Online ISSN: 2515-8260

Keywords : infertility

Infertility predictors for prolactin-secreting pituitary adenomas

Kh.K Nasirova; Z.Yu. Khalimova; Yu. M. Urmanova; G.D. Narimova

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 2488-2503

Abstract: Purpose of research - To improve reproductive outcomes of women with
prolactinomas by evaluating fertility predictors. Material and methods. We examined 250
women aged 17-35 years (average age 30.5 years) with endocrine infertility (EI) and
hyperprolactinemia. Of these, 71 (28.4%) patients with prolactinoma and endocrine
infertility were selected for an in-depth study. All patients underwent a complete clinical -
hormonal and visualization examination and were divided into patients with EI with
pituitary microprolactinomas (64.7%) and patients with EI with macroprolactinomas
(35.2%). Clinical, imaging, and hormonal studies have been performed. The basal levels of
the pituitary gonadotropic hormones — LH, FSH, as well as PRL, TH, peripheral gland
hormones cortisol (C), estradiol (E) and total testosterone (T), dehydroepiandrosterone
sulfate (DHEA-S), progesterone, inhibins A and B were determined , activin, antimuller
hormone. The research materials were subjected to statistical processing using the methods
of parametric and non-parametric analysis. Results. According to the objectives, the
functional state of the HPO system and the clinical characteristics of infertility in
prolactinomas were studied, an analysis of complaints and anamnestic data of patients
with EI with prolactinomas was made, depending on the size of the formation in a
comparative aspect. The state of ovarian reserve was assessed, with the determination of
FSH, activin, AMH, inhibin A and B in the blood serum. The inhibin A level in both Me
groups was 1.30 ng/ml, which significantly differed from the control group (p₂ ˂0.0001,
p₃ ˂0.0001). The level of inhibin B underwent significant changes in both groups. A
decrease in inhibin B and an increase in FSH can prove a decrease in ovulatory ovarian
reserve. The studied women with EI in both groups showed a decrease in AMH, in the
group with microadenomas ranged from 0.12 to 2.1 and averaged 0.75 ± 0.27 ng/ml, and in
the group with macroadenomas ranged from 0.09-2.2 and averaged 0.97 ± 0.49 ng/ml,
which significantly differed from the control group (p₁ ˂0.05, p₂ ˂0.001 p₃ ˂0.001). The
conducted Spearman correlation and regression analysis showed that between prolactin
and AMH (r = -0.4; p˂0.01), between prolactin and progesterone (21dMC) (r = -0.576;
p˂0.0001) as well as between prolactin and inhibin B (r = -0.67) there is a strong “-“
negative relationship and all indicators were statistically significant. Conclusions:
Endocrine disorders in women with prolactinomas are significantly increased in patients
with macroadenoma compared with microadenoma. Correlation-regression analysis found
a negative relationship between PRL and AMH (r = -0.4, P <0.0001), PRL and
progesterone (r = -0.57, P <0.0001). With an increase in PRL by 1 unit, there is a decrease
in AMH by 0.008 units (P <0.001), a decrease in inhibin B by 0.11 (P <0.001),
progesterone by 0.04 units (P <0.0001) and the degree of hyperprolactinemia and this all
can predict EI development.

Features of perinatal outcomes in women after supporting reproductive technologies

Shakhnoza F. Bakhodirova; Gulchekhra A. Ikhtiyarova; Aslonova M.J .; Salim S. Davlatov

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 6350-6356

Pregnancy conceived with assisted reproductive technologies (ART) has a higher risk of maternal and perinatal complications, and the overall risk of adverse outcomes requiring extended obstetric care has not been thoroughly studied. The review is devoted to the actual problem of the health status of children born after IVF. A systematic review of the health indicators of children conceived with IVF after the neonatal period was carried out versus natural, conceived.

Detection of SARS-CoV-2 in Follicular and Endocervical Fluid of IVF Candidates with Positive PCR Tests

Mina Ataei .; Ali Sadeghitabar; Atousa Karimi; Marjan Ghaemi; Sara Amirajam; Soheila Ansaripour

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 3752-3758

Introduction & Objective: The COVID-19 pandemic is a unique global challenge with a wide range of severity
extending from an asymptomatic form to a serious intense respiratory syndrome. We have restarted the ART
treatments in cases that need emergent IVF treatment according to the international and local guidelines. This
study aimed to evaluate the presence of viruses in follicular and endocervical fluid in patients with a positive
PCR tests provided on the day of the oocyte trigger. Method: All participants and their partners, who were a
candidate to start ART from April 2020 to October 2020, completed a triage questionnaire two weeks before
starting the ART cycle. A PCR test was performed for all participants before starting the cycle. According to
Avicenna center protocol, a diagnostic test (real-time PCR) by Dacron swap and Pishtazteb kit. The
nasopharynx test for COVID-19 was conducted for all ART patients 48 hours before the day of the oocyte
trigger. PCR test was positive in 32 women. In the operating theater, sterile swabs were used to provide
cervicovaginal specimens to determine COVID 19 virus in cervicovaginal fluid. Also, the first aspirated
follicular fluid was referred to the lab to assess the presence of COVID 19. Result: In this study, virus particles
were not detected in the follicular and endocervical fluid of the women with positive PCR tests. Case
presentation: We describe 32 patients who were candidates for IVF, with approved positive COVID-19 PCR
tests to evaluate whether the virus is present in the follicular and endocervical fluid or not? Discussion: We are
still at the beginning of the road and need reliable data on the safety of the ART at the time of pandemic. The
risk of infection during all process of ART including oocyte retrieval needs attention. The fluids from mature
follicles are a potential site to be infected and the human cumulus cells could not be a deterrent factor to
entrance of the virus in the oocyte. This process may lead to gametes infection. Indeed in real life evaluating
the risk of sexual transmission of COVID-19 is very important. Conclusion: We did not detect virus RNA in
the follicular and endocervical fluid of the patients with positive PCR test. Although, more studies with a
greater sample size are mandatory in this field.