Disorders Of Reproductive Function Research Articles

The Potential Toxic Side Effects of Flavonoids

Flavonoids are a class of phytochemical molecules abundant in many plants, fruits, vegetables, and leaves. Flavonoids possess a series of significant biological activities, including anticancer, antioxidant, antiviral, and antiinflammatory properties. They become an important source of dietary supplements and natural health products. Though many studies confirmed the safety of flavonoids, the potential toxicity of flavonoids is still a remarkable field of research to be explored. The enthusiasm for flavonoids expressed by the public has sometimes overlooked their toxicity and also consumed the flavonoids exceeding the body requirements. The current review focused on the potential toxicity of flavonoids to make the public consume flavonoids with caution. This review summarizes the current toxicity which has been reported in vivo and in vitro experiments. The toxicity involves carcinogenicity and mutation, liver and kidney toxicity, and the influence on the thyroid and reproductive function and intestinal flora disorders. The mechanism of toxicity is fully complicated, and current evidence indicates that natural flavonoid glycosides act on different targets with different doses in vivo and in vitro experiments. Though most kinds of flavonoids are considered safe, flavonoids proposed as food supplements need to be assessed their tolerable upper intake level as there have been reports of toxic flavonoids.

Changes in morphofunctional and genetic indicators of ejaculate in men with disorders of reproductive function depending on kind of alcohol drinks consumed

Purpose of the study. Due to the scanty information and the lack of precise data on etiology and pathogenesis of fertility in men consuming alcohol this research was aimed at studying the changes in morphofunctional and genetic parameters of ejaculate in men with impaired ejaculate fertility depending on the type and amount of alcohol consumed
 Materials and methods. The article contains the data of researching ejaculate fertile properties and features of spermatozoa DNA fragmentation in 110 men being divided into three groups depending on kind and amount of alcohol consumed.
 Results. According to the obtained data the degree of spermatogenesis disorder and tendency to increase level of spermatozoa DNA fragmentation depends on the kind, rate and an amount of alcohol consumed. Thus, the low level in consumption of alcoholic drinks was accompanied by variations of admissible values in spermogram. The most evident changes in ejaculate fertile properties were being observed at middle and high risk in consumption of beer and alcohol mixed, as teratozoospermia has been revealed as a result not only from the ethanol effect but from the impact of components free alcohol character. Revealed tendency of increasing spermatozoa DNA fragmentation level extends our view concerning disorders of ejaculate fertile properties that is obviously connected with alcohol consumption.
 Conclusions. Thus, alcohol consumption in great amounts, especially, consuming beer with mixed strong alcohol and also pattern of consuming alcohol as “great doses for short time” contribute to a considerable damage to ejaculate fertile properties.

CHARACTERISTICS OF METABOLIC PROCESSES IN THE FORMATION OF MENSTRUAL FUNCTION DISORDERS IN ADOLESCENT GIRLS WITH OBESITY

Іntroduction. Today, a quarter of the population of economically developed countries has a body weight that is 15% larger than the norm. According to various authors, the timely onset of menarche in women with various forms of obesity and reproductive dysfunction is observed in 31% of cases only.
 Obesity results in insulin resistance, which in its turn results in hyperinsulinemia. The main reason of the connection of insulin resistance with reproductive function disorders consists in the specific influence of insulin on ovaries. Insulin suppresses apoptosis, binding to receptors of various growth factors that promotes long existence of atresizing follicles. In the pathogenesis of the metabolic syndrome, along with the development of hyperinsulinemia and insulin resistance, a significant role belongs to the imbalance of adipocytokines, one of which is adiponectin.
 The aim is to analyze metabolic processes in the formation of menstrual dysfunction in adolescent girls with obesity to improve diagnostic methods of menstrual disorders.
 Material and methods. Clinical and laboratory examination of adolescent girls aged 12-18 years was held, among which 79 had obesity and complaints about menstrual dysfunction (the main group); 31 with normal body weight and regular menstrual cycle (the control group).
 Research methods: general clinical, biochemical (indicators of lipid and carbohydrate metabolism were determined), instrumental (ultrasound), statistical.
 Results. It was found that 53.3% of the girls from the main group had the beginning of the first menstruation after 14 years, delayed menstruation from 42 days to 6 days, duration 2.1 ± 0.05 days, which was significantly shorter, the volume of 10.2 ± 0.05; 0.4 points (average 1-2 pads per day) was significantly lower (p <0.05).
 Ultrasound showed uterine hypoplasia in almost every second girl in the main group - 36 (45.46%).
 Hyperleptinemia and leptin resistance was found in obesity of the first degree 34.8 ± 1.75, in obesity of the second degree 37.15 ± 2.12, in obesity of the third degree 40.64 ± 2.0. It was 14.35 ng / ml in the control group, p<0,01.
 Hyperleptinemia in the main group was accompanied by hyperinsulinemia in 26% of cases and insulin resistance. The relationship between low values of adiponectin and elevated body mass index in patients of the main group was established, which was confirmed by the results of correlation analysis (adiponectin & body mass index: ρ = -0.74).
 Analysis of the results revealed a decrease of A/L level in the main group by 4.3 times. Based on our own results, the A/L and HOMA-AD models can be considered more accurate for determining insulin resistance.
 Conclusions. 1. Changes of the menstrual cycle in overweight girls were found.
 
 The association of adipokines secretion disorders is characterized by hyperleptinemia, leptin resistance, decreased Adiponectin / Leptin index and hypoadiponectinemia, which, in combination with insulin resistance, indicates the participation of adipokines in the genesis of oligomenorrhea.
 The algorithm of adolescents’ treatment with menstrual dysfunction on the background of obesity must include the calculation of Adiponectin/Leptin and HOMA-AD, which will make it possible to avoid overdiagnosis of insulin resistance.

Development of Methods for the Treatment and Prevention of Disorders of Reproductive Function of Animals because of the Use of Modern Insecticides in Animal Husbandry

Development of Methods for the Treatment and Prevention of Disorders of Reproductive Function of Animals because of the Use of Modern Insecticides in Animal Husbandry

O-068 Training of clinicians: How to do it and how to best evaluate it

Abstract Training of clinicians: How to do it and how to best evaluate it? Anis Feki, Tatjana Motrenko, Roy Farquharson Many countries within Europe and EU do not have a specific national agency that provides the necessary structure or governance for appropriate training in Reproductive Medicine (RM). Therefore, The European Society of Human Reproduction and Embryology (ESHRE) has been the responsible agency for accreditation of RM training alongside its sister organization, the European Board and College of Obstetrics and Gynaecology (EBCOG). Both of these organizations are ultimately responsible to and approved by the Union of European Medical Specialties (UEMS), which represents the European Union (EU) governing body for medical practitioners’ education. The Reproductive Medicine subspecialist is a specialist in basic obstetrics and gynecology who has undergone theoretical and practical training in the medical and surgical management of infertility, including assisted reproductive techniques (ART). In general, the comprehensive management of these problems includes both diagnostic and therapeutic procedures allied to continuous audit of outcome. The global aim is to improve the care of patients with disorders of reproductive function. To reach this target, both ESHRE and EBCOG put in place a program that starts with accreditation of training centers in obstetrics and gynecology and more specifically, specialist training centers in reproductive medicine. Fellows must have a structured program of a minimum of 2 years after completing their basic obstetrics and gynecology syllabus and/or obtaining EFOG European Fellow of Obstetrics and Gynecology) diploma for non-European basic training. When a training fellow in RM has completed their logbook, the fellow will finish by assessing an individual’s knowledge and skills by passing an exit-training exam called the EFRM (ESHRE-EBCOG Fellow in Reproductive Medicine) diploma. The success of and the need for such certification has led ESHRE to structure the training also for reproductive surgeons, embryologists, as well as nurses and midwives. In addition, several countries within the EU already have a national compulsory specialist accreditation system for RM training. Recent proposals by the EU Commission to build European reference networks across all specialties, including RM may require the recognition of ESHRE/EBCOG–accreditation as an appropriate entry point for consideration of diagnostic and other interventions. Encouraging subspecialists and centers to apply for training accreditation may well prove to be an increasingly attractive option as educational needs across Europe become integrated and formalized through UEMS. ESHRE holds the view that accredited centers/subspecialists for training are beacons of excellence that often go hand in hand with high-quality research.

THE USE OF GADOLINIUM ORTHOVANADATE NANOPARTICLES FOR THE CORRECTION OF REPRODUCTIVE ABILITY IN BOARS UNDER OXIDATIVE STRESS

The search for effective and safe means of correcting male hypofertility is an urgent problem of modern reproductology. Researchers have proved the possibility of the use of nanoparticles based on oxides of rare earth elements for the treatment of disorders of male reproductive function. We investigated the effectiveness of the use of gadolinium orthovanadate nanoparticles activated by europium the size of which was 25×8 nm in the dose of 0,0125 mg per kg of live weight to correct reproductive ability decrease in boars under oxidative stress. After 14 days of hydrosol nanoparticles administration we established experimentally the dynamics of the content markers of oxidative stress and stable metabolites in the Nitrogen oxide cycle, and also determined the changes in sperm quality indicators. Thus, diene conjugates concentration in the blood serum of boars on the 15 th day tended to decrease, and on the 30 th day of the study was lower by 9,4 % compared to the group of animals before administration. At the same time the amount of thiobarbiturate-active products decreased on the 15 th day of the study by 24,7 %, and on the 30 th day – by 48,2 %, which indicates the normalization of oxidative processes in males. We noted positive changes in the system of the Nitrogen oxide cycle, the content of stable metabolites on the 15 th day was lower than in animals before administration by 25,2 %, and on the 30 th day – by 42,6 %. At the same time, we observed an improvement in the quality of boar sperm, especially motility and the number of motile sperm in the ejaculate increased by 42,9 % and 57,1 % on the 60 th day and by 95,2 % and 1,48 times on the 90 th the day of the study, respectively. In this case, the volume of ejaculate, sperm concentration and sperm content with morphological anomalies with the introduction of nanoparticles normalized and almost reached the values of the control group. The researchers are interested in further elucidating the effect of correction of reduced reproductive ability in boars under oxidative stress with gadolinium orthovanadate nanoparticles on hormonal background and the state of enzymatic and non-enzymatic systems of antioxidant protection. Keywords: sperm quality, prooxidant-antioxidant system, peroxidation, oxidative stress markers, the Nitrogen oxide cycle, nanomaterials

MO476EFFECT OF ESTROGEN DEFICIENCY ON THE STATE OF BONE AND MINERAL METABOLISM IN WOMEN WITH STAGE III-V CHRONIC KIDNEY DISEASE

Abstract Background and Aims Clinical studies in recent years have revealed a close relationship between hormonal disorders in women with CKD and the duration and quality of life, bone mineral and related disorders of the cardiovascular system. In individual studies, there is a tendency to improve the indicators of mineral and bone metabolism and the state of the cardiovascular system in hormonal or other drug-induced correction of hormonal dysfunctions in women. - Aims to study the effect of estrogen deficiency on bone and mineral metabolism in a population of women suffering from CKD stages III-V Method The study included 52 women who met the clinical criteria for the possible appointment of hormone therapy (both replacement and combined oral contraceptives) for the purpose of a detailed examination of the state of their cardiovascular system and bone-mineral metabolism in dynamics (with an interval of 10-12 months) in order to assess the degree of influence of estrogen-deficient conditions on the course of such common complications of CKD as cardiovascular diseases and pathology of the bone system. The age of the patients ranged from 26 to 61 years (mean age-50.65±9.17 years). The duration of CPN averaged 77.02 months.. The stages of CKD were determined according to the K/DOQI (2012) criteria, and the glomerular filtration rate was calculated using the CKD-EPI formula. The following parameters were evaluated: the concentration of sclerostin, osteoprotegerin, fibroblast growth factor 23 (FGF-23), parathyroid hormone, total calcium, phosphorus, alkaline phosphatase, creatinine, and urea. Follicle-stimulating hormone( FSH), luteinizing hormone(LH) and estradiol were determined by solid-phase chemiluminescent enzyme immunoassay (commercial sets of Alkor-Bio, St. Petersburg). Serum concentrations of sclerostin, sRANKL (soluble RANKL), and osteoprotegerin were determined by the enzyme-linked immunoassay using Biomedica gruppe test systems. Results The examined patients showed hormonal dysfunctions (82%), accompanied by changes in the content of sex hormones: the concentration of estradiol was below normal: 123.4±72.5 pmol/l and 150.0-450.0 pmol/l, respectively, in patients and in normal (p<0.01), which confirms the presence of estrogen deficiency in the examined patients . Concentrations of FSH and LH exceeded the norm in the group of patients as a whole: 91.6±46.1 IU/l and 3.0-8.0 IU/l FSH content in patients and normal; 51.8±32.1 IU/l and 3.0-10.0 IU/l LH in patients and normal. In the group of patients as a whole, an increase in the level of sclerostin to 28.5 ± 9.2 pmol/l was detected ( norm 12±33.45 pmol/l), an increase in the level of osteoprotegerin to 6.9±0.4 pmol/l (norm 2.7 pmol/l). Positive and negative correlations were found between the levels of morphogenetic proteins, sex hormones, and characteristic parameters of hormonal dysfunctions Conclusion Pre-and postmenopausal women with CKD have hormonal dysfunctions, including disorders of sexual and reproductive function, menstrual cycle, decreased fertility, increased risks of miscarriage at its onset, the basis of hormonal dysfunctions is the absence of LH peaks and changes in the concentration of estradiol depending on the phase of the cycle, hypoestrogenemia. It is assumed that there is a pathogenetic link between hormonal dysfunctions and disorders in the system of bone metabolism regulatory proteins in patients with CKD.

Approaches to the realization of reproductive function in women with systemic lupus erythematosus and antiphospholipid syndrome

Aim. To assess the safety and efficacy of assisted reproductive technology (ART) programs in patients with systemic lupus erythematosus (SLE) with/without comorbid antiphospholipid syndrome (APLS).
 Materials and methods. The observational study included 26 patients with diagnosed SLE, of whom 7 women had comorbid APLS and disorders of reproductive function. The analysis of the causes of impaired fertility was based on history and comprehensive examination data, which, along with risk factors for possible complications, determined the choice of ART programs.
 Results. In 23 of 26 patients, infertility (primary: 14, secondary: 9) was diagnosed, and 3 patients were diagnosed with repeated miscarriage. The main etiological factors of infertility were tubal (n=6), male (n=8) and their combination (n=3); in 9 cases the etiology of infertility remained unclear. 10 patients with a history of lupus nephritis had a reduced ovarian reserve. In total, 23 infertile patients underwent 33 in vitro fertilization programs. 11 (33%) clinical pregnancies were registered, of which 7 ended in live birth. There were no cases of severe exacerbation of SLE and thrombotic complications.
 Conclusion. ART can be used in patients with SLE with / without APLS, if the underlying disease is compensated for and prevention for complications is used. The effectiveness of ART programs is comparable to that in the general population. Further research is needed to make a final judgment on the safety of various ART programs in SLE with/without APLS.

EFFECTIVENESS OF MICROELEMENTS IN THE FORMATION OF MECHANISMS OF PROTECTION OF THE BODY UNDER THE INFLUENCE OF ENVIRONMENTAL STRESS FACTORS

Analysis of literature data and the results of our own research show that even with intensive rearing of animals with the use of balanced feeding and keeping them in accordance with the technology - it is almost impossible to avoid stress. And especially, excessive man-made load on agroecosystems also has a negative impact on animal life.
 Factors that cause a decrease in immune status and the emergence of immune pathology in animals include: industrial technology of animal husbandry, chemicalization in crop and livestock production, man-made pressure, dietary imbalance in nutrients and biologically active substances. This increases the impact on the body of heavy metals, which displace nutrients from body tissues, in particular trace elements and replace them in metabolic processes, which is a potential prerequisite for the development of oxidative stress. The mechanism of development of stress reaction of an organism is closely connected with activity of POL (lipid peroxidation) and depression of antioxidant potential. Under these conditions, the ability of the organism to mobilize protective and adaptive capabilities in response to the action of negative factors becomes especially important. Keeping productive animals in adverse conditions, unbalanced feeding are components of immobilization stress, which reduces their productivity, affects reproductive function, metabolic and functional disorders, reducing nonspecific and specific resistance of the organism (Fedoruk & Kravtsiv, 2003; Velychko, 2008; Velychko, 2011).
 Under conditions of man-caused load on the environment, respectively, and animals – it is promising to develop effective methods for regulating the activity of the enzymatic system of antioxidant protection with the help of biologically active substances, in particular trace elements. The results of research confirm that this has a positive effect on the formation of productive and adaptive properties of animals.
 The system of antioxidant protection is a necessary part of non-specific reactions of the organism, a component of the processes of its adaptation to environmental conditions, a component of normal life, a factor in maintaining homeostasis. Widespread immunodeficiency and elucidation of the main links of their pathogenesis have exacerbated the problem of regulating disorders of the immune system. Therefore, knowledge of the patterns of formation of the immune status of animals, especially in the early postnatal period, is important in the development of methods for the correction of immunodeficiency, antioxidant protection.

SOME DISCUSSION ISSUES OF THE HYPOTHYROIDISM PROBLEM

The notion “subclinical hypothyroidism”, its significance in the genesis of metabolismdisorders, debatable approaches to the treatment as well as the role of the thyroidgland hypofunction in pathogenesis of the menstrual cycle disorders and infertility onthe example of the own clinical observation is given in the article.Objective – to designate the criteria for diagnosis and approaches to the treatmentof subclinical hypothyroidism, as well as to confirm the role of the manifestedhypothyroidism in the pathogenesis of the reproductive function disorders in women.Conclusions. 1. The thyroid gland hypofunction plays a significant role in the genesisof metabolic changes and development of the menstrual cycle disorders, galactorrheaand infertility. 2. The problem of hypothyroidism in general and, subclinicalhypothyroidism, in particular, requires further study in order to reduce the risk ofmetabolic diseases development.

Вплив перенесеного пренатального стресу на майбутнє репродуктивного здоров’я жінок

Prenatal stress is quite a common occurrence in a modern society and in return affects the development of violations of women’s` reproductive health. It is an obvious need to give an appropriate attention to the woman in the process of a diagnosis of an obstetric and gynecological pathology and also a use of anti-stress therapy and the correction of systemic stress-induced disorders in treatment regimes. The purpose of research was to analyze the literary tributes, dedicated to the problem of prenatal stress and this infusion on the reproductive health of women. Material and methods. We analyzed publication of national and foreign authors on the research topic. Methods of research: statistical and method of expert evaluations. Results and discussion. Psychological unavailability to motherhood of infertile women creates a situation of a prolonged emotional stress, which leads to the prenatal stress and provokes an activation of the modified adaptive response, launches a pathological range of reproductive disorders. We studied the problem of prenatal stress and the general mechanisms of its effects on the body of women in the reproductive period. We described the long-term effects of prenatal stress on emotional suffering, mental and physical health of women. The experienced prenatal stress is a predictor of disorders of the reproductive system in the future, associated with emotional states, the elimination of which restores reproductive function. Psychological unpreparedness for motherhood among women with infertility creates a situation of prolonged emotional stress, which leads to prenatal stress and provokes the activation of their inherent altered adaptive response. The mentioned factors are the triggers for pathological range of reproductive disorders. Prenatal stress is a common phenomenon in modern society, which effects on the development of disorders of women reproductive function. Conclusion. There is a necessity to pay appropriate attention to the patient within the diagnosis of obstetric and gynecological pathology, as well as the necessity for adequate therapy and correction of system stress-induced disorders in treatment regimens. There is a necessity for in-depth study of infertility associated with prenatal stress, development of a comprehensive differential approach to diagnosis and treatment, taking into account the patients' psycho-emotional state with further improvement of pre-pregnancy training and tactics for treatment of such women

The effect of sclerotherapy and pre-pregnancy training with inositol and vitamin D3 on the size and number of cysts in women with infertility on the background of endometriosis

Annotation. Among gynecological diseases, external genital endometriosis leads to disorders of reproductive function and promotes the development of infertility. Currently, the search for less traumatic and more effective treatments for endometriosis continues. The aim of our study was to analyze the diameter of endometrioid cysts in women with infertility on the background of endometriosis before and after sclerotherapy using pre-pregnancy preparation of a complex vitamin preparation with inositol and vitamin D3. The study included 105 women aged 22 to 40 years with endometriosis-associated infertility. The presence of cysts was confirmed by ultrasound and bimanual examination. The drug FT 500 plus was prescribed in a dosage of 1 sachet – once a day from the 2nd or 3rd day of the cycle for 2 menstrual cycles (the cycle in which sclerotherapy was performed and the next cycle). Vitamin D3 “EuTilia D3” was prescribed in prophylactic doses of 2000 IU to women, or therapeutic (depending on the diagnosed or refuted diagnosis of vitamin D hypovitaminosis). The sclerotherapy procedure was performed by transvaginal puncture of the cyst and aspiration of its contents under the control of transvaginal ultrasound, introduction into the capsule of the cyst (without violating its integrity) 76% ethanol solution. It was found that women with endometriosis-associated infertility, who underwent pre-pregnancy preparation with a complex vitamin preparation with inositol and vitamin D3 after sclerotherapy, probably decreased the diameter of cysts in the right (5.85 times) and left (5.57 times) ovaries relative to data before sclerotherapy. When comparing the diameter of cysts in women who underwent pre-pregnancy preparation with a complex vitamin preparation with inositol and vitamin D3, depending on the type of surgery (sclerotherapy or cystectomy) found a probable decrease in the diameter of cysts after sclerotherapy in the right (82.89%) and left (82.05%) ovaries for such data after cystectomy. Therefore, sclerotherapy with pregravidar preparation with a complex vitamin preparation with inositol and vitamin D3 in women with endometriosis-associated infertility probably reduces the diameter of cysts relative to the experimental group without pregravidar preparation, as well as to the group with a history of cystectomy.

Chronic endometritis in women with endometriosis-associated infertility

The article highlights modern ideas about the role of the endometrium in the genesis of reproductive failures. A crucial place of chronic endometritis in the structure of the endometrial infertility factor in endometriosis is noted. Given the frequent association of chronic endometritis and endometriosis, common features of these diseases have been identified. The characteristic of endometrial microbiota in infertility, chronic endometritis and endometriosis is given. An extremely important area of scientific research is precisely the interaction between the microbiota of the endometrium and its immunity, and not just the confirmation of the presence of microorganisms in the endometrium. The modern aspects of the etiology and pathogenesis of chronic endometritis and endometriosis are described. The main pathogenetic determinants of chronic endometritis are the failure of adaptation mechanisms to the constant effects of microbes and, as a consequence, the decrease and inferiority of the immune response and the development of autoimmune reactions. The modern paradigm for the development and progression of endometriosis involves the presence of bacterial contamination of the endometrium and the abdominal cavity, which in turn becomes a trigger for genetically-epigenetic modifications of cells, launching different cascades that underlie reproductive function disorders. The pathogenetically significant relationship between chronic endometritis and endometriosis is highlighted. It was revealed that chronic endometritis can be both a cause and a consequence of endometriosis. Disorders of the endometrial receptivity in chronic endometritis associated with endometriosis, their importance in the implementation of endometrial infertility are described. The important role of the microbiome in the formation of reproductive disorders is noted.

Adipokines: A Rainbow of Proteins with Metabolic and Endocrine Functions.

Obesity represents one of the most important health problems worldwide with increasing morbidity and mortality. Widespread prevalence of this disease justifies its actual definition of a "global epidemic". Adipose tissue is nowadays considered a complex organ with lots of endocrine and metabolic functions. In addition to fulfilling its task for energy storage and thermal regulation, by virtue of its constituent white and brown cells, adipose tissue represents, considering its size, the biggest endocrine gland in the body. Both adipocytes and surrounding resident cells (macrophages, endothelial cells and others) produce a huge number of molecules, or adipokines, with endocrine or paracrine functions, that regulate various aspects of metabolism whose clinical relevance is emerging. By balancing pro-inflammatory and anti-inflammatory effects, the adipokines control insulin sensitivity and related glucose metabolism changes, lipid accumulation in the liver and other organs, and finally gonadal function. Collectively, literature data remains cloudy because of still conflicting results of pre-clinical and clinical studies. The aim of this review was to summarize scientific evidence about adipokines' effects on human metabolism, by focusing on their role on either Metabolic Syndrome and NAFLD, or insulin-resistance in pregnancy, or finally, reproductive function disorders.

Актуальні питання внутрішньоутробного програмування здоров’я і репродуктивної функції жінок, народжених з низькою та надмірною масою тіла (Клінічна лекція)

The replenishment and updatе of information for practitioners, both primary and specialized care providers, about the impact of a woman’s perinatal history on her future health, formation pathological conditions and diseases, is necessary for the integration of modern physicians into space of individualized (personalized, precision) medicine. In recent years, on the background of a decrease in the birth rate and a negative demographic balance of Ukrainian population, the frequency of birth of newborns with deviations of physical development parameters from the boundaries of population standards has been increasing, and this is projects on reducing of children’s and adolescents’s quality of health, increasing the overall morbidity in adulthood, and reproductive function disorders, in particular, gynecological pathology, infertility, pregnancy complications. In such conditions, the importance of pregravid background for the realization of woman’s reproductive function with a positive result is updated. The article provides up-to-date data that will help to understand the relationship between a woman’s perinatal development and the state of her reproductive system in postnatal ontogenesis, which will maximize individualization of medical observation based on the predicted risk due to the realities of intrauterine programming. Key words: intrauterine programming, reproductive function, low birth weight, overweight at birth, gynecological pathology, pregnancy complications, perinatal risk.

Development of innovative hygienic technologies for preservation of the workers’ reproductive health

The new model «Prognosis of men’ reproductive function disorders» was developed. The machine learning algorithms (artificial intelligence) was used for this purpose, the model has high prognosis accuracy. The aim of the model applying is prioritize diagnostic and preventive measures to minimize reproductive system diseases complications and preserve workers’ health and efficiency.

ANATOMIC-FUNCTIONAL STATE OF PELVIC ORGANS IN WOMEN WITH INFERTILITY AND OVARICOVARICOCELE

ANATOMIC-FUNCTIONAL STATE OF PELVIC ORGANS IN WOMEN WITH INFERTILITY AND OVARICOVARICOCELE

Neutrophils, monocytes and other immune components in the equine endometrium: Friends or foes?

The innate and adaptive immune mechanisms are key components of regulation of reproductive physiological function and uterine disorders in equine uterus. The predominant immunological response in equine endometrium, characterized by an innate immune response, occurs under estrogens influence, in the follicular phase. Although, the increase in immune-related genes in equine endometrium during estrus has been suggested to play a role in uterine clearance after mating, immune cells and their product, i.e. cytokines play also mandatory role in the luteal development and maintenance, regression of equine corpus luteum, as well as in early pregnancy. Innate immune response is nonspecific and acts as the first line of defense against pathogens, foreign stimuli that include constituents of seminal fluid and local infections (endometritis). It has been recently established that a phagocytosis-independent mechanism to restrain bacteria, by means of neutrophil extracellular traps (NETs) formation, is involved in pathogenesis of in mare endometrial fibrosis (endometrosis). Moreover, persistent macrophages and mast cell activation could also have pro-fibrotic roles by secreting great amounts of pro-fibrotic factors and lead to fibrosis. This review will highlight the involvement of immune key components of the innate and adaptive immune system and their products in equine uterus and their contribution to reproductive physiological function and uterine disorders.

Chapter 1 - Neuroendocrine mechanisms of reproduction

The neuroendocrinology of reproduction focuses on the neuromodulation of gonadotropin-releasing hormone (GnRH), the ontogeny of the hypothalamic-pituitary-gonadal axis, and common reproductive events and conditions, namely, puberty, the menstrual cycle, and disorders of reproductive function. The core concept underpinning the neuroendocrinology of reproduction is neuroregulation of hypothalamic GnRH drive. In both men and women, reproductive function requires that GnRH input elicit appropriate secretion of follicle-stimulating hormone and luteinizing hormone from the anterior pituitary and that the gonads respond to such input appropriately. Moreover, insufficient GnRH drive causes hypothalamic hypogonadism and secondary insufficiency of gonadal sex steroid hormone synthesis and release in both sexes. Alterations in GnRH drive also reflect gonadal conditions such as dysgenesis, hyperandrogenism, gonadotropin mutations, and aging and loss or absence of oocytes or Sertoli cells. The most common cause of insufficient GnRH drive is functional, that is, due to the endocrine effects of psychologic or behavioral variables. Rarely does reduced GnRH drive reflect organic or congenital causes such as developmental defects, brain tumors, or celiac disease. Despite a common neuropathogenesis the heterogeneity of behavioral variables associated with reduced GnRH drive has resulted in a variety of names, including functional hypothalamic amenorrhea, stress-induced anovulation, and psychogenic amenorrhea.

CHRONIC ENDOMETRITIS AS A FACTOR OF FAILURE ATTEMPT IN ASSISTED REPRODUCTIVE TECHNOLOGIES

Increase in frequency of disorders of women's reproductive function justifies a careful study of the underlying pathological processes. In recent years, increased attention in solving fertility problems is paid to endometrial pathology when chronic endometritis plays an important role. Current worksarefeeding an in-depth study of the etiology and pathogenesis of chronic endometritis. However, results of research pose new questions with an imaginary comprehensive study of this problem. Chronic endometritis is one of the causes of infertility and may play a role in certain complications of pregnancy and childbirth (30.3 % in patients with repeated failures of in vitro fertilization, 9.3 % with recurrent miscarriages, 9.8 % in infertility). Clinically, chronic endometritis is often asymptomatic or accompanied by nonspecific symptoms such as pelvic pain, dyspareunia, abnormal uterine bleeding, and discharges. Previously, scientists considered the uterine cavity as a sterile container. But a team of Spanish scientists sought to test for the presence of intrauterine microflora, which differs from the vaginal. As a result, the study of endometrial fluid and vaginal samples from the same patients revealed different bacterial compositions. Microflora in the intrauterine fluid was classified as Lactobacillus, and women with non-lactobacillary flora of the endometrium had a significantly lower frequency of implantation. At the initial stage of endometrial inflammation is an activation of neutrophils and macrophages, increased cytokines synthesis, extracellular matrix degradation by proteolytic enzymes. Disorders of microcirculation and sclerotic processes in the area of ​​injury lead to the ischemia and tissue hypoxia, which activates the processes of sclerosis and angiogenesis. Chronization of the process increases the expression of chemokines and adhesion molecules, that is lead to migration of B-lymphocytes from the bloodstream and their differentiation into plasma cells, increases the activity of matrix metalloproteinases, changes local expression of estrogen and progesterone receptors. Lack of a pronounced specific clinical picture of chronic endometritis, its later detection causes impaired reproductive function. Untimely diagnosis and treatment of chronic endometritis has significant consequences in terms of the possibility of implantation of a fertilized egg in the programs of assisted reproductive technologies.