Late Reproductive Period Research Articles

Impact of nitrogen on photosynthesis, remobilization, yield, and efficiency in winter wheat under heat and drought stress

Droughts and high temperatures often occur during the late reproductive periods of winter wheat, greatly threatening winter crop production. However, the potential of nitrogen (N) management to mitigate the adverse effects of heat and drought stress on winter wheat remains unclear. Therefore, a two-season wheat experiment was performed to examine the impacts of temperature, soil moisture, and N supply on the photosynthetic rate, N accumulation and remobilization efficiency, and water and N use efficiency. Drought and heat stress resulted in a significant reduction in gas exchange, which was exacerbated by combined stress. In the combined stress treatment (HD), the stomatal conductance and transpiration rate under low N (N1) application increased by approximately 20 % and 15 %, respectively, compared to those under high N (N3) application. The highest net photosynthetic rate and instantaneous water use efficiency were observed under medium N (N2) application. An appropriate reduction in N supply alleviated the impacts of combined stress on growth traits, with the aboveground dry mass and green leaf area under N1 application increasing by 8.49 % and 24.10 %, respectively, compared with those under N3. Drought and heat stress significantly reduced the mean grain-filling rate, grain N accumulation (GNA), and contribution to grain N by post-anthesis N uptake (CANU), especially under combined stress. Compared with that under N1, the GNA in the DH treatment under N2 increased by 7.16 %, whereas the CANU gradually decreased with increasing N supply. Compared with the control, combined stress slightly increased WUE-biomass but decreased WUE-yield, and 19.91 % and 10.77 % lower NUE-yield and NUE-biomass, respectively, were observed under combined stress. The yield, WUE-biomass, and NUE-biomass of the DH treatment with N1 application increased by 16.19 %, 9.27 %, and 6.97 %, respectively, compared with those of the N3 treatment, whereas the WUE-biomass and NUE-yield were greatest under the N2 treatment. Entropy-topsis analysis revealed that the DH treatment under the N1 supply had a greater composite evaluation index than did the N2 and N3 supplies. Reducing nitrogen application effectively mitigated yield suppression and improved water and nitrogen use efficiency in winter wheat under post-anthesis combined stress.

Age-associated risk of sarcopenia, falls and fractures: results of Ukrainian cohort study

Background. It is well-known that sarcopenia increases the risk of falls and fractures, and therefore, requires correction to improve the quality of life of elderly people. This research purposed to study the age-related changes in the sarcopenia risk, falls, and fractures in Ukrainian women in the late reproductive and postmenopausal periods. Materials and methods. We examined 573 females aged from 40 to 89 years old. The subjects were grouped by age decades and presence of high sarcopenia risk (HSR). The SARC-F questionnaire measured the sarcopenia risk, and the risk of falls using the Desmond Fall Risk Questionnaire, the 10-year probability of major osteoporotic and hip fractures was assessed by FRAX, and daily activity — according to the IADL scale. Also, we performed the hand grip strength and five-repetition sit-to-stand tests. Results. The frequency of HSR increased with age from 1.5 % in the 40–49-year-old group to 73.7 % in subjects over 80, as well as fracture and fall risks (p < 0.00001 for both indices) related to decreasing independence in the subject’s everyday life. Also, we revealed age-dependent loss of muscle strength according to the hand grip and the five-repetition sit-to-stand tests. After the adjustment of the subjects by age we found that the females with HSR had a higher risk of falls, a lower level of independence, and increased frequency and risk of osteoporotic fractures. Conclusions. Women with HSR have a higher risk of falls, fractures, and more limitations in daily living activities independently from age and body mass index. These findings request comprehensive management of older women with attention to various parameters for the increase of independence and quality of life.

The role of morphofunctional asymmetries of the female body in the autonomic regulation of heart rate during menopause

The aim of the work was to study the features of autonomic regulation of heart rhythm (HR) in women in the peri- and postmenopausal periods, depending on morphofunctional asymmetries of the female body. A total of 417 women aged 35–60 were examined. According to the lateral behavioral profile of asymmetries of the female body (Annette’s test), the nature of vegetative regulation at rest and orthostasis was determined according to the data of cardiac intervalography using the Varicard 2.51 complex and the Eskim-6 program. As a result, it was found that in the reproductive period in women with the right lateral phenotype, the autonomous circuit of HR variability regulation prevailed, and in ambidextrous women, the central one dominated. Ambidextrous and right-handers were characterized by egalitarian modulation, while left-handers were characterized by a respiratory typology of autonomic regulation of HR. In perimenopause, a moderate tension of regulatory mechanisms was formed in the lateral subgroups, and a high tension was formed in the postmenopausal subgroups. In ambidextrous and left-handers, discoordination of HR regulation prevailed. Thus, women with the polarity of the lateral phenotype in the late reproductive period were distinguished by the stability and economy of the mechanisms of autonomic regulation of HR. Ambidextrous had the most energy-consuming mechanisms in the postmenopausal period, which is a risk of cardiovascular disease pathology.

Allometry of rostrum and sexual appendages in Hippolyte sapphica morphotypes (Crustacea: Decapoda: Hippolytidae) during the reproductive period

ABSTRACT This study focuses on the post-larval development of Hippolyte sapphica morphotypes, during the late reproductive period. The species is endemic to Central/Eastern Mediterranean and displays morphοtype A with a well-developed rostrum and morphotype B with a short, juvenile-like one. Our results partly confirm the previous findings on the rostral dimorphism, while also providing new, detailed results obtained on pre-ovigerous specimens. In the A-males, two distinct sub-populations were discriminated: the main group with a fast rostral development, and a small one, with a slower rostral growth rate. The rostral growth in A-females was significantly attenuated, without identifiable subgroups. No difference was detected in the negative allometric rostral growth of B-specimens in both sexes. The relative growth of the appendix interna was nearly the same in females of both morphotypes, whereas the growth rate of the appendix masculina was significantly higher in A-males with fast rostral development, attenuated in B-males, and finally being the lowest in A-males with slowly developing rostral. Even within the A-males’ subgroup, a significant partial correlation was detected between the relative growth of the rostrum and that of the appendix masculina. The relationship between growth of the rostrum and sexual appendages raises the question about underlying molecular mechanisms.

Comparison of Water Utilization Patterns of Sunflowers and Maize at Different Fertility Stages along the Yellow River

Currently, there is a limited supply of freshwater on a worldwide scale, and finding effective ways to use agricultural freshwater resources has become a widely discussed subject. To investigate the most suitable crops and the efficient use of water resources in dry regions, we performed a comparison study of water consumption between two common crops, maize and sunflowers, in the irrigation area located on the south bank of the Yellow River in Northwest China. Both sunflowers and maize have diverse water sources at various reproductive phases. We discovered that sunflower predominantly consumes 0–50 cm soil water throughout the reproductive cycle, whereas maize mostly utilizes 0–50 cm soil water in the early reproductive phase and 50–90 cm soil water in the late reproductive period. The comparison of yield sustainability between sunflowers and maize demonstrated that sunflowers exhibited more resilience than maize when subjected to the same level of water decrease. Sunflowers’ yield sustainability score stayed consistently over 0.95, while maize had a lowest score of 0.84. We observed via correlation analysis that it was the fraction of subsurface water contribution and the water contribution of the 50~70 cm soil layer that impacted the yield of sunflowers and maize, with coefficients of 0.88 or higher. Ultimately, sunflowers exhibited a lower level of responsiveness to water scarcity compared to maize. Sunflowers have greater drought tolerance compared to maize since they rely less on soil layers replenished by a limited water supply. Based on our findings, sunflowers are well suited to arid conditions and limited spaces that do not have access to irrigation, while maize is better suited to well-watered conditions and expansive cultivation areas.

Determining the level of stromal and epithelial cells activity in normal and hyperplastic endometrium of late reproductive and perimenopausal women.

Hyperplastic processes of the endometrium (HPE) are a group of benign endometrial and stromal cells that have undergone altered growth. This study aimed to investigate the potential role of hypoxia (as indicated by Hif-1α) and apoptosis markers (p53 and BCL-2) in the development of hyperplastic processes of the endometrium (HPE). Results showed that endometrial cells with atypical hyperplasia had increased levels of Hif-1ɑ, which indicates the presence of endometrial hypoxia and may trigger pathological manifestations. Though this result was not statistically significant, it could be the cause of atypia hyperplasia in the late reproductive period (Hif-1ɑ=1.89±0.09 units) and the perimenopausal period (Hif-1ɑ=2.09±0.07 units). Additionally, the study found that p53 markers were elevated in epithelial cells in the late reproductive period, and similar patterns were observed in the perimenopausal period, with the biggest expression in atypical hyperplasia. The study also found that the high expression of BCL-2 indicator (+++) was less common in late reproductive period women with atypia than those without it (χ2=7.2 p=0.01). A similar situation was observed in women in the perimenopausal period (χ2=4.2 p=0.04). These findings suggest that hypoxia may play a role in the development of HPE, as well as changes in apoptotic markers present in the endometrial tissue.

Chemical topping with 1,1-dimethylpiperidinium chloride increases lint yield and defoliation of cotton by improving canopy development

Chemical topping with 1,1-dimethylpiperidinium chloride (DPC) has been considered a promising measure to inhibit apical dominance in cotton (Gossypium hirsutum L.). However, knowledge of the plant growth and canopy development of cotton under chemical topping with DPC remains limited, and the effect of this practice on lint yield and defoliation is unclear. A two-year (2019–2020) field experiment was conducted with two varieties, Xinluzao 60 (L60, DPC-insensitive) and Jinken1402 (JK1402, DPC-sensitive), and four topping methods, manual topping (MT), no topping (NT), DPC+ (fortified DPC) and DPC. We found that the lint yields of L60 and JK1402 treated with DPC were equivalent to those of L60 and JK1402 treated with DPC+ but were enhanced by 0.9–4.7% in L60 and 6.7–11.8% in JK1402 relative to those under MT and NT, with no significant difference in fiber quality. This was mainly due to the change in plant growth and canopy structure. In particular, compared with MT, application of DPC shortened the upper branches and extended the duration of the leaf area index peak. Moreover, in the late reproductive period, DPC application increased the number of upper leaves and reduced diffuse noninterceptance. Notably, the light transmittance rate (LLR) of JK1402 treated with DPC was higher than that of MT in the middle and lower parts of the canopy. Furthermore, there was positive correlation between LLR and defoliation rate. Therefore, chemical topping with DPC provided an effective alternative for manual topping.

СОДЕРЖАНИЕ МИКРОЭЛЕМЕНТОВ В КРОВИ ПРИ НАРУШЕНИЯХ МЕНСТРУАЛЬНОГО ЦИКЛА У ЖЕНЩИН РЕПРОДУКТИВНОГО ВОЗРАСТА

Among the microelements, calcium, magnesium and phosphorus have the greatest influence on bone tissue. Calcium with phosphorus complement each other in their main function - preservation of the mineral base of bone tissue. The aim of our study was to compare the content of calcium, phosphorus, magnesium in the blood serum in women with menstrual irregularities of the type of secondary amenorrhea, oligomenorrhea, polymenorrhea in reproductive age with healthy young women. Materials and methods. The study group consisted of women of reproductive age who were observed in the clinic of the Simferopol Central Regional Clinical Hospital, Simferopol, during 2018-2020 with menstrual irregularities. The patients were divided into two age groups, early reproductive period (23-34 years) and late reproductive period (35-40 years). Each group is divided into subgroups according to nosology: secondary amenorrhea, oligomenorrhea, polymenorrhea. The control groups included healthy women 23-34 years old (10 people) and 35-40 years old (10 people). For the determination of inorganic phosphorus, calcium. we used a set of reagents for photometric determination in biological fluids
 «Olvex Diagnostics», Russia. An examination was carried out in the Gemotest laboratory, Simferopol. Statistical methods were used to process the results using the STATISTICA 10 program. Research results. When analyzing the average indicators of total calcium in the blood in women with amenorrhea of 23-34 years, it was found that its content was 2.25 ± 0.15 mmol / L, which corresponded to the normal values, but was lower than in the control group (p <0 , 05). The calcium level in IIA and IIIA groups is significantly lower than in healthy women and did not differ from its concentration in the first group. Findings. The blood calcium content in women with menstrual irregularities by the type of secondary amenorrhea was significantly lower than in other groups. No significant decrease in the concentration of phosphorus and magnesium in the blood was found in any group. The mineral balance was impaired in all women with menstrual irregularities.

Effects of low salinity on hemolymph osmolality and transcriptome of the Iwagaki oyster, Crassostrea nippona

Crassostrea nippona is a kind of oysters with great development value as it can be edible in summer for its late reproductive period. Salinity is one of the important limiting abiotic factors to the survival and distribution of this stenohaline species. To better understand the physiological and immunological response of C. nippona to varying environmental salinities, the effects of low salinity on the hemolymph osmolality and gill transcriptome were investigated in this study. The osmolality of hemolymph in vivo and surrounding water were assessed regularly over one week at five test salinities ranging from 5 psμ to 30 psμ. They reached osmotic equilibrium within hours above 15 psμ but remained hyperosmotic at 10 and 5 psμ for the whole sampling period. Through comparative transcriptome analysis, there were less differentially expressed genes (DEGs) in pairwise comparison of S1 (10 psμ) vs S3 (30 psμ) than in S2 (20 psμ) vs S3. KEGG enrichment analysis identified ubiquitin-mediated proteolysis and mitochondrial apoptosis pathway specifically enriched at 10 psμ. This study gained comprehensive insights on the low salinity response of C. nippona at the molecular level, which provide a theoretical basis for understanding the immune mechanism under low salinity stress.

Аномальные маточные кровотечения. Анализ результатов ультрасонографии по системе IETA

Objective. To study the features of the uterine cavity echo and the prognostic value of ultrasound signs of endometrial pathology in patients with abnormal uterine bleeding based on the terminology and recommendations of IETA. Patients and methods. The study included 196 women with abnormal uterine bleeding in the late reproductive period and premenopause and 54 patients with postmenopausal bleeding and/or ultrasound signs of endometrial pathology. All ultrasonography results were interpreted according to the IETA classification and terminology and were subsequently verified by histological examination. Results. In patients with endometrial intraepithelial neoplasia (EIN), the thickness of the endometrium was in the range of 9–19 mm and, according to this criterion, did not differ from endometrial hyperplasia without atypia. Only in some patients with EIN, the endometrial-myometrial junction was characterized by unevenness (16.7% in the reproductive period/premenopause and 22.2% in postmenopause). Compared with endometrial hyperplasia, EIN was dominated by uneven, heterogeneous echogenicity without cystic inclusions with a color scale 2–3 points. In endometrial cancer, the endometrial-myometrial junction was interrupted in 77.8–100% of cases, and the color score reached 4 points. Conclusion. Modern possibilities of ultrasonography allow improving the principles of early diagnosis of EIN and preinvasive endometrial carcinoma. Key words: ultrasound, IETA, endometrial cancer, endometrial intraepithelial neoplasia

Impact of Polycystic Ovary Syndrome on Silent Coronary Artery Disease and Cardiovascular Events; A Long-term Population-based Cohort Study

The existing data regarding the impact of Polycystic Ovary Syndrome (PCOS) on the risk of developing cardiovascular disease (CVD) are conflicting. To explore the effect of PCOS status on the occurrence of silent coronary artery disease (CAD)/CVD. A total of 1591 women without CVD at baseline, aged 18-45 years, including 356 PCOS patients (defined by the Rotterdam criteria) and 1235 eumenorrheic non-hirsute women without polycystic ovarian morphology (controls), were selected from the Tehran Lipid and Glucose Study (TLGS). The median follow-up was 15.4 years, and most participants were in their late reproductive years at the end of the study. Silent CAD and CVD outcomes in PCOS and control groups were compared according to the multivariable-adjusted hazard ratios (HRs) and cumulative hazard functions. There was no difference in CVD risk factors between the PCOS and control groups. After controlling for confounders, PCOS status did not increase the risk of silent CAD (HR: 0.96, 95% CI 0.86-1.08). Regardless of PCOS status, women with a history of silent CAD showed 2.25 times higher CVD events than those without this history (95% CI 1.63-3.10). PCOS status reduced the CVD incidence by 42%, independently of silent CAD or traditional risk factors (HR: 0.58, 95% CI 0.35-0.98). Whereas silent CAD, regardless of PCOS, accelerated CVD, PCOS preserved it, most likely due to a combination of protective factors, including the endocrine pattern in the late reproductive period, environmental/social elements, and recruiting additional counseling and lifestyle modifications.

Natural variation in reproductive timing and X-chromosome nondisjunction in Caenorhabditis elegans.

Caenorhabditis elegans hermaphrodites first produce a limited number of sperm cells, before their germline switches to oogenesis. Production of progeny then ensues until sperm is depleted. Male production in the self-progeny of hermaphrodites occurs following X-chromosome nondisjunction during gametogenesis, and in the reference strain increases with age of the hermaphrodite parent. To enhance our understanding of the reproductive timecourse in C. elegans, we measured and compared progeny production and male proportion during the early and late reproductive periods of hermaphrodites for 96 wild C. elegans strains. We found that the two traits exhibited natural phenotypic variation with few outliers and a similar reproductive timing pattern as previous reports. Progeny number and male proportion were not correlated in the wild strains, implying that wild strains with a large brood size did not produce males at a higher rate. We also identified loci and candidate genetic variants significantly associated with male-production rate in the late and total reproductive periods. Our results provide an insight into life-history traits in wild C. elegans strains.

Assessment of the health status of infants born from women of the late reproductive period

Objective.To assess the condition of newborns from women of the late reproductive period (LRP), depending on the parity of births.Material and methods.The authors examined 130 pregnant women and their 130 newborns. Group I consisted of 60 primiparouswomen of late reproductive period and their 60 newborns, Group II included 40 multiparous women of the late reproductive periodand their 40 newborns, Group III (control group) consisted of 30 healthy pregnant women aged from 18 to 25 years and their 30newborns. The authors performed a retrospective analysis of the gestation course and perinatal outcomes. Ultrasound and neurosonography were used among the instrumental research methods.Results.Women of the late reproductive period gave birth to children in a state of asphyxia twice more often, who develop neurologicaldisorders 1,5 times more often and complex postnatal adaptation and disorders of the perinatal period are twice more likely. Amongwomen of the late reproductive period, primiparous women gave birth to children with the most severe disorders.Conclusion.The high incidence of neurological diseases in children born from women of the late reproductive period is associatedwith age-related changes in their germ cells, the implementation of assisted reproductive technologies, and the intake of hormonaldrugs in early pregnancy. The data obtained should be taken into account by obstetricians in the course of pregnancy in women of latereproductive age; they should be included in the group of high risk of developing neurological disorders in children.

ОЦЕНКА СОСТОЯНИЯ ПЛОДА И ОСОБЕННОСТИ ТЕЧЕНИЯ НЕОНАТАЛЬНОГО ПЕРИОДА У ДЕТЕЙ, РОЖДЕННЫХ ОТ ЖЕНЩИН ПОЗДНЕГО РЕПРОДУКТИВНОГО ВОЗРАСТА, ПРОЖИВАЮЩИХ В ЧЕЧЕНСКОЙ РЕСПУБЛИКЕ

Objective of the research: conduct a Doppler ultrasound (DUS) assessment of utero-placentalfetal blood flow and the condition of newborns in the early neonatal period from women of the late reproductive period (LRP), depending on the parity of delivery, using the example of women in the Chechen Republic. Material and methods: retrospective multicenter study. DUS assessment of the state of utero-placental-fetal blood flow and the state of newborns in the early neonatal period was performed in 95 pregnant women, including: group 1–35 primiparous of LRP and their 35 newborns, group 2 – 35 multi-pregnant (MP) of LRP and their 35 newborns. The 3 control group included 25 healthy pregnant women aged 18 to 25 years and their 25 newborns. DUS was performed on Aloka SD SSD 3500 device (Japan), and a transvaginal sensor was used if necessary. Newborns were assessed on the APGAR score at 1 and 5 minutes after birth. Of the instrumental methods for examining newborns, brain ultrasound examination (neurosonography) was used. Results: analyzing the DUS results of LRP pregnant, depending on the labor parity, it was found that in the 1st group there was an increase in resistance in both uterine arteries (61%), an increase in the resistance index and pulsation index, a decrease in diastolic blood flow, characteristic of arteries with high resistance. Hemodynamic parameters in the mid-brain artery (MBA) of the fetus remained normal in all pregnant women. LRP women often born children in a state of asphyxia, with neurological disorders, and these children often has more complex postnatal adaptation and concomitant pathology. Among LRP women, primiparous has significantly more severe disorders. Conclusion: the data of uteroplacental fetal blood flow of the 1st group correspond to blood flow disorders of the IA degree, which indirectly indicates a compensatory reaction of the vascular system of uteroplacental fetal blood flow, as well as the absence of a tendency to an increase in the severity of fetoplacental insufficiency. It is possible that high incidence of neurological disorders in children born to LRP women is associated with age-related changes in their germ cells, use of assisted reproductive technologies, intake of hormonal drugs at an early stage of pregnancy and environmental factors associated with iodine deficiency in the region which includes the North Caucasus.

Features of the course of pregnancy and the outcomes of childbirth in women of different ages.

This article presents the features of pregnancy in adolescence and old age associated with a high risk of adverse outcomes both during pregnancy and childbirth, and in the later period. The purpose of our study was to identify the features of pregnancy and childbirth, the postpartum period in young and elderly mothers. Materials and Methods: The history of pregnancy, childbirth and individual charts of newborns (n=330) were retrospectively analyzed, of which group I (n=150) young pregnant women aged 13-18 years, group II (n=80) pregnant women of favorable reproductive age (20-25 years) and group III (n=100) women of late reproductive period (40 years and older). Results: It was found that young primiparous women are somatically healthier, but sexually transmitted infections are significantly more common in the group of underage pregnant women (pIIII= 0.043) than in the group of late reproductive period. Pregnancy in adolescents often occurs against the background of anemia, placental insufficiency, moderate preeclampsia; childbirth is complicated by a large percentage of injuries. In the group of women of late reproductive age, diseases of the cardiovascular system, mainly arterial hypertension, obesity, and liver diseases predominate. Conclusion: Pregnancy in adolescent girls, as well as in age-related primiparous women, is a serious medical and social problem. Pregnant women in these groups are at high risk for miscarriage and require an individual approach to the management of pregnancy and childbirth.

Features of the functional state of the pituitary-ovarian systems in women with polycystic ovary syndrome at different periods of reproductive age

Background. PCOS is one of the most common endocrinological pathologies in women of reproductive age, manifested by a wide range of clinical manifestations. There are many unresolved issues related to the pathogenesis, diagnosis and treatment of this pathological condition in different periods of reproductive age. Aim the objective of the study was to identify the features of the functioning of the pituitary-ovarian system in women with PCOS at different periods of reproductive age. Methods. Study was performed in 20172019 at the FSPSI SCFHHRP, and involved women aged 1845 years. The study groups included women (a group of women with PCOS and a control group) in the follicular phase from 1 to 12 days of the menstrual cycle. As a result of the survey, a group of 44 women with PCOS and a group of 56 healthy women were formed. PCOS was diagnosed according to ESHRE/ASRM criteria (Rotterdam, 2003). Next, subgroups of women in early reproductive age from 35 to 45 years were formed: a group of women with PCOS (n = 29) and a control group (n = 22). And groups of women in late reproductive age from 35 to 45 years were formed: a group of women with PCOS (n = 15) and a control group (n = 34). Conducted: questionnaire survey, general and gynecological examination, ultrasound examination of the pelvic organs, laboratory tests, statistical data analysis. Results. In women with polycystic ovary syndrome of early reproductive age (1835 years), we detected an increase in the level of testosterone by 2 times, DHEA-S by 1.3 times, 17-OH-progesterone by 2 times, sex steroid-binding globulin by 1.4 times, in comparison with control group. The ratio of luteinizing hormone to follicle-stimulating hormone increased by 52%. In women with polycystic ovary syndrome of late reproductive age (3545 years), we detected an increase in the level of testosterone by 1.5 times, 17-OH-progesterone by 1.9 times, luteinizing hormone by 1.4 times, sex steroid-binding globulin by 1.6 times, in comparison with control group, without any significant differences in DHEA-S. At the same time, the ratio of luteinizing hormone to follicle-stimulating hormone increased by 60%. Conclusion. The hormonal profile of women with PCOS of early and late reproductive period is characterized by series of age-related changes in the pituitary-ovarian system, which should be taken into account in preventive and therapeutic measures.

Hysteroscopic and morphological assessment of intrauterine pathology in different age periods

The pathology of the endo- and myometrium takes the main place in the structure of gynecological diseases. The introduction of endoscopic technologies has expanded the diagnostic capabilities of the study of intrauterine pathology. The morphological method is the gold standard in diagnosing the uterine cavity pathology. A retrospective analysis of 100 video protocols of hysteroscopy and morphological data obtained in Vash Doctor Clinic Ltd., Simferopol over the year 2018 was performed. During a retrospective analysis of hysteroscopic pictures and pathomorphological findings, all patients were divided into three age groups: (I) 2535 years old (35 women); (II) 3645 years old (35 women); and (III) 4655 years old (30 women). In the early reproductive period, endometrial hyperplasia without atypia prevailed, chronic endometritis prevailing in the late reproductive period, and polyps of the uterus in the period of the menopausal transition and postmenopause.

HYPERGONADOTROPIC OVARIAN INSUFFICIENCY IN WOMEN OF LATE REPRODUCTIVE AGE

Background. At present, the increasing frequency of hypergonadotropic ovarian insufficiency in women of late reproductive periods is associated with various problems, which requires the development of new criteria and an integrated approach to solving these problems. Aim of the study. To investigate the causes, clinical manifestations and diagnostic criteria of hypergonadotropic ovarian insufficiency in women of late reproductive age. Materials and methods. We examined 42 patients with clinical and laboratory criteria for hypergonadotropic ovarian failure. The causes and clinical manifestations of hypergonadotropism, as related to ovarian failure, in women of late reproductive age were revealed through this analysis. Results. Women aged 36 – 42 years that have had previous surgery on pelvic organs often undergo changes typical of hypergonadotropism. Certain clinical indicators such as lability of follicle-stimulating hormone (FSH) levels and other direct and indirect signs of decreased ovarian reserves allow practitioners to prescribe appropriate therapy on time. Timely diagnosis and an individualized approach can help prevent symptoms of hypoestrogenia and related complications. The results of this study show that early detection of a luteal out-of-phase (LOOP) event, along with a more detailed history was diagnosed in 16 (38.1%) of cases. Early detection allows more timely changes in diagnosis, may noted signs that can reflect both the normal state and pathology. Conclusions. Levels of Anti-Müllerian hormone, basal levels of FSH in two successive cycles, early detection of an LOOP-event and the use of ultrasound are significant factors that can help in the assessment of ovarian reserves.

Фитотерапия климактерических нарушений

A study to examine the efficacy and safety of drug Menomedin in patients with climacteric disorders of mild to moderate severity in late reproductive period was performed. The average menopausal index, according to a Menopause Rating Scale (MRS), was significantly lower after treatment (8.6±0.1) than before treatment (23.2±0.5). In all examined women hormone levels corresponded to perimenopausal values. Side effects and individual intolerance reactions were not observed. Antiatherosclerotic effect was detected during treatment Menomedin. Author of the study conclude that a good level of efficacy and safety Menomedin allows to use it at the earliest manifestations of menopausal disorders in women in the late reproductive period (perimenopause). Key words: climacteric syndrome, perimenopause, Menomedin.

Функціональні та ендоскопічні методи діагностики внутрішньоматкової патології

Endometrial pathology (EP) is one of the most common problems which complicate the life of women in the late reproductive, menopausal and postmenopausal periods. Today it is proved that EP acts as a premotor background on which cancer processes of the female reproductive system develop. A special role in the verification of EP belongs to non-invasive and invasive methods of investigation, the diagnostic value of which are not the same. The objective: to evaluate the diagnostic effectiveness of the main methods of verification of endometrial pathology in women in the late reproductive and postmenopausal periods. Materials and methods. A comprehensive examination of 162 women with endometrial pathology was conducted. In addition to conventional investigations for all patients at the first stage of the survey transabdominal and transvaginal ultrasonography (TVUSI), subsequent 3D\4D echographies in the sonoelastography (TV-SEG) regime were conducted. At the second stage of examination hysteroresectoscopy with subsequent histological verification of the obtained material was performed. Results. According TVUSI diagnosis of endometrial hyperplasia was set in 162 cases. In 76 patients (59.4%) non-typical form (NF) of EH was diagnosed. In 52 women (40.6%) the diagnosis of HE atypical form (AF) was set. The discrepancy between ultrasound and pathohistological diagnosis was observed in 34 (20.9%) patients. The frequency of EH diagnosis according to TV + SEG was 145 cases (89.5%), which is 10.5% less compared to TVUSI. Increased echogenicity of the endometrium was revealed in 58 (76.3%) women with NF EH, with AF EH this diagnostic criteria was established in 42 (80.1%) patients. Deformation of the uterine cavity relief was detected in 52 (68.4%) patients with NF HE in women with AF HE this ultrasound index was detected in 38 (73.1%) women. Uneven external contour of M-echo was determined in 8 (10.5%) women with NF HE and 14 (26.9%) women with AF HE (p<0.05). During hysteroresectoscopy HE was diagnosed in 154 cases (95.0%). Fibrous polyps were found characteristic for patients in the post- and premenopausal periods. Conclusion. The comparative analysis of diagnostic characteristics revealed that the addition of sonoelastography to ultrasound investigation can reduce the percentage of false results and increase the diagnostic sensitivity of ultrasound in the diagnosis of endometrial hyperplasia from 79.0% to 89.5%. The inclusion of hysteroresectoscopy to the diagnostic algorithm makes it possible to visualize the pathology of the endometrium and obtain a sighting biopsy. This makes it possible to increase the diagnostic sensitivity of ultrasound investigation by the means of sonoelastography from 89.5% to 95.0%. Key words: endometrial pathology, sonoelastography, endometrial hyperplasia, endometrial polyp, hysteroresectoscopy.