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Reproductive Endocrinology     Open Access   (Followers: 1)
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Reproductive Endocrinology
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2309-4117 - ISSN (Online) 2411-1295
Published by Trilist Publishing Homepage  [1 journal]
  • Current global threats to the reproductive health of the nation

    • Authors: I.M. Zharovska, M.M. Blikhar, R.M. Matkivska, O.V. Malikov, L.A. Cherkasova
      Pages: 8 - 16
      Abstract: Background. In the article, the reproductive health of the nation is interpreted as a key aspect of social development, since it directly affects the demographic situation, the economy, and the general state of health of the nation. Therefore, insufficient awareness of reproductive rights, lack of access to sexual education and reproductive health services, as well as socio-cultural and economic factors only complicate the situation.
      Objective of the review: a comprehensive analysis of modern threats to the reproductive health of the nation in the conditions of a globalized society through the analysis of political, economic, social, cultural and environmental factors of influence and determination of the level of individual dangers.
      Materials and methods. Disclosure of the research subject requires the use of an inter-complementary approach, which involves the use of various methods and sources of information to obtain a comprehensive and deep understanding of the problem. The article uses the method of comparative analysis with the use of tables, which is applied to the analysis of fertility rates and reproductive health in the world and in Ukraine.
      Analysis of literary data. A system of interrelated factors affecting the reproductive health of the population in the conditions of a globalized society, population migration and war is defined. It is also revealed that the paradox of modern global society is that individuals who achieve higher economic wealth usually do not want to have many children. In addition to the physiological aspects, the increase in the average age of the population can also affect the ability of families to plan pregnancy and the number of children, as many families in today’s postmodern society postpone the decision to become pregnant until later in life due to professional ambitions, financial constraints or personal circumstances, which causes a shorter period, during that they can safely conceive and give birth to a child and poses a risk of complications.
      Conclusions. Based on the results of the analysis of the declared problem, it is argued that the study of the reproductive health problems of the nation is of great importance for the social development and sustainable development of mankind. This not only helps to improve the demographic situation, the economy and the general state of health of the nation, but also provides the basis for the development of effective strategies and programs aimed at supporting motherhood and childhood, ensuring access to quality reproductive health services, educating the population on sexual issues health, fertility etc.
      PubDate: 2024-06-30
      DOI: 10.18370/2309-4117.2024.72.8-16
       
  • Modern progestogens in the treatment of genital endometriosis

    • Authors: L.B. Markin, O.O. Matvienko
      Pages: 17 - 21
      Abstract: Objective of the review: to evaluate modern approaches to the use of progestogens for the treatment of endometriosis, using literature sources, to provide examples of their effectiveness in global and own practices.
      Analysis of literary data. In total, 41 publications by foreign authors were selected and processed. Information on the effectiveness of the domestic progestogen drug Vigest-KV in the treatment of endometriosis in our own practice is also presented.
      Today, the newest progestin is dienogest, a derivative of 19-nortestosterone. It has shown its high efficiency in various clinical manifestations of endometriosis, as well as in its recurrences. Long-term treatment regimens with dienogest (60 months) are promising, as they effectively reduce pain and the risk of endometriosis recurrence, in particular after surgical treatment. An important advantage of dienogest is the low frequency of side effects (1.2–2.5%), especially such as the effect on bone mineral density.
      Our clinical experience allows us to recommend the Ukrainian medicinal product Vigest-KV, containing dienogest, for the treatment of various types of endometriosis. Its advantage is a special mechanism of ovulation blockade aimed at apoptosis of the granulosa cells of the growing follicle. Also, long-term use of this drug leads to the inhibition of follicle-stimulating and luteinizing hormones and a moderate decrease in the estradiol, the level of which is within the physiological parameters. This is very important to avoid the symptoms of estrogen deficiency while maintaining the anti-proliferative effect.
      Conclusions. Today, the main method of treating endometriosis is hormone therapy. It not only reduces the clinical symptoms of endometriosis, but is also used before and after surgical treatment to reduce the risk of disease recurrence. Progestins (dienogest) are the most common hormonal method of treating endometriosis. Dienogest, as the most effective progestin, has a  pronounced anti-proliferative effect directed at the endometrium, as well as anti-inflammatory and immunomodulatory effects with a minimal risk of side effects. Dienogest in a dose of 2 mg/day provides a reduction in clinical symptoms, an improvement in the quality of life and preservation of reproductive function. Taking into account our own clinical experience of using Vigest-KV in various types of endometriosis, we can recommend its implementation into clinical practice.
      PubDate: 2024-06-30
      DOI: 10.18370/2309-4117.2024.72.17-21
       
  • The effect of vitamin D and magnesium deficiency on the course of
           adenomyosis in the post covid-19 period in women of reproductive age

    • Authors: M.B. Zaporozhchenko, A.V. Bulhar, G.F. Stepanov
      Pages: 23 - 27
      Abstract: Objective of the study: to investigate the content of vitamin D and the trace element magnesium in the blood of women of reproductive age with adenomyosis of the I–II and III–IV degrees after the COVID-19 disease depending on the algorithm of their management at 3, 6 and 12 months, as well as assess the general condition of patients.
      Materials and methods. 150 women after the COVID-19 disease were under observation: 30 practically healthy women (control group A), 60 patients with adenomyosis of the I–II degree (group B) and 60 patients with adenomyosis of the III–IV degree (group C). Observation continued for 3, 6 and 12 months after the COVID-19 disease.
      Results. Deterioration of well-being in patients with adenomyosis in the first months after COVID-19 has been proven. The frequency of complaints increased significantly: lethargy (55.0%), headache (36.7%), joint pain (41.7%), muscle pain (40.8%), pelvic pain (38.3%), dyspareunia (100%), etc. According to the scale of verbal assessment of pelvic pain, moderate pain (2 points) was experienced by 30.0% of patients of group B and 43.3% in group C, at the same time, severe (3 points) – 33.3%, very strong
      (4 points) – 20.0%.
      A significant decrease in the level of vitamin D and Mg was detected in women after the COVID-19 disease (p < 0.05): in almost all healthy women (group A) and in patients with adenomyosis (groups B and C). A significantly lower content of vitamin D and Mg was found in groups B and C compared to group A (p < 0.05), and in group C compared to group B.
      The effectiveness of taking vitamin D and magnesium preparations in patients with adenomyosis after the COVID-19 disease was confirmed: a significant difference in the frequency of symptoms characterizing the general condition of patients after 3, 6 and 12 months was obtained: a decrease in the frequency of neuroses, headaches, muscle pain, constant lower abdominal pain, dyspareunia, etc.
      Conclusions. The effectiveness of taking vitamin D and magnesium preparations by women with adenomyosis after the COVID-19 disease has been confirmed.
      PubDate: 2024-06-30
      DOI: 10.18370/2309-4117.2024.72.23-27
       
  • Consequences of wartime stress on women’s reproductive health

    • Authors: T.F. Tatarchuk, O.О. Yefimenkoa, O.S. Myronenko, R.O. Mnevets
      Pages: 28 - 34
      Abstract: Background. Experts observe that Russia’s war against Ukraine led to a significant decline in the demographic situation and caused a severe impact on the reproductive health of women.
      Objective of the review: to assess and predict the consequences of war-related stress on the reproductive health of women residing in various zones - war zones, adjacent areas, remote territories, and even abroad; managing menopausal disorders in women with premature menopause and perimenopause remotely becomes crucial due to the existing limitations of
      in-person gynecological consultations.
      Analysis of literary data. The findings indicate a detrimental influence of wartime stress on the reproductive health of women across different categories - those experiencing active combat in adjacent regions, in remote areas, and even overseas.
      There is an increase in the frequency of diseases of the female reproductive system, namely: menstrual cycle disorders, abnormal uterine bleeding, premature menopause, hyperandrogenism, severe climacteric disorders. Due to severe negative stressor consequences caused by the war in Ukraine, the number of younger women with premature ovarian failure syndrome has increased, as well as the number of perimenopausal women with severe manifestations of menopause.
      Taking into account the difficult social and domestic conditions of some Ukrainian women and the impossibility of seeing a doctor, it is important to prescribe initial therapy for stress-induced consequences of reproductive disorders. The drugs of choice in treatment are modern estrogen-progestagen preparations, the effectiveness and safety of which has been proven by numerous scientific studies. Patients who complain of manifestations of concomitant pathology should be referred to the relevant specialists.
      Conclusion: The impact of war-related stress on the female reproductive health system poses a considerable challenge for gynecologists and healthcare professionals in preventing and managing these issues.
      PubDate: 2024-06-30
      DOI: 10.18370/2309-4117.2024.72.28-34
       
  • Assessment of anxiety, depression, stress and vitamin d levels in women in
           warfare

    • Authors: N.V. Kosei, T.F. Tatarchuk, V.M. Yakimets, N.V. Iarotska, I.S. Kolesnichenko, K.D. Plaksiieva
      Pages: 35 - 45
      Abstract: Objective of the study: to assess the levels of vitamin D (25(OH)D) in the blood serum of military women and women involved in a military conflict, as well as to identify the relationship of its indicators with the level of anxiety, depression and stress.
      Materials and methods. 52 women serving in the Armed Forces of Ukraine and other categories of women involved in the military conflict were surveyed. They entered the main group. The comparison group includes 50 women who are not related to military conflict.
      The concentration of vitamin D (25(OH)D) in blood serum was determined by enzyme immunoassay In all women. The level of stress was studied using the Depression Anxiety and Stress Scale (DASS-21).
      Results. The vast majority of women in the main group (76.5%) were diagnosed with vitamin D hypovitaminosis conditions, which significantly exceeded the specific gravity of such patients in the comparison group – 46.0% (р < 0.05). Only 12 (23.08%) women of the main group had a normal level of this vitamin, which was half as much as the specific gravity of such patients in the comparison group – 54% (р < 0.05).
      The values of the DASS-21 test on the depression scale were 5.74 ± 0.26 points In the main group, while in the comparison group – 4.57 ± 0.31 points (p < 0.05), on the stress scale – 8.22 ± 0.24 points and 6.67 ± 0.28 points, respectively (p < 0.05). Anxiety levels, on the contrary, were more pronounced in civilian women – 5.81 ± 0.24 points compared to the main group (р < 0.001). Signs of anxiety were found in 84.0% of civilian women and in 61.54% of women involved in the military conflict (p < 0.05). However, the specific weight of patients with different levels of this disorder almost did not differ between groups.
      Conclusions. Today, vitamin D deficiency is a widespread problem among women, regardless of profession. But a more pronounced decrease in its levels was found in female military personnel and other categories of women involved in the military conflict, which is related to the type of chosen profession, service conditions and psycho-emotional stress.
      It has been established that women who serve in the Armed Forces of Ukraine are more prone to depression and stress. Civilian women, on the other hand, show more signs of anxiety. The revealed relationship between the levels of vitamin D in the blood and elevated scores of the DASS-21 questionnaire in both groups indicates the importance of this vitamin in psycho-emotional stability. The pronounced decrease in the concentration of vitamin D, found in military women against the background of high stress load, substantiates the feasibility of a rational approach to the examination before military service and periodic determination of the vitamin D level, as well as the regular use of its adequate preventive doses.
      PubDate: 2024-06-30
      DOI: 10.18370/2309-4117.2024.72.35-45
       
  • Vaginal microbiota and its changes due to the stress in women who had a
           medical abortion

    • Authors: Vl.V. Podolskyi, V.V. Podolskyi, U.I. Botsyuk, N.V. Medvedovska, D.A. Emir-Useinova
      Pages: 47 - 52
      Abstract: Objective of the study: to explore the impact of medical abortion on infections, stress, and the vaginal microbiota, providing essential insights into the associated risks and the need for comprehensive care.
      Materials and methods. A total of 120 patients were examined, divided into groups: 50 women who underwent medical abortion, 50 women underwent surgical abortion and 20 women with no abortions as the control group. Additionally, the women were categorized based on stress levels into high stress group (29 women), medium stress group (54 women), and low stress group (17 women). Bacteriological studies were conducted to assess the species composition and quantitative composition of the vaginal microbiota in women post-abortion and with varying levels of stress.
      Results. The study found significant alterations in the vaginal microbiota of women post-abortion, differentiated by the type of abortion and stress levels. Women who underwent medical abortions exhibited higher levels of S. epidermidis, including strains with hemolytic properties, compared to those who had surgical abortions. The concentration of S. epidermidis in the medical abortion group was significantly higher than in healthy women, suggesting a potential link between medical abortion and increased susceptibility to opportunistic infections. Additionally, higher concentrations of E. coli, particularly hemolytic strains, were found in both abortion groups, with a slightly higher prevalence in the medical abortion group, highlighting an increased risk of post-abortion infections.
      The level of stress significantly affects the composition of the vaginal microbiota. Women experiencing high stress post-abortion showed a more pronounced dysbiosis compared to those with moderate or low stress levels. High-stress individuals had significantly elevated levels of pathogenic microorganisms, including S. aureus, S. agalactiae, and various Enterobacteriaceae, and a marked deficiency in protective Lactobacillus spp. The study also identified a higher incidence of mixed infections in high-stress women, often involving bacterial and viral pathogens such as G. vaginalis, C. trachomatis, U. urealyticum, and herpes simplex virus.
      Comparative analysis revealed that both types of abortion are associated with microbiota disruptions; however, medical abortions had a more substantial impact on certain pathogenic bacteria. For instance, the levels of Candida spp. were significantly higher in the medical abortion group compared to the surgical group, indicating a higher risk of fungal infections. Conversely, the concentration of Lactobacillus spp. was notably lower in women who underwent surgical abortions, suggesting a more severe impact on beneficial microbiota from surgical procedures.
      Conclusions. The findings underscore the importance of monitoring and managing the vaginal microbiota in women post-abortion, particularly those undergoing medical abortions and those experiencing high stress levels. Prophylactic and therapeutic measures, including the use of probiotics, should be considered to mitigate the risk of infections and restore the balance of protective bacteria.
      PubDate: 2024-06-30
      DOI: 10.18370/2309-4117.2024.72.47-52
       
  • Fetal inflammatory response syndrome in extremely premature newborns

    • Authors: V.V. Bila
      Pages: 53 - 59
      Abstract: Background. Fetal inflammatory response syndrome (FIRS) is a pathological reaction of the fetal immune system to infection of the amnion or inflammation of the chorion, which significantly increases the risk of neonatal mortality and morbidity. Objective of the study: to study the clinical features of the course of the neonatal period in premature babies with different gestational periods against the background of FIRS. Material and methods. The course of the neonatal period was analyzed in 405 premature newborns, divided depending on the gestational age and the presence of premature rupture of the fetal membranes. The content of IL-6 in umbilical cord blood was determined in all newborns by enzyme-linked immunosorbent assay. Its value greater than 11 pg/ml was the basis for establishing a diagnosis of FIRS. The duration of respiratory support in general, artificial lung ventilation, non-invasive lung ventilation, and the need for additional oxygen, periventricular hemorrhages, and necrotizing enterocolitis were analyzed in all newborns depending on the presence of FIRS. Results. Extremely premature newborns with FIRS have a longer duration of both invasive and non-invasive ventilation, newborns from early preterm births with FIRS required non-invasive ventilation longer only in case of premature rupture of the fetal membranes. In extremely premature newborns with FIRS the duration of the additional oxygen supply increases, in newborns from early premature births this pattern was only in the case of premature rupture of the fetal membranes. Only in premature babies from very early premature births with FIRS a doubling of the frequency of hemorrhages in the ventricles of the brain and necrotizing enterocolitis was found. Conclusions. FIRS in extremely premature newborns is associated with a longer duration of invasive and non-invasive ventilation, as well as with a longer need for oxygen enrichment of inhaled air. FIRS in extremely premature newborns increase the frequency and severity of intraventricular hemorrhages and necrotizing enterocolitis.
      PubDate: 2024-06-30
      DOI: 10.18370/2309-4117.2024.72.53-59
       
  • Assisted reproductive technologies in multiple sclerosis

    • Authors: O.D. Shulga, M.I. Hrytsko, A.S. Romaniuk, O.G. Kotsiuba
      Pages: 60 - 70
      Abstract: Objective of the review: to study the topic of fertility, pregnancy and assisted reproductive technologies (ART) in patients with multiple sclerosis (MS). The analysis of scientific literature in international medical databases was performed.
      Analysis of literary data. MS is a chronic inflammatory demyelinating disease of the central nervous system that most often affects young people of reproductive age. Research in this area is important given that the average age of MS diagnosis in Ukraine is approximately 31–34 years. As a result, patients are in the process of making important decisions about their future lifestyle and family planning.
      According to the data of modern research, MS does not affect the course of pregnancy and is not associated with obstetric pathologies. However, patients are often forced to postpone their desire to become pregnant due to the risks of taking drugs for disease-modifying therapy (DMT), the need to stabilize the disease along with reducing its radiological activity. It is also important to consider the presence of sexual dysfunction in patients with MS, particularly in men, which often negatively affects male fertility and requires timely diagnosis and treatment. For example, in case of ejaculation disorders, a testicular biopsy or electroejaculation can be used to collect seminal fluid.
      The algorithm of proper counseling before conception for both partners was analyzed. It is important to use a multidisciplinary approach for joint decision-making of the patient with both a neurologist and a gynecologist, which allows for the formation of the most reasonable conclusions regarding pregnancy planning. In particular, the elimination periods of the main DMT drugs are discussed and drugs that can be used during pregnancy are specified.
      Conclusions. Women with MS are more likely to need AR than the general population. This is associated with a later age of pregnancy planning and infertility. In this regard, the method of in vitro fertilization and cryopreservation of oocytes as the most effective types of ART for patients with MS was considered in detail.
      PubDate: 2024-06-30
      DOI: 10.18370/2309-4117.2024.72.60-70
       
  • Evolution of the endometrial cancer staging system. Challenges for Ukraine

    • Authors: V.S. Svintsitskiy, N.P. Tsip, S.V. Nespryadko, Y.G. Tkalya, O.O. Samokhvalova, M.Y. Yegorov, I.V. Honcharuk, T.V. Dermenzhy, O.P. Renkas, A.S. Rekuta, О.І. Khoptiana, M.V. Lyzogub
      Pages: 71 - 76
      Abstract: Endometrial cancer is a disease that is still among the top ten causes of mortality and morbidity in Ukraine today. More and more new data about this malignant neoplasm appear every day, which forces us to revise the approaches in the diagnosis and treatment of it. In June 2023, the International Federation of Gynecology and Obstetrics (FIGO) published the staging of endometrial cancer, which included new data obtained in recent years in the process of studying this pathology.
      It is important to note that the new review is significantly different from the previous one, because it is based not only on the anatomical spread of the tumor, but also on histological characteristics: lymphovascular invasion and its spread, differentiation and histological type of the tumor, invasion into the myometrium. Molecular classification was implemented, taking into account the new WHO edition of histological forms of tumors of the female reproductive system in 2020.
      The 2023 FIGO staging calls attention to the important role of the histologist in deciding the stage of endometrial cancer. This is one of the challenges for the gynecological oncology community, which will require a single protocol that would include the main histological aspects in the description of the tumor.
      It is also indicated the molecular profile of the tumor, which plays an important role in FIGO-2023 staging of endometrial cancer. Knowledge of the molecular profile of the tumor is importantly in the management of patients in the early stages of endometrial cancer, namely stages I and II. The presence or absence of certain markers of tumor aggressiveness can not only change the stage, but also lead to de-escalation of the patient’s treatment.
      Currently, there is a challenge of financial inaccessibility of the NGS (next generation sequencing) method, which is why this type of diagnosis is often avoided. This requires the search for new adapted algorithms for determining the molecular profile of a tumor, until the determination of POLEmut becomes more accessible to the Ukrainian community.
      PubDate: 2024-06-30
      DOI: 10.18370/2309-4117.2024.72.71-76
       
  • Immunohistochemical assessment of epidermal growth factor receptor and
           prohibitin expression in “post-COVID” placentas: results of a
           comparative cross-sectional study

    • Authors: G.S. Manasova, Y.O. Stasii
      Pages: 77 - 86
      Abstract: Background. COVID-19 pandemic is accompanied by a considerable number of morbidity cases among pregnant women. Certain knowledge has been accumulated about the histopathological features of the placenta during SARS-CoV-2 infection. Specific proteomic studies of the function of the placenta are insufficient.
      Objective of the study: to study the perinatal outcomes of pregnancy and histopathological features of the placenta and the expression of epidermal growth factor receptors (EFGR) and prohibitin (PHB) in the placenta in pregnant women with COVID-19 infection in comparison with data in a group of healthy pregnant women without a COVID-19 history.
      Materials and methods. 58 pregnant women with COVID-19 infection during pregnancy and 40 healthy pregnant women were examined at the base of Maternity Hospital No. 2 of the Odessa City Council. A histological and immunohistochemical study of placentas was carried out for the expression of EFGR and PHB In addition to a general clinical examination.
      Results. A higher frequency of premature births (15.51% vs 5%) and cesarean sections (34.4% vs 12.5%) in the “post-COVID” group was revealed. Most women fell ill in the third trimester of pregnancy (65.51%). A significant difference was found in Apgar scores in the groups (6.48 ± 2.39 vs 8.05 ± 0.54 points), in the weight of newborns (3067.93 ± 620.21 g vs
      3617.25 ± 354.58 g). In the placentas of the “post-COVID” group, signs of mother’s (53.45% vs 12.5%) and fetus’ vascular malperfusion (32.7% vs 15%) were detected with greater frequency; as well as hemodynamic disturbances (53.45% vs 15%). Analysis of EFGR expression in the groups showed no differences (2.96 ± 0.2 vs 2.75 ± 0.44) in contrast to PHB (1.52 ± 1.12 vs 0.25 ± 0.5), which was characterized by overexpression in the women with COVID-19.
      Conclusions. SARS-CoV-2 infection during pregnancy is associated with certain changes in placental metabolism, and changes in the expression of placental proteins EGFR and PHB may be involved in the pathogenetic mechanisms of the placental dysfunction development. The limited sample size requires additional research.
      PubDate: 2024-06-30
      DOI: 10.18370/2309-4117.2024.72.77-86
       
 
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