FUNCTIONAL CONDITION OF THE REPRODUCTIVE SYSTEM IN WOMEN OF ADVANCED MATERNAL AGE
DOI:
https://doi.org/10.11603/1811-2471.2021.v.i4.12798Keywords:
infertility, advanced maternal age, hormonal status, PRP therapyAbstract
SUMMARY. The frequency of infertile marriages in Ukraine ranges from 15 to 25 % of all couples, exceeding the critical level of 15 %, indicated by a group of WHO experts, when infertility is a factor that significantly affects demographic indicators in the country and is a state problem. Infertility in marriage is one of the most pressing problems of modern society and modern medicine, despite the progress made in the widespread use of assisted reproductive technologies (ART). The issue of starting a family and motherhood is sometimes postponed until it becomes extremely difficult for a couple to conceive a child on their own. With age, there is a deterioration in physical health and reduced reproductive function.
The aim – to research of the main parameters of the functional condition of the reproductive system in women of advanced maternal age.
Material and Methods. 66 women of late reproductive age were monitored. Of these, 36 patients with tubal-peritoneal infertility in women with low ovarian reserve, who were shown the use of ART programs – formed the main group and by simple randomization this group was divided depending on the treatment regimen and proposed the use of PRP-therapy (activation of folliculogenesis).
Evaluation of reproductive system function was performed by determining such hormonal parameters as prolactin (PRL), testosterone (T), cortisone (K) estradiol (E2), luteinizing hormone (LH), follicle-stimulating hormone (FSH), and antimullerian hormone (A early follicular phase, except for progesterone (P), which was determined in the luteal phase.
Statistical processing of research results was performed on a personal computer using parametric and nonparametric methods of variation statistics using the application software "Statistica".
Results. Analysis of hormonal indicators of the reproductive system revealed statistically significant differences between the average FSH, AMG, LH, PRL, progesterone and estradiol in women of the main and control groups, which is explained primarily by the presence of disorders of the reproductive system in patients of the main group. which is characteristic of the clinical course of infertility in women of late reproductive age with low ovarian reserve.
Conclusions. The study showed that patients with low ovarian reserve who underwent PRP therapy had a better ovarian response and oocyte quality, and therefore the results of assisted reproductive technologies were successful. This issue is important for women of older reproductive age, as depletion of the ovulatory reserve reduces the likelihood of having children.
References
Aleksandrova, N.V., & Marchenko, L.A. (2007). Sovremennyye podkhody k otsenke ovarialnogo rezerva u zhenshchin s prezhdevremennoy nedostatochnostyu yaichnikov [Modern approaches to the assessment of ovarian reserve in women with premature ovarian failure]. Problemy reproduktsii – Probl. Reprod., 2, 22-29 [in Russian].
Dankovich, N.A., & Vorobey-Vikhovskaya, V.N. (2013). Prichiny i formy besplodiya. Sovremennyye vozmozhnosti diagnostiki i lecheniya [Causes and forms of infertility. Modern possibilities of diagnosis and treatment]. Zdorovye zhenshchiny – Womenʼs Health, 3, 192-197 [in Russian].
Masliy, Yu.V., Sudoma, I.O., & Livshyts, H.B. (2006). Chynnyky syndromu slabkoi vidpovidi yaiechnykiv v tsyklakh dopomizhnykh reproduktyvnykh tekhnolohii [Ethiopathogenetic factors of ovarian poor response syndrome in cycles of assisted reproductive technology]. Zdorovye zhenshchiny – Womenʼs Health, 4(28), 152-157 [in Ukrainian].
Mishiyeva, N.G. (2010). Besplodiye u zhenshchin pozdnego reproduktivnogo vozrasta: printsipy diagnostiki i lecheniya v zavisimosti ot ovarialnogo rezerva [Infertility in women of late reproductive age: principles of diagnosis and treatment depending on the ovarian reserve]. Doctorʼs thesis. Moscow [in Russian].
Yuzko, O.M., Yuzko, T.A., & Rudenko, N.H. (2013). Stan ta perspektyvy vykorystannia dopomizhnykh reproduktyvnykh tekhnolohii pry likuvanni bezpliddia v Ukraini [Status and pros-pects of using assisted reproductive technologies in the treat-ment of infertility in Ukraine]. Zdorovye zhenshchiny – Womenʼs Health, 8, 26-30 [in Ukrainian].
Avramenko, N.V. (2014). Vspomogatelnyye reproduktivnyye tekhnologii [Assisted reproductive technologies]. Zaporozhskiy meditsinskiy zhurnal – Zaporozhye Medical Journal, 3(84), 95-100 [in Russian].
Forouhari, S., & Ghaemi, S.Z. (2013). A survey of psychosexual disorders in infertile women referred to the Zeinabiee Infertility Center of Shiraz University of Medical Sciences. Res. J. Biol. Sci., 8(4), 99-103.
Monga, M., Alexandrescu, B., Katz, S.E., Stein, M., & Ganiats, T. (2004). Impact of infertility on quality of life, marital adjustment, and sexual function. Urology, 63 (1), 126-130. DOI: 10.1016/j.urology.2003.09.015.
Jun Chi, H., Park, I.H., Sun, H.G., Kim, J.W., & Lee, K.H. (2016). Psychological distress and fertility quality of life (FertiQoL) in infertile Korean women: the first validation study of Korean FertiQoL. Clin. Exp. Reprod. Med., 43(3), 174-180. DOI: 10.5653/cerm.2016.43.3.174.
Keramat, A., Masoomi, S.Z., Mousavi, S.A., Poorolajal, J., Shobeiri, F., & Hazavhei, S.M. (2014). Quality of life and its re-lated factors in infertile couples. J. Res. Health Sci., 14(1), 57-63.
Ramezanzadeh, F., Aghssa, M.M., Abedinia, N., Zayeri, F., Khanafshar, N., Shariat, M., et al. A survey of relationship between anxiety, depression and duration of infertility. BMC Womens Health, 4(1), 9. DOI: 10.1186/1472-6874-4-9.
Ware, J.E., Snow, K.K., Kosinski, M., & Gandek, B. (1993). SF-36 Health Survey. Manual and interpretation guide. The Health Institute, New England Medical Center. Boston, Mass.
Boivin, J., Takefman, J., & Braverman, A. (2011). The fertility quality of life (FertiQoL) tool: development and general psychometric properties. Hum. Reprod., 26(8), 2084-2091. DOI: 10.1093/humrep/der171.
Gayvoronskaya, S.I., Grishchenko, N.G., & Paraschuk, V.Yu. (2015). Vliyanie faktorov riska na razvitie sindroma giperstimulyatsii yaichnikov v programme vspomogatelnykh reproduktivnykh tekhnologiy [Influence of risk factors on the development of ovarian hyperstimulation syndrome in the program of auxiliary reproductive technologies]. Proceedings of the Int. Sci. Pract. Conf.: Teoretychni ta praktychni aspekty rozvytku suchasnoi medytsyny – Theoretical and Practical Aspects of the Development of Modern Medicine. (pp. 17-18). Lviv: Lviv Medical Society [in Russian].
Dakhno, F.V., & Kaminskyi, V.V. (Eds.). (2011). Dopomizhni reproduktyvni tekhnolohii likuvannia bezpliddia: navchalnyi posibnyk dlia likariv – slukhachiv zakladiv (fakultetiv) pisliadyplomnoi osvity [Assisted reproductive infertility treatment technologies: A manual for doctors – listeners postgraduate education courses]. Kyiv [in Ukrainian].
Lee, A., Sator, M., Kratochwil, A., Deutinger, J., Vytiska-Binsdorfer, E., & Bernaschek, G. (1997). Endometrial volume change during spontaneous menstrual cycles: volumetry by transvaginal three-dimensional ultrasound. Fertil. Steril., 68(5), 831-835. DOI: 10.1016/s0015-0282(97)00362-2.
Raine-Fenning, N.J., Campbell, B.K., Clewes, J.S., Kendall, N.R., & Johnson, I.R. (2004). Defining endometrial growth during the menstrual cycle with three-dimensional ultrasound. BJOG., 111(9), 944-949. DOI: 10.1111/j.1471-0528.2004.00214.x.
Palyga, I.E. (2013). Klinicheskiy analiz neudachnykh popytok ispolzovaniya vspomagatelnykh reproduktivnykh tekhnologiy [Clinical analysis of failed attempts to use assisted reproductive technologies]. Zdorovye zhenshchiny – Womanʼs Health, 8(84), 164-166 [in Russian].
Baskakov, V.P. (2005). Sostoyanie reproduktivnoy sistemy zhenshchiny pri endometrioze [Condition of the reproductive system of a woman with endometriosis]. Problemy reproduktsii – Probl. Reprod., 2, 15-18 [in Russian].
Babenko, I.V. (2013). Vykorystannia modyfikovanoho pryrodnoho tsyklu v dopomizhnykh reproduktyvnykh tekhnolohiiakh u patsientok z neplidnistiu i znyzhenym yaiechnykovym rezervom [Use of the modified natural cycle in assisted reproduc-tive technologies in patients with infertility and reduced ovarian reserve]. Zbirnyk naukovykh prats Asotsiatsii akusheriv-hinekolohiv Ukrainy – Collection of Scientific Works of the Association of Obstetricians-Gynecologists of Ukraine. (pp 18-19). Kyiv: Polihraf plius [in Ukrainian]
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