scholarly journals Improvement Effect of Metformin on Female and Male Reproduction in Endocrine Pathologies and Its Mechanisms

2021 ◽  
Vol 14 (1) ◽  
pp. 42
Author(s):  
Alexander O. Shpakov
Keyword(s):  
Diabetes Mellitus ◽  
Pregnancy Outcomes ◽  
Hormonal Regulation ◽  
Ovarian Function ◽  
Assisted Reproductive Technologies ◽  
Polycystic Ovary ◽  
Health Effect ◽  
Reproductive Technologies ◽  
Male Reproduction ◽  
Endocrine Disorders

Metformin (MF), a first-line drug to treat type 2 diabetes mellitus (T2DM), alone and in combination with other drugs, restores the ovarian function in women with polycystic ovary syndrome (PCOS) and improves fetal development, pregnancy outcomes and offspring health in gestational diabetes mellitus (GDM) and T2DM. MF treatment is demonstrated to improve the efficiency of in vitro fertilization and is considered a supplementary drug in assisted reproductive technologies. MF administration shows positive effect on steroidogenesis and spermatogenesis in men with metabolic disorders, thus MF treatment indicates prospective use for improvement of male reproductive functions and fertility. MF lacks teratogenic effects and has positive health effect in newborns. The review is focused on use of MF therapy for restoration of female and male reproductive functions and improvement of pregnancy outcomes in metabolic and endocrine disorders. The mechanisms of MF action are discussed, including normalization of metabolic and hormonal status in PCOS, GDM, T2DM and metabolic syndrome and restoration of functional activity and hormonal regulation of the gonadal axis.

scholarly journals Inositol and folates in the restoration of reproductive function in women and prevention of congenital malformations

2021 ◽  
pp. 95-100
Author(s):  
H.I. Reznichenko ◽  
Y.H. Reznichenko
Keyword(s):  
Folic Acid ◽  
Reproductive Health ◽  
Congenital Malformations ◽  
Ovarian Function ◽  
Assisted Reproductive Technologies ◽  
Polycystic Ovary ◽  
Reproductive Technologies ◽  
Late Gestation ◽  
Trophoblast Invasion ◽  
Pregnancy And Childbirth

In recent years, Ukraine has seen a significant deterioration in the reproductive health of women in the face of declining birth rates. One of the main causes of comorbidity of infertility and background pathologies is the insufficient supply of a woman's body in the pre-pregnancy period with micronutrients – folate, vitamins, myo-inositol and others. This increases the risk of complications during pregnancy and childbirth and congenital malformations.Literature analysis showed that myo-inositol in combination with folate are an extremely important way to prevent fertility disorders, complications of pregnancy and childbirth, congenital malformations and support the reproductive health of the next generation. Myo-inositol in combination with folic acid promotes the effects of luteinizing and follicle-stimulating hormones, normalization of ovarian function, oocyte quality, trophoblast invasion during blastocyst attachment, prevention of congenital malformations by neutralizing the action of homocysteine with metafolin in the pregravid period and during pregnancy and assisted reproductive technologies, reducing the incidence of miscarriage, preeclampsia and other complications. The neuroprotective effect of myo-inositol indicates the importance of its use for fetal neuroprotection in late gestation, especially in hypoxia.Fertifolin, which contains an improved combination of natural nutrients as myo-inositol 1000 mg and folic acid 100 µg in the form of metafolin (calcium L-methylfolate), successfully copes with this goal. Metafolin has greater bioavailability and more actively helps to increase the level of folate in blood plasma, in contrast to folic acid. Metafolin is characterized by fewer drug interactions and less often masks the symptoms of B12-deficient anemia, reduces the risk of anemia, placental dysfunction, malformations of the neural tube. Fertifolin is also effectively used as an adjunct in polycystic ovary syndrome and in assisted reproductive technology protocols.

scholarly journals Infertility and reproductive disorders: impact of hormonal and inflammatory mechanisms on pregnancy outcome

2015 ◽  
Vol 22 (1) ◽  
pp. 104-115 ◽  
Author(s):  
Silvia Vannuccini ◽  
Vicki L. Clifton ◽  
Ian S. Fraser ◽  
Hugh S. Taylor ◽  
Hilary Critchley ◽  
...  
Keyword(s):  
Pregnancy Outcome ◽  
Pregnancy Outcomes ◽  
Assisted Reproductive Technologies ◽  
Negative Impact ◽  
Polycystic Ovary ◽  
Reproductive Technologies ◽  
Obstetric Complications ◽  
Reproductive Disorders ◽  
Childbearing Age ◽  
Increased Risk

Abstract BACKGROUND Reproductive disorders and infertility are associated with the risk of obstetric complications and have a negative impact on pregnancy outcome. Affected patients often require assisted reproductive technologies (ART) to conceive, and advanced maternal age is a further confounding factor. The challenge is to dissect causation, correlation and confounders in determining how infertility and reproductive disorders individually or together predispose women to poor pregnancy outcomes. METHODS The published literature, to June 2015, was searched using PubMed, summarizing all evidences concerning the perinatal outcome of women with infertility and reproductive disorders and the potential mechanisms that may influence poor pregnancy outcome. RESULTS Reproductive disorders (endometriosis, adenomyosis, polycystic ovary syndrome and uterine fibroids) and unexplained infertility share inflammatory pathways, hormonal aberrations, decidual senescence and vascular abnormalities that may impair pregnancy success through common mechanisms. Either in combination or alone, these disorders results in an increased risk of preterm birth, fetal growth restriction, placental pathologies and hypertensive disorders. Systemic hormonal aberrations, and inflammatory and metabolic factors acting on endometrium, myometrium, cervix and placenta are all associated with an aberrant milieu during implantation and pregnancy, thus contributing to the genesis of obstetric complications. Some of these features have been also described in placentas from ART. CONCLUSIONS Reproductive disorders are common in women of childbearing age and rarely occur in isolation. Inflammatory, endocrine and metabolic mechanisms associated with these disorders are responsible for an increased incidence of obstetric complications. These patients should be recognized as ‘high risk’ for poor pregnancy outcomes and monitored with specialized follow-up. There is a real need for development of evidence-based recommendations about clinical management and specific obstetric care pathways for the introduction of prompt preventative care measures.

scholarly journals Impact of myo-inositol treatment in women with polycystic ovary syndrome in assisted reproductive technologies

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Philippe Merviel ◽  
Pandora James ◽  
Sarah Bouée ◽  
Mathilde Le Guillou ◽  
Camille Rince ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Embryo Quality ◽  
Ovarian Function ◽  
Assisted Reproductive Technologies ◽  
Polycystic Ovary ◽  
Reproductive Technologies ◽  
Review Of The Literature ◽  
Ovary Syndrome ◽  
Randomized Controlled ◽  
The Impact

AbstractPolycystic ovary syndrome (PCOS) is marked in 30 to 40% by insulin resistance and hyperandrogenism. Myo-inositol (MI) increases insulin sensitivity, decreases hyperandrogenism and improves the menstrual cycle. Its effect during assisted reproductive technologies (ART) has been studied by many authors. We conducted a review of the literature on the impact of MI administration in PCOS women in assisted reproductive technologies. Myo-inositol is effective in normalizing ovarian function, improving oocyte and embryo quality in PCOS, however further evaluations by large multicentre randomized controlled trials are needed to assess the clinical pregnancy and live birth rates in ART.

scholarly journals Risk of developing gestational diabetes in women after assisted reproductive technologies

2019 ◽  
Vol 68 (2) ◽  
pp. 17-22
Author(s):  
Olga N. Arzhanova ◽  
Anna V. Rulyova ◽  
Yulia M. Paykacheva ◽  
Alina O. Ivanova ◽  
Natalya G. Nichiporuk
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Gestational Diabetes ◽  
Comparison Group ◽  
Assisted Reproductive Technologies ◽  
Polycystic Ovary ◽  
Significant Risk ◽  
Reproductive Technologies ◽  
Main Group ◽  
Reproductive Age

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.

The role of the growth hormone in assisted reproductive technologies cycles

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (4) ◽  
pp. 6-8
Author(s):  
Andrey Y Romanov ◽  
Anastasiya G Syrkasheva ◽  
Nataliya V Dolgushina ◽  
Elena A Kalinina
Keyword(s):  
Growth Hormone ◽  
Live Birth ◽  
Ovarian Stimulation ◽  
Assisted Reproductive Technologies ◽  
Polycystic Ovary ◽  
Live Birth Rate ◽  
Reproductive Technologies ◽  
Blood Levels ◽  
Main Research ◽  
Poor Ovarian Responders

The paper analyzes the literature data on the use of the growth hormone (GH) in ovarian stimulation in assisted reproductive technologies (ART). Routine use of GH in ovarian stimulation in patients with a normal GH level does not increase pregnancy and childbirth rates in ART. Also, no benefits of using GH have been identified for patients with polycystic ovary syndrome, despite the increase in insulin and IGF-1 blood levels. The main research focus is to study the use of GH in patients with poor ovarian response. According to the meta-analysis conducted by X.-L. Li et al. (2017), GH in ovarian stimulation of poor ovarian responders increases the number of received oocytes, mature oocytes number, reduces the embryo transfer cancellation rate and does not affect the fertilization rate. The pregnancy and live birth rates are significantly higher in the group of GH use - by 1.65 (95% CI 1.23-2.22) and 1.73 (95% CI 1.25-2.40) times, respectively. Thus, it is advisable to use GH in ovarian stimulation in poor ovarian responders, since it allows to increases live birth rate in ART. However, further studies should determine the optimal GH dose and assesse it`s safety in ART programs.

Genetic polymorphisms of reproductive hormones and their receptors in assisted reproduction technology for patients with polycystic ovary syndrome

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Yulia A. Koloda ◽  
Yulia V. Denisova ◽  
Natalia M. Podzolkova
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Assisted Reproductive Technologies ◽  
Polycystic Ovary ◽  
Ovarian Response ◽  
Reproductive Technologies ◽  
Reproductive Hormones ◽  
Current Data ◽  
Nucleotide Polymorphisms ◽  
Ovary Syndrome ◽  
Art Programs

Abstract Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in women of childbearing, which is defined by the accumulation of multiple, small fluid-filled ovarian cysts without the selection of a single dominant follicle. Most PCOS phenotypes are characterized by the absence of spontaneous ovulation, resistance toward ovulation inductors, the production of a large immature oocytes number, and the high prevalence of ovarian hyperstimulation syndrome, resulting in reduced assisted reproductive technologies (ART) programs effectiveness. The review analyses current data about the relationship between polymorphism genotypes of KISS genes, follicle stimulating hormone (FSH), luteinizing hormone (LH), anti-Müllerian hormone (AMH) and their receptors genes, gonadotropin-releasing hormone (GnRH), estrogen, and progesterone receptors genes, the PCOS risk and the features of ovarian response to stimulation during ART cycles. The use of single nucleotide polymorphisms (SNPs) as prognostic markers of ART programs outcomes would provide a personalized approach to the drugs and doses choice for ovarian stimulation and significantly increase the chance of pregnancy.

scholarly journals Erbb4 regulates the oocyte microenvironment during folliculogenesis

2020 ◽  
Vol 29 (17) ◽  
pp. 2813-2830
Author(s):  
Ville Veikkolainen ◽  
Nsrein Ali ◽  
Milena Doroszko ◽  
Antti Kiviniemi ◽  
Ilkka Miinalainen ◽  
...  
Keyword(s):  
Ovarian Function ◽  
Polycystic Ovary ◽  
Association Studies ◽  
Reproductive Function ◽  
Intercellular Junctions ◽  
Ovary Development ◽  
Endocrine Disorders ◽  
Metabolic Systems ◽  
Reproductive Endocrine

Abstract Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders leading to infertility in women affecting reproductive, endocrine and metabolic systems. Recent genomewide association studies on PCOS cohorts revealed a single nucleotide polymorphism (SNP) in the ERBB4 receptor tyrosine kinase 4 gene, but its role in ovary development or during folliculogenesis remains poorly understood. Since no genetic animal models mimicking all PCOS reproductive features are available, we conditionally deleted Erbb4 in murine granulosa cells (GCs) under the control of Amh promoter. While we have demonstrated that Erbb4 deletion displayed aberrant ovarian function by affecting the reproductive function (asynchronous oestrous cycle leading to few ovulations and subfertility) and metabolic function (obesity), their ovaries also present severe structural and functional abnormalities (impaired oocyte development). Hormone analysis revealed an up-regulation of serum luteinizing hormone, hyperandrogenism, increased production of ovarian and circulating anti-Müllerian hormone. Our data implicate that Erbb4 deletion in GCs leads to defective intercellular junctions between the GCs and oocytes, causing changes in the expression of genes regulating the local microenvironment of the follicles. In vitro culture assays reducing the level of Erbb4 via shRNAs confirm that Erbb4 is essential for regulating Amh level. In conclusion, our results indicate a functional role for Erbb4 in the ovary, especially during folliculogenesis and its reduced expression plays an important role in reproductive pathophysiology, such as PCOS development.

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