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Reproductive Endocrinology     Open Access   (Followers: 2)
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Reproductive Endocrinology
Number of Followers: 2  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2309-4117 - ISSN (Online) 2411-1295
Published by Trilist Publishing Homepage  [1 journal]
  • Diabetes mellitus in combination with COVID-19: modern views on therapy

    • Authors: V.I. Tsymbaliuk, M.D. Tronko, Y.G. Antypkin, S.V. Kushnirenko, V.V. Popova
      Pages: 8 - 20
      Abstract: Diabetic patients are in the spotlight from the early stages of a pandemic, as growing epidemiological data show they are at higher risk for severe clinical outcomes from COVID-19. As the global COVID-19 pandemic continues to evolve, it is also becoming increasingly apparent that the interactions between COVID-19 and diabetes mellitus (DM) are complex pathophysiological mechanisms. The outcome of COVID-19 is more severe in people with DM, which has the potential to accelerate the onset of acute metabolic complications of DM such as diabetic ketoacidosis and hyperglycemia. These mechanisms underlying these associations remain unclear, but they likely include the angiotensin converting enzyme receptor 2, a binding site for SARS-CoV-2, which is expressed in key metabolic organs such as in the pancreas, in particular in β-cells. The potential β-cell tropism of SARS-CoV-2 can damage cells and impair insulin secretion, causing hyperglycemia and ketoacidosis. Understanding the bidirectional interaction between DM and COVID-19 will be critical to protecting and treating people with DM. Current epidemiological data on COVID-19 do not support the hypothesis that diabetic patients are at increased risk of infection compared to the general population. To date, it has been established that decompensated DM is an independent factor that aggravates the course of coronavirus infection and significantly increases the risk of a fatal outcome of the disease.
      The review provides a brief summary of the evolution of pathogenetic and clinical aspects for understanding the mechanisms of this pathological tandem, as well as therapeutic strategies for treating patients with COVID-19 and DM. As the incidence of DM continues to rise globally, more than ever, diabetes prevention and control must be a priority for health systems around the world.
      PubDate: 2021-03-31
       
  • Regional features of pregnant women's health

    • Authors: Y.G. Antypkin, T.F. Tatarchuk, R.V. Marushko, O.O. Dudina
      Pages: 21 - 28
      Abstract: Purpose of the study: to determine the regional characteristics of the health indicators of pregnant women on the basis of integral assessment of extragenital pathology, complications and adverse consequences of pregnancy.
      Materials and methods. A comprehensive retrospective analysis of regional characteristics and dynamics of the main indicators of pregnant women’s health in Ukraine for the period 2010–2019 was carried out. According to the Center for Medical Statistics of Ukraine integral assessment (IA) of pregnant women’s health was carried out according to the generally accepted calculation method using integral indicators of the extragenital pathology frequency, pregnancy complications and its adverse consequences.
      Results. Health of pregnant women remains unsatisfactory with multidirectional trends in the frequency of individual pathologies in recent years. Simultaneously with a downward trend against the background of a high level of anemia and genitourinary system diseases (24.73 and 14.38 per 100 pregnant women in 2019, the rate of decline was 6.29% and 1.74%), gestosis, preeclampsia and eclampsia (6.57, 2.11 and 1.2%, 9.48%), not carrying a pregnancy, delivering a dead fetus (5.84, 0.43 and 15.92%, 9.3%), the incidence of circulatory system diseases and thyroid gland dysfunctions (7.61, 9.88, growth rate 18.7%, 2.33%) is increasing. Incidence of diabetes in pregnant women in Ukraine rapid increases in 10.4 times (0.17 per 100 pregnant women in 2010 and 0.77 in 2019).
      High regional differences in the frequency of different pathologies of pregnant women were revealed. The difference between the highest and lowest rates of circulatory system diseases in 2019 was 23.9 times, diabetes mellitus – 12.6 times, thyroid diseases – 5.4 times, genitourinary system diseases – 4.3 times, anemia in pregnant women – 3.4 times, and complications and adverse effects of pregnancy – 2.4–4.7 times.
      The analysis of the IA of the health status of pregnant women according in 2019 revealed that the level of health was higher than the average in Ukraine in Ivano-Frankivsk (65.5%), Zaporizhzhya (72.82%), Odesa (75.5%), Zakarpattia (76.5%), Lviv (81.1%), Sumy (81.3%), Luhansk (84.3%) and Ternopil (84.4%) regions, and low than the average level in Dnipropetrovsk (132.35%), Poltava (123.1%), Chernivtsi (118.0%), Chernihiv (111.7%) regions and Kyiv (117.1%).
      Conclusions. Developed toolkit for the IA of pregnant women’s health makes it possible to provide an objective assessment of pregnant women’s health in general and for individual components in the context of regions as a means of timely identification of problems that require intervention and effective management decisions to minimize risk factors that cause impaired health in pregnant women.
      PubDate: 2021-03-31
       
  • Differences in anthropometric, somatotypological and components of body
           weight composition in teenager girls with primary dysmenorrhea

    • Authors: H.V. Chaika, D.G. Konkov, O.A. Taran, B.O. Markevych
      Pages: 29 - 36
      Abstract: Research aim was to identify differences in anthropometric, somatotypological and components of body weight between the respective groups of healthy teenager girls and patients with primary dysmenorrhea. Identifying such relationships will identify risk groups for primary dysmenorrhea and prevent its occurrence in adolescent girls.
      Materials and methods. All materials presented in the article are part of the dissertation “Prognosis, diagnosis and prevention of primary dysmenorrhea in patients of pubertal age with different somatotypes.”
      Authors analyzed the indicators of 270 teenager girls, among which 200 persons were almost healthy and 70 patients with primary dysmenorrhea.
      For examination were used questionnaire-anamnestic method, measurement of anthropometric, somatotypological, components of body weight, ultrasound examination of the pelvic organs in two cycle phases and hormonal profile examination in the follicular and luteal phase of the menstrual cycle and statistical research methods.
      Results. Comparing anthropometric, somatotypological and components of body weight between the relevant (general or somatotype) groups of healthy girls and patients with primary dysmenorrhea, between the general group with primary dysmenorrhea and girls with primary dysmenorrhea of different somatotypes, as well as between patients with primary dysmenorrhea different somatotypes found significant differences (p <0.05) or tendencies of differences (p = 0.05) among total body size, body circumference, torso diameter, width of the distal epiphyses of the long tubular bones of the extremities, thickness of skin and fat folds, somatotype components, indicators of body weight composition.
      Conclusions. Medicine of the future will be preventive, aimed to identify predictors of pathology, factors influencing the development of nosology, and individual characteristics of teenage girls, which may lead to etiological and pathogenic impulse of clinical progression of primary dysmenorrhea. Therefore, the identification of prognostic markers of primary dysmenorrhea and formation of risk groups can improve not only life quality of a particular girl, but also the reproductive potential of nation.
      PubDate: 2021-03-31
       
  • Anti-relapse therapy of endometriosis: possible variations

    • Authors: N.F. Zakharenko, S.I. Regeda, I.P. Manoliak, V.S. Solskyy
      Pages: 38 - 42
      Abstract: Research aim: to determine the clinical efficacy and safety of bioavailable curcumin Longimin® in the complex anti-relapse therapy of patients with extragenital endometriosis after surgery.
      Materials and methods. Study involved 45 women with a mean age of 29.3 ± 3.6 years with a diagnosis of extragenital endometriosis. After surgical treatment of this disease all patients were prescribed dienogest 2 mg/day for 6 months with anti-relapse purpose. After that, 22 patients did not receive drug treatment (group 1) and other 23 women started a six-month course of 400 mg bioavailable curcumin (group 2).
      Results. After 12 months of observation 3 cases (13.6%) of newly formed foci of endometriosis were found among patients of group 1, two of which were multi-endometriomas, and the third was retrocervical heterotopia. There were no signs of recurrence in the group of sequential use of dienogest and bioavailable curcumin. In addition, 6 months after completion of hormonal treatment the number of women with chronic pelvic pain in group 1 was increased and average score on a visual analogue scale (VAS) was increased by 80% (p ≤0.05). It was accompanied by a stable moderately high level of anxiety throughout the observation period. At the same time the number of women who complained of intermenstrual pain in group 2 decreased from 15 to 13, and the average VAS score decreased by 13% (p ≥0.05) during the treatment period. Patients in group 2 noted an improvement in emotional control during treatment, which resulted in the average score decrease on the scale of personal and situational anxiety of the Spielberg-Hanin's questionnaire (25% and 30% respectively, p ≤0.05).
      Conclusions. The nature of the endometriosis development and progression is multipathogenetic. Blocking only its hormonal link, especially in cases of extragenital forms, may not be sufficient to stop the pathological process and prevent recurrence
      in the long term. Оbtained results of sequential course of dienogest and bioavailable curcumin Longimin® with anti-relapse purpose showed the wider clinical effectiveness of this therapy, which is probably based on additional inhibition of systemic inflammation, proliferation, stroma and psychogenic component of disease.
      PubDate: 2021-03-31
       
  • Problematic issues of diagnosis and treatment of vulvovaginitis of mixed
           bacterial-candidiasis etiology

    • Authors: О.V. Kravchenko
      Pages: 43 - 46
      Abstract: The aim of the study is to evaluate the effectiveness of modern antiseptic agent Gynodek in the treatment of mixed bacterial-candidiasis vulvovaginitis.
      Materials and methods. There were 67 patients with bacterial-candidiasis vulvovaginitis under observation. The diagnosis of candidiasis infection was verified according to the data of clinical and laboratory research methods. Patients received vaginal gel Gynodek 5 ml once a day for 7 days. The effectiveness of treatment was assessed according to the data of the clinical examination before treatment and
      on the 7th day of observation, and according to the laboratory (bacterioscopic, bacteriological) data before and after treatment. Complete clinical and bacterial debridement was criteria of the treatment effectiveness.
      Results and discussion. The clinical picture of bacterial-fungal vulvovaginitis was characterized by a decrease in the number and severity of symptoms such as hyperemia and edema of the mucous membrane, discharge from the genital tract was not typical.
      There were no complaints in 95.5% of the examined women after end of therapy, there were no objective symptoms in all women on the 7th day of treatment. Bacteriological examination after 2 weeks confirmed the therapy effectiveness in 86.6% of women. Peptostreptococcus spp. after treatment sowed at significant concentrations 106–107 CFU/ml only in 1.5% of patients, Streptococcus spp. in 8.9% of women, Candida albicans in 13.4%. Lactobacilli in the amount of 107 CFU/ml were in 86.6% of patients, which indicates a rapid restoration of normal vaginal microflora.
      Conclusions. Bacterial-fungal associations of microorganisms in the vaginal biotope lead to a complex clinical symptoms, which makes it difficult to make a timely diagnosis. Gynodek vaginal gel is highly effective against gram-positive, gram-negative and fungal microflora, which makes it the drug of choice in the treatment of bacterial-candidiasis vulvovaginitis. Gynodek creates a comfortable pH, promotes the rapid restoration of own lactoflora, and increases the functional activity of the vaginal mucosa epithelium, which ensures the prevention of vaginal infection recurrence.
      PubDate: 2021-03-31
       
  • Diffusive non-tumoral pathology of the breast: current state of the
           problem. Diagnosis and treatment of mastalgia

    • Authors: O.S. Zotov
      Pages: 48 - 53
      Abstract: In the twentieth century, a whole teaching of mastopathy was formed. However, over time, accumulated data have questioned the existence of mastopathy as a separate nosological form, because the term “fibrocystic disease” while mastalgia is the most common symptom does not correspond to a holistic concept of the disease. This “disease” can be diagnosed in any woman and more or less successfully treated. In the United States, this term was obsolete in 1985. Instead, the term ANDI (Aberrations in the Normal Development and Involution of the breast) was proposed, which correctly corresponds to the pathogenesis. Leading guidelines on management of benign diseases of the breast now use this term. Therefore, treatment is necessary only for a very limited number of patients. Cyclic mastalgia is required therapeutic intervention, which in most cases is classified as a “disorder” according to the ANDI classification.
      There are the following types of mastalgia that require medical intervention: cyclic, non-cyclic, extramammary. Homogeneous evidence has been obtained in favor of antigonadotropins, dopamine agonists, selective estrogen receptor modulators, gonadotropic releasing hormone agonists among non-surgical methods of treatment of cyclic mastalgia.
      A number of numerous studies have shown that Vitex agnus castus can reduce pain and discomfort in patients with cyclic mastalgia and its effects can be compared with the effects of bromocriptine and cabergoline. The European Medicines Agency has recognized Vitex agnus castus extract, obtained by extraction with ethanol 60% (Prefemin), as the only extract with the status of “widespread medical use” for the treatment of premenstrual syndrome. Prefemin is well studied, its efficacy and safety, as well as satisfactory long-term tolerability have been proven in European clinical trials evidenced A. Therefore, Prefemin as a preparation with a high dosage of Vitex agnus castus extract can be considered as the drug of choice for premenstrual syndrome.
      PubDate: 2021-03-31
       
  • Experience of using plant complexes in physiological completion of
           lactation

    • Authors: N. V. Kosei, O.V. Zanko, L.А. Vasylchenko, N.V. Iarotska
      Pages: 54 - 58
      Abstract: Ending breastfeeding is often quite a challenge for women, justifying the need for qualified medical counseling and accompaniment by a doctor. Quite frequently during weaning the baby, women complain about pain, discomfort and swelling of the breasts, which affects their overall physical and psychological well-being. However, due to possible rather serious side effects, medical support for stopping lactation is mostly recommended for women with clinical indications.
      Research aim: to determine the effectiveness of the proposed method with Normomens for physiological completion of lactation.
      Materials and methods. The study involved 65 women with an average duration of lactation 9 ± 1.23 months. Patients were divided into two groups: group 1 included 34 women who received Normomens according to the scheme to stop lactation; group 2 included 31 patients who did not receive any medication. Patients were gynecological examined and counseled by oncologist. Patients' diaries included questions about the duration of lactation, presence and severity of mastalgia according to the Visual Analogue Scale, necessity of analgesics, frequency of breast pumping per day, features of psycho-emotional state according to the Hospital Anxiety and Depression Scale. Prolactin levels were also determined at the screening visit and on 25th day after weaning.
      Results. On the background of Normomens use the process of lactation completion was significantly easier, its completion came mostly on the 3–4 day after drug use, patients almost never complained of pain and discomfort in mammary glands, they less frequently breast pumped and had a more stable psycho-emotional state compared to the control group. Рrolactin level with usage of Normomens had a quick decrease compared to the control group.
      Conclusion. Normomens using for support the physiological finishing of lactation lead to acceleration of involutive processes in mammary glands, reduces pain severity and prevented psycho-emotional disorders in women.
      PubDate: 2021-03-31
       
  • The cytological component of cervical cancer screening: causes of false
           negative and false positive results, and ways to avoid them

    • Authors: O.A. Burka, N.F. Lygyrda, V.V. Kutsovol, A.V. Svintsitska
      Pages: 61 - 67
      Abstract: Cervical cancer (CC) screening is a major component of secondary prevention of CC and involves screening all women at risk of developing this disease, most of whom are asymptomatic. Cytology remains an important component of CC screening in the era of primary screening by genotyping the human papillomavirus. Papanikolaou staining is the method of choice for CC screening. This review highlights the causes of false negative results for various methods of Pap tests and how they can be prevented. A detailed analysis of conditions accompanied by a high probability of false positive abnormal results of the Pap test, an explanation of the pathophysiological basis of this phenomenon, clinical and cytological criteria for differential diagnosis is also presented.
      Pap test is a screening test. The aim of the cytological examination in CC screening is to assign the patient to a group with absent neoplastic changes in the cervical epithelium, a group with neoplastic changes in the cervical epithelium present, or a group when it is impossible to make an accurate differential diagnosis between benign reactive changes and neoplasia. The Bethesda Cytology Reporting System is used to unify and standardize these categories in most countries of the world. Benign conditions are a common cause of false positive reports of cellular atypia on cervical screening, as evidenced by a large number of studies. This fact should be taken into account both in the interpretation of the results and, if possible, in the planning of cervical screening. The most common conditions that are accompanied by reactive changes in the cervical epithelium, which can be incorrectly assessed as atypia, are: reactive and reparative inflammatory changes, atrophy, metaplasia, reactive changes caused by intrauterine devices. In this regard, when working with the cytological component of cervical screening, it is important for the clinician to understand the basic principles of assessing the cervical epithelium, which will allow using the descriptive part of the report to determine tactics if a false negative or false positive screening result is suspected.
      Thus, understanding the impact of common benign conditions on the cervical epithelium makes it possible to rationally plan cytological cervical screening and correctly interpret its results in order to achieve the best clinical results that are not limited to the detection of precancerous conditions.
      PubDate: 2021-03-31
       
  • Epigenetic profile of endometrial proliferation in the different
           morphotypes of endometrial hyperplasia

    • Authors: O.L. Gromova, V.O. Potapov, D.A. Khaskhachykh, O.P. Finkova, O.V. Gaponova, G.O. Kukina, K.V. Penner
      Pages: 68 - 78
      Abstract: Research aim: to investigate the proliferative status of endometrium in the different morphotypes of endometrial hyperplasia based upon the identification of key molecular markers of the cell cycle.
      Materials and methods. Endometrial samples taken from 137 women were investigated: 40 – normal endometrium (NE), 61 – non-atypical endometrial hyperplasia (ЕH), 36 – atypical hyperplasia (AHE). Expression of gene cyclin D1, nuclear antigen Кі-67, glycoproteins Е-cadherin and β-catenin, estradiol receptors (ER) and progesterone receptors (PGR) were investigated.
      Results. ER expression of NE was high in the proliferative phase and decreased significantly in the secretory phase. PGR expression was high in both phases. ER expression of EH in glandular (180 ± 8.3) and in stromal cells (170.5 ± 4.1) exceed the indicators of the secretory phase. PGR expression in the stromal cells of EH (197.5 ± 9.3) exceed significantly indicators of NE. ER and PGR expression significantly and reliably decreased if there was AHE. ER expression of glandular cells was 2.6 times lower (74.6 ± 3.9) compere to proliferative NE (p <0.05) and 2.4 times lower to EH (р <0.05). ER of stromal AHE cells dropped to 30.3 ± 2.8, which was 5.5–5.6 times lower than in the proliferative NE and EH (p <0.002). PGR expression was 2.5–2.7 times lower (71.1 ± 2.3) in AHE glands than in NE and 2.8 times lower than in EH (p <0.05). Gene cyclin D1 expression was reliably increased in AHE cells compere to NE and EH. Protein Кі-67 expression in the glandular cells of EH was 2.6 times lower (p <0.05) and in AHE 2.9 times lower (p <0.05) than NE proliferative phase. We discovered strong direction to decreasing Е-cadherin expression in EH and it was lowest for AHE. Opposite direction was expression of β-catenin. The highest numbers of positive samples were observed in AHE and it was 100%. The highest numbers of negative β-catenin samples were in the NE cells (32,5–35%).
      Conclusion. The epigenetic profile investigation of endometrial hyperplasia will be useful for future development of carcinogenesis risk stratification, identifying patients with high risk of endometrial cancer and also for choosing the optimal way to influence the pathological process in the endometrium.
      PubDate: 2021-03-31
       
  • Mechanisms of hepatic steatosis formation in adolescent boys with
           hypoandrogenism

    • Authors: L.K. Parkhomenko, L.A. Strashok, S.I. Turchyna, Z.V. Yeloyeva, T.M. Klymenko, H.V. Kosovtsova, D.A. Kashkalda, E.M. Zavelya, M.Y. Isakova, A.V. Yeshchenko, T.P. Kostenko
      Pages: 79 - 83
      Abstract: There has been an increase the prevalence of andrological diseases in all age groups in recent decades, including those with comorbid conditions such as pathology of the cardiovascular system and liver, which are manifestations of metabolic syndrome.
      Research aim: to investigate the relationship between formation of hepatic steatosis and hypoandrogenism (HA) in adolescent boys.
      Materials and methods. The study involved 42 adolescent boys aged 14–18 years with laboratory confirmed HA in whom total testosterone levels were less than 12.0 nmol/l. Sex hormones, gonadotropins, insulin levels, biochemical parameters of liver function, the state of free radical oxidation and antioxidant protection were determined in patients. Based on ultrasound examination adolescents with HA were divided into 2 groups: group 1 – 15 adolescents with signs of liver steatosis; group 2 – 27 adolescents with normal ultrasound parameters of a liver. The control group consisted of 38 boys of the same age with normal indicators of physical and sexual development without signs of pathology of the hepatobiliary system.
      Results. Individual assessment of sexual development allowed to diagnose I degree of delayed sexual development in 44.7%, II degree in 38.3% and III degree in 17.0% of adolescents. HA negatively affects the physical development of most boys (78.7%), due to short stature (40.0%), weight deficiency (20.0%) and overweight (18.7%). Factor analysis allowed to build a factor model of hepatic steatosis formation in adolescents with delayed sexual development and HA, which describes 76.0% of the sample and consists of five factors.
      Conclusion. Atherogenic changes of the lipid profile, androgen deficiency, insulin resistance, activation of cytolytic processes in the liver and oxidative stress formation due to a decrease in the effectiveness of antioxidant protection are important in the pathogenesis of hepatic steatosis in boys with HA. A factor model of the hepatic steatosis development in adolescent boys with HA gives grounds for the development of therapeutic and preventive measures in adolescent boys with HA and comorbid liver pathology.
      PubDate: 2021-03-31
       
  • High-risk human papillomavirus testing in women with ASCUS cytology:
           results from The ATHENA HPV study

    • Authors: M.H. Stoler, T.C. Wright; Jr., A. Sharma
      Pages: 93 - 98
      Abstract: This study evaluated the clinical performance of the cobas 4800 HPV Test (Roche Molecular Systems, Pleasanton, CA, USA) for high-risk human papillomavirus (HR-HPV) testing with individual HPV-16/HPV-18 genotyping in women 21 years or older with atypical squamous cells of undetermined significance (ASCUS). Women (N = 47,208) were recruited in the United States during routine screening, and liquid-based cytology and HPV testing were performed. The ASCUS prevalence was 4.1% (1,923/47,208), and 1,578 women underwent colposcopy with valid results. The cobas 4800 HPV Test demonstrated performance comparable to the Hybrid Capture 2 test (QIAGEN, Gaithersburg, MD, USA) for the detection of cervical intraepithelial neoplasia (CIN) grade 2 or worse and grade 3 or worse. HPV-16/HPV-18+ women had a greater absolute risk of CIN 2 or worse compared with pooled HR-HPV+ and HR-HPV- women (24.4%, 14.0%, and 0.8%, respectively).
      The cobas 4800 HPV Test is clinically validated for ASCUS triage. HPV-16/HPV-18 genotyping can identify women at highest risk for high-grade cervical disease, and this additional risk stratification may be used in formulating patient management decisions.
      PubDate: 2021-03-31
       
  • The continuum of ovarian response leading to birth, a real world study of
           ART in Spain

    • Authors: M. Ferrando, B. Coroleu, L. Rodríguez-Tabernero
      Pages: 99 - 104
      Abstract: Background. The first biosimilar of recombinant follicle stimulating hormone (rFSH) launched in Europe was Bemfola® in 2014 following a clinical development programme demonstrating efficacy and safety to the satisfaction of the European Medicines Agency. Since then the increasing use of biosimilar rFSH has provided the opportunity to study both effectiveness across the whole population and the variation of rFSH use during routine clinical care in a real-world setting in Spain.
      Methods. This is a real-world study of 1222 women treated in 26 assisted reproduction treatment centres throughout Spain providing experience of the use of a biosimilar recombinant follicle stimulating hormone in four distinct populations. The four populations studied were poor responders, suboptimal responders, normal responders and oocyte donors. The primary endpoint was the total number of oocytes retrieved. Secondary endpoints included number of days of rFSH stimulation, total dose of rFSH administered, number of MII oocytes, number of fertilized oocytes, quality of embryos, number of embryos transferred, implantation rates, clinical pregnancy rates following embryo transfer, number of multiple pregnancies and number of serious adverse reactions, including moderate-to-severe OHSS.
      Results. Differences were seen across the populations both in the characteristics of the women and ART outcomes suggestive of a continuum of fertility prognosis. In the poor responders, suboptimal responders, normal responders and oocyte donor populations the mean age in years was 39.9 (±SD 3.4), 38.4 (±SD 2.9), 34.4 (±SD 3.3) and 26 (±SD 4.6) respectively and number of oocytes retrieved was 4.1 (±SD 2.7), 8.6 (±SD 6.0), 12.2 (±SD 7.2) and 19.5 (±SD 9.5) respectively. The proportion of embryos graded as best quality was 18.5%, 33.0% and 43.8%, and graded as worst quality was 20.4%, 5.8% and 5.8% for poor responders, suboptimal responders and normal responders respectively. In a similar pattern, for poor responders, suboptimal responders and normal responders the implantation rates were 16.0%, (8/50), 22.4% (49/219), 30.6% (97/317) respectively and clinical pregnancy rates were 23.2% (10/43), 30.4% (59/194) and 37.0% (114/308) respectively. Adverse events were reported in only 7 of 1222 women (0.6%).
      Conclusion. Overall the results were consistent with the national ART results reported for Spain, hence this study provides reassurance of the clinical effectiveness of a biosimilar rFSH used in a real world setting.
      PubDate: 2021-03-31
       
 
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