Modern views about reproductive health and potential in women with HIV infection and viral blood-borne hepatitis

The article presents a review of literature devoted to the epidemiology of HIV infection in the world and Russia, as well as the investigation of reproductive disorders in women with HIV infection and viral blood-borne hepatitis. Actuality of the problem lies in the fact that grows the number of HIV infected and having blood-borne viral hepatitis with involvement in the epidemiological process people of reproductive age, and especially the increase in the number of HIV-infected women of childbearing age. Importantly, it is necessary to predict, diagnose and correct reproductive disorders in women, taking into account basic patterns and risk factors for the formation of such violations with a view to the restoration and preservation of reproductive capacity and ability to have healthy children

Polycystic ovary syndrome - 80 years of research and new directions in the study (literature review)

The article presents the current data of history of polycystic ovary syndrome (PCOS) study. It contains studies of genetic susceptibility of PCOS, PCOS symptoms and connection with development of anxiety and depressive disorders. The article covers ethnic differences in the phenotypic manifestations of PCOS. The papers describes the study of endocrine causes of infertility in Russian and Buryat women. Several theories of PCOS, including the theory of PCOS connection with intestinal bacterial flora disorders ("dysbiotic intestinal microbiota") are being discussed. The article also provides an overview of various scientific research in this area and the data of the relationship of PCOS and the risk of cardiometabolic disorders, insulin resistance, metabolic syndrome, obesity and sleep apnea. It highlights modern aspects in the study of PCOS etiology - studies of adipose tissue as an endocrine organ. The article reflects study of PCOS relationship with the level of the gastrointestinal tract hormones: leptin, insulin, ghrelin, cholecystokinin, peptide YY. The effect of short-term low-dose hormonal contraceptives on appetite levels in PCOS is covered. The scientific articles on the severity of hypertension in menopausal women with PCOS history and the presence of overweight are reviewed. The scientific work determines molecular genetic markers of PCOS in the aspect of the influence of environmental factors on the expression of genes

Basic mechanisms of primary infertility in reproductive age women with hypothalamic dysfunction in puberty

Hypothalamic dysfunction is the most common pathology of the puberty and is accompanied by obesity in 39 % of adolescent girls. Obesity is one of the main causes of reproductive function disorders leading to decrease infertility in women. The aim of the study is to assess the gynecological health of reproductive age women with hypothalamic dysfunction in puberty and to determine the mechanisms of the primary infertility formation. We conducted a prospective study of adolescent girls with hypothalamic dysfunction (n = 170) from 2000 to 2013 year. According to the screening criteria, fertility was assessed in 86 women of reproductive age, a comparative characteristic was performed in fertile women (n = 46) and in women with primary infertility (n = 21). PCOS (38.1 %), absence of ayellow body in one of the ovaries (71.4 %), a decrease in serum progesterone by 2 times, an increase in ERa/PGR by 2.3 times and activity of NF-kB by 1.4 times in the endometrium were detected significantly more often in women with primary infertility with hypothalamic dysfunction in puberty in comparison with fertile women. The level of ERa and PGR in the endometrium decreased with increasing activity of NF-kB and BMI. The relationship between the activity of NF-kB and BMI in both study groups was established

SOME RESULTS OF ACTIVE DETECTION OF GENITAL TUBERCULOSIS IN INFERTILE WOMEN

The article presents the results of analysis of statistics and hospital records of women of reproductive age with infertility, who were examined in 2008—2011. It was shown that after the implication of active monitoring of infertile women tubercolosis prevalence in risk group increased from 0 to 18 %

FEATURES OF DIAGNOSIS OF UROGENITAL TUBERCULOSIS IN PATIENTS WITH INFERTILITY

Diagnosis of urogenital tuberculosis presents great difficulties. The article shows the main methods of diagnosing disease in modern conditions. For the early and timely detection of tuberculosis of female genital mutilation it is necessary to restore the interaction, of TB doctors and. gynecologists

Ethnic difference of neuroendocrine regulation in women with reproductive disturbances associated with genital tuberculosis

Genital tuberculosis is an actual socially significant disease associated with tubal peritoneal infertility, as well as hormonal disorders of women of fertile age. Studies of the prevalence of genital tuberculosis among women with infertility in other countries and various ethnic groups have not been found, but ethnic factors must be taken into account when assessing epidemiology, causes, clinical characteristics of the course and outcomes of many diseases. The aim of the work was to establish the clinical and hormonal features of reproductive disorders associated with tuberculosis of the genital organs in women of the two main ethnic groups in the Republic of Buryatia. Hormonal features have been revealed in women with reproductive disorders and genital tuberculosis, which are characterized by a statically significant decrease in the levels of estradiol, progesterone and free testosterone in the blood serum compared to women in whom genital tuberculosis has not been verified. When analyzing ethnic characteristics, it is shown that for women with reproductive disorders associated with genital tuberculosis, a decrease in the level of ovarian hormones in the blood serum is characteristic, and also a higher level of free testosterone and a decrease in free T4 in serum for women in the Buryat ethnogroup with the Russians. Timely detection of a decrease in the level of ovarian hormones in women with reproductive disorders and genital tuberculosis will allow rational and effective correction of hypogonadism

Profile of a patient with tubal peritoneal infertility with unsuccessful attempts of IVF

Tubal-peritoneal infertility ranks first among the reasons for carrying out IVF in the Irkutsk region. The effectiveness of assisted reproductive technologies programs in particular, programs of in vitro fertilization depends on many factors. In addition to the quality of embryos - factor that is almost impossible to influence, the effectiveness of IVF depends on the presence of persistent foci of infection in women with infertility. A retrospective analysis of 83 patients with an established diagnosis of primary infertility, tubal-peritoneal factor, the average age of 35.8 ± 1.5years, the duration of infertility averaged 4.5 ± 1.3 years, the level of Anti-Müllerian hormone (AMG) is not lower than 1 ng/ml (sufficient ovarian reserve), after unsuccessful attempts of application of methods of assisted reproductive technologies (one or more inefficient IVF program). Mostly, patients had normal indices of body mass index. We preformed a retrospective analysis of 83 cases histories of patients of "Mother and child" clinic, Irkutsk, with established diagnosis of primary infertility with tubal-peritoneal factor and composed a clinical profile of a patient. All patients were examined for genital tuberculosis, which was diagnosed in 12 women (14.4 %). Genital tuberculosis as a hidden source of infection has no pathognomonic symptoms and difficult to diagnose, so the presence of indirect signs should alert the obstetrician-gynecologist for early diagnosis of this disease. For early and timely detection of genital tuberculosis in women with reproductive disorders, active implementation of an expanded list of risk factors in the outpatient stage is necessary

Prognosis and diagnosis of reproductive disorders associated with genital tuberculosis in women

Diagnosis of tuberculosis of female genitalia is based on a complex of traditional and new diagnostic methods used in a certain sequence in outpatient and/or inpatient settings. Because of insufficiently effective diagnostic tests, genital tuberculosis is often detected in irreversible anatomical changes, when the prospects for restoring the reproductive function are unsatisfactory. The aim of the work was to identify socio-economic and biomedical risk factors for reproductive disorders associated with genital tuberculosis in order to create statistical models for the prediction and diagnosis of these disorders. To study the connection between the presence of genital tuberculosis and a number of prognostic and diagnostic features, the method of nonlinear regression analysis (logistic regression) was used. Statistical models of prognosis and diagnosis of reproductive disorders associated with genital tuberculosis (HT) in women at the outpatient stage are proposed. The forecast model included clinical and anamnestic predictors: prolonged subfebrile condition, weight loss, increase in inguinal lymph nodes, membership in the social group «female students», contact with tuberculosis patients, tuberculin specimen turnover, presence of pulmonary tuberculosis in the anamnesis. The statistical diagnostic model included the following important methods: enzyme immunoassay, laser fluorescence method, Diaskin-test, hysterosalpingography (segmented fallopian tubes), determination of progesterone, estradiol and testosterone levels in the blood serum (decrease of these hormones)

FEMALE GENITAL TUBERCULOSIS IN THE MAIN ETHNIC GROUPS IN BURYAT REPUBLIC

The article presents the results of analysis of statistical data and medical cases of women with urogenital tuberculosis, examined at the Republic's clinical TB dispensary in Ulan-Ude (Buryat Respublic) in the 2008-2012. It was shown that in accordance with hospital register the genital TB incidence and the rate of infertility associated with tuberculosis in Buryats and Russian patients are similar