Hormonal parameters and embryological outcomes of in vitro fertilisation/intra cytoplasmic sperm injection cycles in women using dydrogesterone for the prevention of premature luteinizing hormone surge during ovarian stimulation

Aim. To evaluate the hormonal parameters and embryological outcomes of an ovarian stimulation protocol using dydrogesterone to prevent the premature LH surge in IVF/ICSI programmes. Materials and methods. A prospective study randomised, including 79 women with normal ovarian reserve undergoing ovarian stimulation for IVF/ICSI with recombinant FSH (rFSH) from Day 2 or 3 of the menstrual cycle. To prevent the premature LH surge, participants in Group 1 (n=38) received oral dydrogesterone 20 mg/day from the start of ovarian stimulation until the day of ovulation trigger administration. Participants in Group 2 (n=41) received a GnRH antagonist. We evaluated the starting and total dose of gonadotropins, duration of stimulation, serum levels of LH, oestradiol and progesterone on Day 1 and 6 of stimulation and the day of trigger administration, number of retrieved and mature oocytes, fertilization rate, and the number of blastocysts and cryopreserved embryos. Results. There were no significant differences in most hormonal parameters, characteristics of the ovarian stimulation and embryological outcomes between the two groups. Serum levels of progesterone in the dydrogesterone arm were higher than in the GnRH antagonist arm (2.3 nmol/l [2.03.4] vs 1.5 [1.02.4] nmol/l; p=0.026), but without any impact on the embryological outcomes. Conclusion. Prevention of premature LH surge in ovarian stimulation cycles using oral dydrogesterone may represent a convenient alternative to the conventional use of GnRH antagonists, reducing the number of required injections and potentially increasing the convenience in patients who are not planning a fresh embryo transfer

Influence of the Water Level in the Yenisei River on the Ecosystem of its Anabranch within the City of Krasnoyarsk

Расположенная в черте города Красноярска в 35 км ниже Красноярской ГЭС Абаканская протока р. Енисей является, с одной стороны, важным рекреационным водоемом, а с другой стороны, подвержена нескольким типам антропогенного воздействия (зарегулирование дамбой, поступление ливневых и теплых вод, наличие садкового рыбоводного хозяйства), ухудшающего ее рекреационные свойства из-за чрезмерного зарастания макрофитами и скоплений метафитона нитчатой водоросли рода Spirogyra, ухудшения органолептических и микробиологических показателей воды. Природные климатические факторы способны существенно модифицировать влияние антропогенных факторов, что представляет интерес в плане прогнозирования и принятия решений по ликвидации негативных явлений. Целью работы является оценка влияния режима уровня воды р. Енисей в весенне-летний период на экосистему протоки через сравнение данных в многоводный (2021) и средневодный (2020) годы. Гидрофизические, гидрохимические и гидробиологические измерения проводили с мая по август 2020 и 2021 гг. сверху вниз на станциях левобережья: 1 – выше дамбы (фон), 2 – ниже дамбы, 3 – напротив выпуска теплых вод ТЭЦ, 4 – пляж, ниже рыбоводных садков. В 2021 г. вода в протоку поступала только снизу (к ст. 4 и 3), так как водопропускные трубы в теле плотины были засыпаны. В 2021 г., по сравнению с 2020 г., на зарегулированном участке протоки значительно увеличились численность и биомасса фито- и зоопланктона, возросла первичная продукция планктона, а аналогичные показатели фитоперифитона и зообентоса, напротив, снизились по причине их формирования на свежезалитых грунтах. Метафитон отсутствовал, но в августе спирогира стала доминировать в биомассе фитоперифитона. Концентрации нитрит-иона в воде увеличились в зарегулированной части протоки, а нитрат-иона и общего фосфора – на всех станциях протоки, в том числе и на фоновой, получающей воды из Красноярского водохранилища. Наблюдаемая в 2021 г. «вспышка трофии» в планктоне ст. 3 и 4 обусловлена длительным (полтора месяца) удержанием высокого уровня воды в протоке, позволившим использовать биоте вымываемые из затопленных берегов органические вещества и биогены, и аналогична таковой в экотонных зонах выклинивания подпора водохранилищ. Ежегодное увеличение концентраций минеральных форм азота и общего фосфора на нижних станциях, по сравнению с другими станциями, вероятно, обусловлено эвтрофирующим влиянием садкового рыбоводного хозяйстваLocated within the city of Krasnoyarsk, 35 km downstream of the Krasnoyarsk Hydropower Plant, the Abakanskaya anabranch of the Yenisei River, on the one hand, is an important recreational water body and, on the other hand, is subject to several types of anthropogenic impact (regulation by a dam, inflow of storm and warm waters, fish farming). These impacts worsen its recreational properties due to excessive growth of macrophytes and metaphytic filamentous algae of the genus Spirogyra, causing deterioration of organoleptic and microbiological parameters of water. Natural climatic factors can significantly modify the influence of anthropogenic factors, which is of interest in terms of forecasting and decision-making about the elimination of negative factors. The aim of the present work is to assess the influence of the water level regime of the Yenisei River in the spring–summer period on the anabranch ecosystem by comparing the data for the high-water (2021) and medium-water (2020) years. Hydrophysical, hydrochemical, and hydrobiological measurements were carried out from May to August 2020 and 2021 at locations on the left bank: 1 – upstream of the dam (reference), 2 – downstream of the dam, 3 – opposite the outlet of warm water, 4 – at the beach, downstream of the fish farm. In 2021, water entered the anabranch only from downstream (to locations 4 and 3), since the culverts in the dam body were filled up. In 2021, compared to 2020, the abundance and biomass of phyto- and zooplankton in the regulated section of the anabranch significantly increased, the primary production of plankton increased, but the corresponding parameters of phytoperiphyton and zoobenthos, on the contrary, decreased due to their formation on freshly flooded soils. Metaphyton was absent, but in August, Spirogyra began to dominate in the phytoperiphyton biomass. Nitrite ion concentrations in the water increased in the regulated part of the anabranch, and the nitrate ion and total phosphorus concentrations increased at all locations, including the reference location, receiving water from the Krasnoyarsk Reservoir. The plankton “abundance outbreak” observed in 2021 at locations 3 and 4 was caused by the water level in the anabranch remaining high over a long period (one and a half months), which made it possible for the biota to use organic matter and nutrients washed out from the flooded banks; the outbreak was similar to those occurring in the ecotone zones of inputs to the upper parts of reservoirs. The annual increase in the concentrations of mineral forms of nitrogen and total phosphorus at the lower locations compared with other locations was probably due to the eutrophic influence of fish farmin

Outcomes of assisted reproductive technologies in discordant couples with HIV infection in a woman

Aim. To evaluate the effectiveness of assisted reproductive technologies (art) in discordant couples with hiv-infected women. Materials and methods. The prospective clinical study included 432 women who received an in vitro fertilization (ivf) program. The main group included 214 subjects with hiv infection, and the control group included 218 subjects without hiv infection. In the main group, 182 "fresh" ivf/icsi (intracytoplasmic sperm injection) cycles and 162 cryocycles were performed; in the control group, 271 and 195 cycles, respectively. Results. The median length of HIV infection was 9.8 (5.7; 12.4) years, subclinical stage 3 of the disease prevailed (59.8%), and the duration of antiretroviral therapy was 4.5 (2.4; 8) years. The CD4+lymphocyte count [630 (496; 791) cells/μL] indicated a relatively "good" state of the immune system due to the antiretroviral therapy. In the main group, a significantly lower number of oocyte-cumulus complexes [6.5 (3; 12) and 9 (6; 15); p0.001], zygotes [4 (2; 8) and 6 (4; 10); p0.001] and blastocysts [2 (0; 2) and 4 (1; 6); p0.001] were obtained in comparison with the control group. The number of abnormally fertilized oocytes (3 or more PNs) was significantly higher in the group of HIV-infected women compared to HIV-negative ones — 0.21 (0.7) and 0.09 (0.2) (p=0.018), respectively. Evaluation of the effectiveness of "fresh" IVF/ICSI cycles showed that HIV-infected women had a significantly lower incidence of clinical pregnancy (16.5 and 32.8%; p=0.001), as well as live births (12.2 and 31.5%; p0.001). Analysis of cryocycle outcomes showed that using their own oocytes in women with HIV infection, the frequency of clinical pregnancy (27.6 and 41%; p=0.014) and childbirth (16.7 and 27.7%; p=0.021) is significantly lower than in patients without HIV infection, and in cases of using donor oocytes, these indicators are comparable between the groups (40%; p=0.910 and 25.7%; p=0.809, respectively). Conclusion. ART in HIV-infected women is associated with low pregnancy rates in both "fresh" and cryocycles using their own oocytes. The decrease in the oocytes/embryos obtained and the high proportion of abnormal fertilization in HIV-infected patients suggest the presence of oocyte factor as the main cause of the low effectiveness of ART programs in this group of patients