scholarly journals Obesity – threat to the reproductive potential of Russia

2019 ◽  
Vol 16 (3) ◽  
pp. 20-28 ◽  
Author(s):  
Elena N. Andreeva ◽  
Ekaterina V. Sheremetyeva ◽  
Valentina A. Fursenko

Obesity is a recurring polyetiological disease. Overweight are 3060% of women of reproductive age, and 2527% are obese. By 2025, it is expected that 50% of women on our planet will be obese. Obesity in women of reproductive age is accompanied by a high frequency of anovulation, hyperandrogenism, menstrual irregularities, endometrial pathology, infertility. During pregnancy, this group of women has a higher risk of short term loss, including pregnancy in the outcome of assisted reproductive technologies. Weight gain and obesity can lead to decreased fertility in women. The body mass index of a woman of reproductive age negatively affects the course of pregnancy, namely: the risk of gestational diabetes, increased blood pressure, eclampsia, the pathological course of the birth act and the pathology of the newborn increase. Obesity in women of reproductive age is an independent risk factor for cancer: breast cancer and endometrial cancer, and also leads to a decrease in the survival rate for ovarian cancer. Obesity often accompanies polycystic ovary syndrome, which occurs in every 10th patient of reproductive age. The combination of these diseases increases the risk of cardiometabolic conditions such as impaired glucose tolerance, type 2 diabetes and dyslipidemia. Weight loss in these patients is a necessary component of complex therapy aimed at improving reproductive potential.

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Vittorio Unfer ◽  
John E. Nestler ◽  
Zdravko A. Kamenov ◽  
Nikos Prapas ◽  
Fabio Facchinetti

Polycystic ovary syndrome (PCOS) is a common endocrine disorder, with complex etiology and pathophysiology, which remains poorly understood. It affects about 5–10% of women of reproductive age who typically suffer from obesity, hyperandrogenism, ovarian dysfunction, and menstrual irregularity. Indeed, PCOS is the most common cause of anovulatory infertility in industrialized nations, and it is associated with insulin resistance, type 2 diabetes mellitus, and increased cardiovascular risk. Although insulin resistance is not included as a criterion for diagnosis, it is a critical pathological condition of PCOS. The purpose of this systematic review is the analysis of recent randomized clinical trials of inositol(s) in PCOS, in particular myo- and D-chiro-inositol, in order to better elucidate their physiological involvement in PCOS and potential therapeutic use, alone and in conjunction with assisted reproductive technologies, in the clinical treatment of women with PCOS.


Author(s):  
Spiridenko G.Yu. ◽  
Petrov Yu.A. ◽  
Palieva N.V.

Infertility is currently a priority problem for women of reproductive age. One of the reasons for this condition may be premature ovarian insufficiency. This is a pathological process causes by primary hypogonadism that occurs in women under 40 years of age. Its prevalence varies from 1:10,000 at the age of 20 to 1:100 at an older age. The absence of specific clinical manifestations of the disease complicates its early diagnosis and timely treatment. This pathological process manifests itself as secondary oligo-or amenorrhea, infertility. Less often, before the onset of reproductive disorders, there are manifestations of estrogenic insufficiency - vasomotor disorders - hot flashes, hyperhidrosis, cephalgia, tachycardia, arterial hypertension, emotional and vegetative disorders-irritability, asthenic manifestations, anxiety, depression, hypo - thymia, decreased libido. The lack of accurate data on etiological factors makes it harder to find methods for preventing this disease. The main direction of treatment is hormone replacement therapy, aimed at eliminating the insufficiency of natural estrogens in the woman's body. The chances of successful realization of the reproductive potential depend on the value of the follicle-stimulating hormone, since its high concentration affects the mitotic activity of granulosa cells of the follicle, which confirms the validity of hormone replacement therapy. The non-occurrence of pregnancy after therapy forces the patient to use assisted reproductive technologies using donor embryos and oocytes, while the effectiveness of in vitro fertilization does not exceed 58%. To prevent this outcome, if a woman has risk factors for developing premature ovarian insufficiency, it is necessary to timely assess the ovarian reserve with the preservation of her own oocytes for subsequent assisted reproductive technologies.


2021 ◽  
Vol 14 (3) ◽  
pp. 1305-1308
Author(s):  
Muhjah Falah Hassan ◽  
Pallav Sengupta ◽  
Sulagna Dutta

Polycystic ovarian syndrome (PCOS) is the most common cause of anovulatory fertility problems in women of reproductive age, with a prevalence as high as 40% to 75%. There are different treatment modalities for increasing the chance of pregnancy in PCOS patients. Since most of the PCOS patients suffer from ovulatory problems, therapeutic efforts are focused mainly towards restoring normal ovulation. However, even after pharmacological interventions to ameliorate ovulatory irregularities, women with polycystic ovary are still at high risk of fetal loss. Thus, assisted reproductive techniques (ARTs) have become popular approaches which significantly increase the chances of successful pregnancy in these women, bypassing the conditions of PCOS. The present mini-review ‘pinpoints’ on the suitability of ARTs for PCOS patients who fail to ovulate following the conventional infertility treatment. The article also briefly explains how intracytoplasmic sperm injection (ICSI), the most effectiveART, correlates with better biological parameters, fertilization rate and better quality of embryos in PCOS women.


2012 ◽  
Vol 08 (01) ◽  
pp. 57 ◽  
Author(s):  
Sanam Lathief ◽  
Lubna Pal ◽  
◽  

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy seen in women of reproductive age. Clinical concerns relating to PCOS range from ovulatory infertility and menstrual disorders to risk of diabetes and cardiovascular disease. Hormonal contraceptives have been the mainstay of the management of common PCOS symptoms, such as menstrual irregularity and clinical stigmata of androgen excess (i.e., hirsutism and acne). An appreciation of the relevance of metabolic pathways in the pathophysiology of PCOS is relatively recent, and has translated into an expansion of the therapeutic strategies available for the management of PCOS. Insulin sensitizers were one of the first metabolic modulators to be incorporated in the clinical management paradigm, albeit with mixed results. Recognizing that insulin resistance is central to the pathophysiology of PCOS, newer agents—e.g., thiazolidinediones— followed, with almost comparable efficacy to metformin. Statins and most recently incretins constitute novel therapies with distinct metabolic targets that seem to hold promise in the management of PCOS. In tandem with the expansion in pharmaceuticals, a host of complementary and alternative medical therapies have generated interest for purported promise in the management of PCOS, including vitamin D, acarbose, and myo-inositol. The therapeutic options for managing PCOS-related infertility have also expanded. Clomiphene citrate (CC) has long been the first-line strategy for ovulation induction in the setting of anovulatory infertility; however, aromatase inhibitors are fast gaining acceptance as an ovulation induction strategy, with results comparable or even better than those seen with CC. An increasing level of therapeutic sophistication is reflected in ovarian stimulation protocols judiciously using gonadotropins, gonadotropin-releasing hormone antagonists, the procedure of ovarian drilling, and assisted reproductive technologies within vitrooocyte maturation.


2013 ◽  
Vol 27 (S1) ◽  
Author(s):  
Alex Kojo Anderson ◽  
Vanessa R Silva ◽  
Richard D Lewis ◽  
Stephen Rathbun ◽  
Dorothy B Hausman ◽  
...  

Author(s):  
Ekaterina Andreevna Sterlyova ◽  
Tatiana Kharitonovna Timokhina ◽  
Yuriy Viktorovich Sivkov ◽  
Alexandr Anatolyevich Markov ◽  
. Huldani ◽  
...  

Autoimmunity of the thyroid gland (TAI) or its dysfunction is quite common among women of reproductive age, and there are suggestions in the literature that they are associated with an unfavorable level of fertility and a negative outcome of pregnancy, as in the case of spontaneous conception or after assisted reproductive technologies (ART). This assumption makes it necessary to screen autoantibodies to thyrotropin (TSH) and thyroid peroxidase among infertile women who have made a number of attempts to become pregnant. Some authors have conducted a number of studies where they have examined the relationship between autoimmunity of the thyroid gland, thyroid function, and fertility. However, there is currently no consensus on the upper limit of the norm for TSH to determine thyroid dysfunction and the limits for intervention. Despite the recent update of the American thyroid Association (ATA) on guidelines for the diagnosis and treatment of thyroid diseases during pregnancy and the postpartum period, many issues remain unresolved in ART. The author came to the following conclusions: open thyroid dysfunction often leads to menstrual disorders, fertility problems, and pregnancy complications, and therefore should be treated accordingly. Currently, there is little evidence to recommend treatment with levothyroxine at TSH levels between 2.5 and 4.0 MMU / l, given the possible side effects of overtreatment, especially in patients with mild thyroid dysfunction. We suggest careful longitudinal monitoring, especially in the presence of thyroid antibodies in women undergoing ART. The 4 MMU / l limit for TSH appears as the intervention level for SCH treatment in women with and without transabdominal utrasound in ART.


2019 ◽  
Vol 68 (2) ◽  
pp. 17-22
Author(s):  
Olga N. Arzhanova ◽  
Anna V. Rulyova ◽  
Yulia M. Paykacheva ◽  
Alina O. Ivanova ◽  
Natalya G. Nichiporuk

Hypothesis/aims of study. Gestational diabetes mellitus (GDM) is one of the leading causes of perinatal morbidity and mortality. The use of assisted reproductive technologies (ART) is an independent risk factor for the development of GDM. Among other risk factors are overweight, diabetes burdened heredity, previous GDM, previous birth weight more than 4 kgs, stillbirth, miscarriage in history, glucosuria, polyhydramnios in this pregnancy, age over 30 years, polycystic ovary syndrome. The most significant risk factor for GDM is excess weight before pregnancy. The aim of this study was to investigate the risks of GDM in patients after ART. Study design, materials, and methods. 342 case histories of women with single pregnancy for the period 2014–2017 were studied on archival material. The main group consisted of 234 women with single pregnancy after ART. The comparison group comprised 108 medical records of fertile women with a history of single pregnancy that occurred spontaneously. The exclusion criteria in the comparison group were pregestational diabetes mellitus and severe extragenital pathology. Results. The incidence of GDM was significantly higher in the group of women in whom pregnancy occurred after ART compared to the comparison group (15.4 ± 0.4% and 5.5 ± 0.4% respectively). In the main group, patients were more likely to have overweight, extragenital pathology and pregnancy complications. Conclusion. The increase in the frequency of GDM among patients after ART is probably associated with late reproductive age, initially negative somatic background at the time of entry into the IVF protocols, as well as long-term hormone therapy during pregnancies after ART, starting from early terms.


2016 ◽  
pp. 152-154
Author(s):  
Yu.P. Bogoslav ◽  
◽  
I.D. Gulmamedova ◽  
R.R. Ahmerov ◽  
A.M. Yakovets ◽  
...  

The objective: to improve the efficiency of infertility treatment methods with the help of assisted reproductive technologies by supplementing a set of preparatory measures with autoplasma treatment via the PlasmoliftingTM technology. Patients and methods. The study involved 93 women of reproductive age (63 infertile patients prepared for IVF, and 30 healthy women). Results. The use of autologous plasma in compliance with the developed technology allowed to increase significantly the number of oocytes and endometrial thickness in IVF cycle, resulting in increased procedure efficiency by 10%. Conclusions. We recommend the use of autologous plasma under the developed technology in women while preparing for the IVF cycle. Key words: female infertility, IVF, autoplasma, Plasmolifting.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Anastasia Smykalova ◽  
Svetlana Kalinchenko ◽  
Aigul Safi ◽  
Mekan Orazov ◽  
Alexander Nizhnik

Abstract An analysis of the structure of the causes of infertility shows that up to almost 25% of women of reproductive age ovulation disorders are observed. Hormonal disorders leading to the absence of ovulation, began to play a leading role in the etiology of infertility, special vitamin D deficiency, while today it has been established that its D receptors (VDR) are localized in most organs, including reproductive ones. VDR affect the expression of 1000 genes and play a crucial role in the implementation of sex hormones function. The aim of the study was to assess the vitamin D level in women of reproductive age, depending on the presence of signs of PCOS and waist circumference (WC). 71 women from 19 to 44 years old were examined of these, 41 patients were diagnosed with PCOS and impaired ovulatory function, in 30 patients the ovulatory cycle was preserved, and signs of PCOS were not detected. The level of vitamin 25 (OH) D3 in the serum of the subjects was evaluated by tandem chromato-mass spectrometry at the ArchiMed clinic of new medical technologies, Moscow. In the recommendations of the Canadian “The Vitamin D society”, 40-60 ng/ml the optimal level of serum vitamin D, a concentration of 20-40 ng/ml insufficiency, <20 ng/ml as a deficiency. Vitamin D deficiency was detected in 57% of women in both groups, with a pronounced deficiency (<10 ng/ml) in 17%, insufficiency was observed in 43% of cases, a sufficient level was not detected in any of the subjects. The average level of vitamin D in patients with PCOS was 18.2 (2 to 32.3) ng/ml, the value in patients without signs of PCOS was 18.5 (6.8 to 31) ng/ml. Comparison of the vitamin D value with WC showed that in women with PCOS with an WC <80 cm the value of this indicator was 18.8 ng/ml, and for WC ≥ 80 cm it was statistically significantly lower - 13.3 ng/ml (p<0.05). Conclusion. High prevalence of vitamin D deficiency among patients of reproductive age, with no differences in the magnitude of this indicator depending on the presence of signs of PCOS and persistent ovulation. Difference was established between the levels of vitamin D in patients with PCOS depending on the waist circumference - its insufficiency increases with an increase in WC. The results of the study suggest that the deficiency of vitamin D in the body increases with the aggravation of hormonal dysfunction in PCOS, which should be taken into account by specialists during the management of this category of patients and the treatment of infertility.


Sign in / Sign up

Export Citation Format

Share Document