of highly purified urine gonadotropin leads to the obtaining of a greater number of good-quality embryos on the second and third days of cultivation.
Key words: stimulation, gonadotropin, oocyte, embryo, morphology (page 82—84).
OBSTETRIC ASPECTS OF VARICOSE VEINS OF THE VULVA, VAGINA AND PERINEUM
E.N. Kravchenko, Yu.T. Tsukanov, I.A. Krivorotov
It was revealed that varicose veins of the vulva, vagina and perineum (VVVVP) on pregnancy and birth is more common in multiparous women with complicated obstetric history and multipara. Gynecological diseases, combined with other extragenital pathology, and pregnancy complications were more common in women with VVVVP. Varicose veins of the vulva, vagina and perineum increases the frequency of perineal ruptures during delivery, bleeding from soft tissue injuries of the birth canal. All women with varicose veins of the vulva, vagina and perineum delivered by cesarean section also had pelvic veins varicose.
Key words: varicose veins of the vulva, vagina, perineum, obstetric complications (page 85—89).
THE ROLE OF VULVOVAGINAL OPPORTUNISTIC INFECTIONS AND INBORN IMMUNITY IN PREGNANTS WITH REALIZATION OF FETAL INFECTION
V.L. Tyutyunnik, N.E. Kan, Т.E. Karapetyan, N.A. Lomova, E.A. Kogan
The role of opportunistic vulvovaginal infections in pregnant women in the implementation of congenital infection in their newborns by measuring the intensity of color receptors for IL-6 and TLR2 in the tissue of the placenta was studied in two groups: with and without vulvovaginal opportunistic infections. Immunohistochemical investigation of two markers in 100 placentas was performed. The morphological and immunnogistochemical study of placentas showed the activation receptors for IL-6 as a largest response to infection. The level of NF-kB is increased in patients with bacterial vaginosis and combination of bacterial vaginosis and aerobic vaginitis. IL-6 receptor is increased in cyto- and syncytiotrophoblast in the group patients with aerobic vaginitis. Significant increase in NF-kB in vascular endothelium and macrophages in patients with a combination of bacterial vaginosis and aerobic vaginitis indicates the usefulness of this marker for determining the presence of inflammation in this group of patients.
Key words: innate immunity, opportunistic vulvovaginal infections, TSRs, IL receptors (page 95—98).
CLINICAL AND PROGNOSTIC SIGNIFICANCE OF AUTOANTIBODIES FOR THE GESTATIONAL HYPERTENSION AND PREECLAMPSIA
N.A. Shahbazova
The aim of this study was to determine early preclinical immunological markers of gestational hypertension and pre-eclampsia. The plasma level of twelve natural autoantibodies were measured in 120 pregnant women with gestational hypertension and pre-eclampsia (group I), 50 pregnant women at the same gestational age (control group) and 100 healthy pregnant women before 16 weeks (group II). The levels of В-2QP, S-100 and ANCA autoantibodies were increased during pregnancy in women with gestational hypertension and pre-eclampsia. The level of autoantibodies directly correlate with the severity of hypertensive disorders.
Key words: pregnancy, gestational hypertension, pre-eclampsia, autoantibodies (page 99—102).