Vol 21, No 4 (2019)

Aim. To asses an effectiveness of assisted reproductive technologies (ART) program given characteristics of the cytokine profile of seminal plasma (SP) entering the female reproductive tract during sexual intercourse. Outcomes and methods. 33 married couples who applied for a treatment of infertility by means of in vitro fertilization /ICSI (Intracytoplasmic Sperm Injection) were included in the prospective study. Patients were recommended to have sexual intercourse with no restrictions during treatment and to have the last sexual intercourse 3 days before an intended transvaginal puncture (ITP). Testing of cytokines (transforming growth factor (TGF)-b1, interferon (IFN)-g, interleukin (IL)-33, IL-6, IL-8, IL-23, IL-10, tumor necrosis factor (TNF)-a, IL-18, IL- 17A, IFN-a, IL-12, monocyte chemotactic protein-1) levels in samples of partners’ SP obtained on the day having ITP were carried out using multiplex analysis with LegendPlex kits (BioLegend, USA). Results. When comparing a cytokine profile of SP in couples who did not become pregnant (n=25) and couples who become pregnant (n=8) increased IL-18 and reduced IL-10 levels (p=0,017 and p=0, 01 respectively) were revealed in the group which got pregnant. To assess a clinical relevance of cytokine content in SP ROC (Receiver Operating Characteristics) curve was used. It was established that determining of IL-18 concentration in SP has the greatest diagnostic significance (the area under a curve was 0.792±0.107, test sensitivity - 62.5%, test specificity - 95.24% at threshold concentration>210.43 pg/ml). Incidence of pregnancy at IL-18 concentration above threshold levels was 83,3% while at lower concentrations of IL-18 pregnancy occurred only in 13.0% of women. Conclusions. Elevated IL-18 levels and decreased IL-10 levels in SP of female patients’ partners who don’t have restriction of sexual life when treating infertility with ART are favorable factors for a pregnancy to occur.

Relevance. Due to the high prevalence of uterine fibroids in young women and the possible effect on reproductive potential, the development, implementation and application of the most benign treatment methods are a priority. Aim. To evaluate the effectiveness of adjuvant anti-progestogen therapy after conservative myomectomy in women of reproductive age. Materials and methods. A comparative analysis of the results of treatment of patients of reproductive age with uterine myoma has been carried out. Group 1 (n=38) included patients who underwent conservative myomectomy and/or hysteroresectoscopy without subsequent anti-relapse drug therapy. The average age is 31.5 years (4.6). Group 2 (n=43) included patients after conservative myomectomy who received mifepristone as anti-relapse therapy after surgery. The average age is 31.9 years (4.5). Results. Mifepristone therapy, as an adjuvant treatment after conservative myomectomy, can significantly reduce the risk of recurrence, stabilize the size of the uterus, reduce the severity of clinical manifestations in the form of pain syndrome and heavy menstruation associated with relapse, thereby improving the reproductive health of women. Conclusions. The use of adjuvant anti-progestogen therapy after conservative myomectomy in women of reproductive age is a very effective method for treating uterine fibroids and can be considered as a therapy of choice in such patients.

Relevance. Despite the achievements of modern medicine, the problem of reducing complications of the gestational period and perinatal outcomes still does not lose its relevance. Lack of security and/or unbalanced consumption of vital micronutrients are factors of constant negative impact on health, growth, development and formation of organs and systemogenesis in all age periods. Unbalanced nutrition, in particular vitamin deficiency conditions, is considered by the World Health Organization as a problem of starvation, which has a direct impact on the incidence and mortality of the population. Aim. Analysis of literary sources to identify the effect of vitamin-mineral complexes on pregnancy and perinatal outcomes. Materials and methods. To write this review, we searched for domestic and foreign publications in Russian and international search engines (PubMed, eLibrary, etc.) over the past 30 years. The review included articles from peer-reviewed literature. Results. The review addresses balanced nutrition for pregnant women who receive close attention throughout the world. The optimal provision of vitamins and minerals for women during the gestational period, when the need for essential micronutrients is significantly increased, is a prerequisite for the physiological course of pregnancy and the full development of the fetus. This is especially important in the conditions of the northern and equivalent territories. The need for vitamins in women during pregnancy and lactation increases by 1.5 times, due to the intensive work of the endocrine system of women, the transfer of some nutrients to the fetus. Deficiency of certain vitamins is a risk factor for the development of birth defects, premature birth, and the birth of children with low body weight. Conclusions. The domestic combined vitamin-mineral preparation with micro and macro elements was created specifically taking into account the changing needs of the woman’s body for vitamins and minerals at different stages of pregnancy. Compatibility of components in 1 tablet is provided by special production technology.