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Genetic and Epigenetic Mechanisms of Endometral Reciptivity Disorder in Patients Born with Low Weight
Melkozerova Oxana Alexandrovna,
Bashmakova Nadezda Vasilyevna,
Tretyakova Tatyana Borisovna,
Schedrina Irina Dmitrievna
Issue:
Volume 6, Issue 4, July 2018
Pages:
71-79
Received:
5 June 2018
Accepted:
12 July 2018
Published:
7 August 2018
Abstract: The aim is to study genetic and intrauterine epigenetic mechanisms of endometrial receptivity disorders in patients with reproductive failures. 96 girls of adolescents with disturbed menstrual function as anomalous uterine bleeding (AUB PP) and 210 women of reproductive age, suffering from uterine infertility or miscarriage, due to "thin" endometrium were examined. All the patients were born on the deadline. Within the main cohorts, the patients were stratified according to their birth weight. Clinical anamnestic data and molecular genetic studies of polymorphic variants of sex steroids receptor genes, endothelial function regulation genes, angiogenesis and thrombophilia were analyzed using the "real-time" allele-specific polymerase chain reaction with melting curves of the amplification products using a set of reagents and protocols of the company Test Gen LTD (Russia). The risk of reproductive failures due to impaired receptivity of the endometrium is associated with the carrier of the polymorphic allele A of the VEGF2578C gene> A: for patients with infertility (OR = 2.73 (1.36-5.45), p = 0.01) and miscarriage OR = 4.61 (2.19-9.71), p = 0.01) and bearing the polymorphic allele 675 4G of the PAI-1 gene 675 5G> 4G: for patients with infertility (OR = 8.45 (3, 96-18,21), p = 0,001) and miscarriage (OR = 9.98 (4.61-21.74), p = 0.001). The carrier of polymorphism pVull-СС of the gene ESR1 397T> C is associated with an increased risk of disruption of the development of the menstrual function, manifested by abnormal uterine bleeding of the pubertal period (OR = 4.58 (0.97-21.68) p = 0.04), and the risk of developing in the reproductive age of miscarriage, caused by a "thin" endometrium (OR = 6.79 (1.94-23.75), p = 0.01). In women born with low weight, a significantly higher frequency of genotypes containing polymorphic allele 786C of the gene for endothelial NO-synthase NOS3 786 T> C was determined: for women with infertility OR = 6.173 (1.83-20.83); p = 0.001; for women with miscarriage OR = 4.902 (1.69-14.08); p = 0.002; for girls OR = 2.56 (1.01-6.50); p = 0.04. The genetic network containing the described variable alleles coordinates the pathological nature of the regulation of the endometrial function, which can lead to the formation of a "thin" non-receptive endometrium in response to traumatic injury.
Abstract: The aim is to study genetic and intrauterine epigenetic mechanisms of endometrial receptivity disorders in patients with reproductive failures. 96 girls of adolescents with disturbed menstrual function as anomalous uterine bleeding (AUB PP) and 210 women of reproductive age, suffering from uterine infertility or miscarriage, due to "thin" endometri...
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How Many Embryos Should Be Transplanted After IVF Having Previous Pre-Eclampsia: A Case Report
Issue:
Volume 6, Issue 4, July 2018
Pages:
80-85
Received:
7 July 2018
Accepted:
26 July 2018
Published:
16 August 2018
Abstract: Pre-eclampsia is a pregnancy-induced hypertensive disorder which affect multiple organ functions, it is one of the main factors increasing the morbidity and mortality of the maternal and neonatal. Furthermore, with the increasing rate of infertility or sub-fertility, more and more couples are conceiving assisted reproductive therapies, especially in vitro fertilization (IVF), which brings high possibility of multiple pregnancy due to its unique process and the patients demands. As is well known that multiple pregnancy may face great challenges of complications such as pre-eclampsia, gestational diabetes, intrahepatic cholestasis of pregnancy etc. If pre-eclampsia is not treated and monitored very well on time the mothers perhaps will have eclampsia, placental abruption or multiple organ dysfunction leading to death, likewise those fetus whose mother suffered from Pre-eclampsia also face the risks of fetus growth restriction, fetal stress or even stillbirth. We represent a patient in our clinic who had done twice in vitro fertilization-embryo transplantation(IVF-ET) with several high risks of pre-eclampsia and followed by recurrent Pre-eclampsia and Intrahepatic Cholestasis of Pregnancy, we fully recognize her risks in her second pregnancy and give a close antenatal surveillance, and she finally have two alive babies, but a large amount of money was spend for the two preterm babies in hospitalization in NICU and also the mother herself became exhausted and almost lost her hope. It reminds us that before conceiving IVF technology for patients, the indication must be clear, the adverse effect must be brought into consideration, cooperation must be obtained from both the reproductive clinicians and obstetrician to fully balance the benefit and adverse effect, attention must be paid to choose the best method during the assisted reproductive therapies and acquire the utmost benefit and avoid the side effect as possible.
Abstract: Pre-eclampsia is a pregnancy-induced hypertensive disorder which affect multiple organ functions, it is one of the main factors increasing the morbidity and mortality of the maternal and neonatal. Furthermore, with the increasing rate of infertility or sub-fertility, more and more couples are conceiving assisted reproductive therapies, especially i...
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Olfactory Sensitivity Change in the Dysmenorrhea Women: A Cross-Sectional Study
Ren-Jen Hwang,
Yu-Jia Yan,
Hsin-Ju Chen,
Yu-Sheun Lee,
Yueh-O Chuang
Issue:
Volume 6, Issue 4, July 2018
Pages:
86-93
Received:
31 July 2018
Accepted:
14 August 2018
Published:
3 September 2018
Abstract: Background: Dysmenorrhea is accompanied by abnormal brain metabolism in affective cortical-limbic structures; regions are functionally involved in nociceptive and olfactory processing. The study aims to examine the manifestation of chemical sensitivity changes in women with dysmenorrhea. Methods: A cross-sectional correlation research design was used for this study. Five subsets of odors (lemon, H2S, ethyl, acetone, and rose) were tested on 120 women. The visual analogue scale was presented to evaluate the intensity (strong to weak) and hedonic value (pleasant to unpleasant) of each odor. The participants underwent Pain index of dysmenorrhea questionnaire (DQ) and psychophysical assessment after performing olfactory tests. Results: (1) An increased unpleasantness rating of the H2S odorant was associated with the degree of dysmenorrhea. DQ-severity score was the statistical significance of the predictor variable on H2S odorant perception alteration (P =.006), after controlling the collinear variables from regression. (2) Lemon, acetone, and ethyl odorant as positive hedonic values recognized were not significantly related to the DQ pain scores. (3) Additionally, decreased perception of the intensity of the rose odorant was related to rising dysmenorrheal frequency level. (P =.015). (4) Women with higher DQ score were positively related to psychological distress such as anxiety, depression and stress level. Conclusions: Findings disclosed that significantly raised the unpleasantness level of odorant H2S, and weakening the intensity value of the pleasantness rose odorant relates to women with severe dysmenorrhea symptoms. The neurobiological bases of olfactory sensitivity changes refer to olfactory-limbic system disturbances and appropriate management of menstrual cramps were discussed.
Abstract: Background: Dysmenorrhea is accompanied by abnormal brain metabolism in affective cortical-limbic structures; regions are functionally involved in nociceptive and olfactory processing. The study aims to examine the manifestation of chemical sensitivity changes in women with dysmenorrhea. Methods: A cross-sectional correlation research design was us...
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Effect of Pelvic Floor Muscle Rehabilitation in Preventing Recurrent Vulvovaginal Candidiasis and Recurrent Bacterial Vaginosis
Cheng Fang,
Yang Yun-Jie,
Shi Wen-jing,
Wang Xue-Ying,
Ma Le
Issue:
Volume 6, Issue 4, July 2018
Pages:
94-97
Received:
10 July 2018
Accepted:
24 July 2018
Published:
13 September 2018
Abstract: Objective To investigate the effect of pelvic floor muscle rehabilitation on recurrent vulvovaginal candidiasis (RVVC) and recurrent bacterial vaginosis (RBV). Methods Between January 2014 and July 2015, 121 cases of RVVC and RBV were selected, and the patients were randomly divided into control group and experimental group. For the control group of RVVC: miconazole suppository and vaginal delivery were utilized in every patient, 1 piece per night, the period of treatment was 7 to 14 days; oral intake of fluconazole was used again after 72 hours. Clotrimazole suppository or fluconazole was still chosen for the maintenance treatment: (1) 1 piece per week and lasted 6 months for every case; (2) 400 mg of itraconazole was used, 1 time every month or 100 mg was used once a week, the period of treatment lasted for 6 months. RBV: oralintake of metronidazole or clindamycin was chosen. One piece of metronidazole suppository by vaginal utilization was still needed per night, or 2% clindamycin ointment was used by inunction for 7 days. Experimental group: pelvic floor muscle rehabilitation. Results Before rehabilitation treatment, there were 4 cases with level 4 or 5 of type I muscle strength and 8 cases level 4 or 5 of type II muscle strength. After the treatment, there were 59 cases with level 4 or 5 of type I muscle, and 60 cases with level 4 or 5 of type II muscle (P＜0.001). There were no statistical differences on the treatment of anterior vaginal wall prolapse. Before the treatment, the number of anterior vaginal wall prolapse was 53 cases, the number was 49 cases after treatment (P=0.328). Before treatment, the number of posterior vaginal wall prolapse was 25 cases, the number was11 cases after treatment (P=0.005). The number of Uterine prolapse was 14 cases, the number was 2 cases after treatment (P=0.002). Compared with the group with drug treatment, the rate of relapse in vaginitis was decreased significantly after pelvic floor rehabilitation within 1 year, 61 patients with vaginitis, there were only 2 cases of recurrences were observed after treatment (P＜0.05). Conclusion Pelvic floor rehabilitation treatment could improve the pelvic floor function significantly, and also get significant recovery of sagging and prolapse in vagina which was injured by pregnancy and childbirth. Compared with the drug treatment group, the rate of relapse in RVVC and RBV was decreased significantly after pelvic floor muscle rehabilitation.
Abstract: Objective To investigate the effect of pelvic floor muscle rehabilitation on recurrent vulvovaginal candidiasis (RVVC) and recurrent bacterial vaginosis (RBV). Methods Between January 2014 and July 2015, 121 cases of RVVC and RBV were selected, and the patients were randomly divided into control group and experimental group. For the control group o...
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The Efficiency of Intrauterine Irrigation of the Cavitated Drug Solutes in Patients with Endometrial Receptivity Disorders
Oxana Alexandrovna Melkozerova,
Evgeniy Yuryevich Gluchov,
Nadezda Vasilyevna Bashmakova,
Guzel Nuchovna Chistyakova,
Alena Valeryevna Lvova,
Anna Michaylovna Bogdanova,
Aigul Adipovna Giniyatova,
Olga Germanovna Barlit
Issue:
Volume 6, Issue 4, July 2018
Pages:
98-107
Received:
6 June 2018
Accepted:
12 July 2018
Published:
17 September 2018
Abstract: Evaluate the efficiency of intrauterine irrigation of cavitated low-frequency sonication drug solution in restoring of endometrial receptivity in patients with uterine infertility. 92 women with uterine infertility due to endometrial hypoplasia were examined in the dynamics of therapy including irrigation of the uterine cavity with cavitated low-frequency ultrasound with drug solutions. The control group consisted of 28 healthy fertile women. An ultrasound examination of the pelvic organs with color dopplerogragy, histological and immunohistochemical study of the endometrium was performed on the "implantation window" LH + 7, in dynamics before the start of therapy and in the next cycle after the end of treatment. After cavitation irrigation of the uterine cavity, 62 (67.39%) women with infertility in the endometrial specimens had adequate vascularization of the stroma (before treatment, 36.95%, p=0.017, in control 78.57%), in 68 (73, 91%) women - a decrease in the density of the stromal matrix, in 64 (69.56%) - according to light microscopy data, mature pinopodia were determined (initially 28.26%, p=0.0015). On the background of therapy, the ratio of ERα / PR expression in the stroma of the implantation endometrium was normalized, which was characterized by the prevalence of the PR pool (1.01±0.34 before treatment, 0.36 ± 0.03 after therapy, p = 0.040, in control 0.34±0.06, p> 0.05). The parameters of stromal expression of natural uterine killers CD56 + bright against the background of treatment in patients with infertility come in accordance with the indices of healthy fertile women (from 35.21 ± 2.14 cells in l/s to 45.75±3.18 cells l/s; in the control 47.8±2.13 cells in l/s; p> 0.05). A significant decrease in stromal expression of CD3+ is noted: 78.17±6.89 cells in l/s versus 23.83±3.63 cells in l/s; p=0.004. The expression level of CD34 in the endometrial stroma after the treatment was significantly increased (20.88±0.77 cells in l/s versus 33.83±3.63 cells in l/s, p=0.035). The use of G-CSF cavitaion solutions for irrigation of the uterine cavity appears to be effective in restoring tissue and molecular endometrial receptivity in patients with uterine infertility due to endometrial hypoplasia.
Abstract: Evaluate the efficiency of intrauterine irrigation of cavitated low-frequency sonication drug solution in restoring of endometrial receptivity in patients with uterine infertility. 92 women with uterine infertility due to endometrial hypoplasia were examined in the dynamics of therapy including irrigation of the uterine cavity with cavitated low-fr...
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