Ovarian endometriosis and fertility preservation problem

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. 110-116
Author(s):  
Galina E. Chernukha ◽  
Madina R. Dumanovskaya ◽  
Lilia M. Ilina
Keyword(s):  
Fertility Preservation ◽  
Ovarian Reserve ◽  
Assisted Reproductive Technologies ◽  
Therapeutic Option ◽  
Reproductive Technologies ◽  
Ovarian Endometriosis ◽  
Urgent Surgery ◽  
Repeated Surgery ◽  
Appropriate Therapy

Aim. To review the most recent literature regarding the modern management of women with ovarian endometriosis and no desire for immediate pregnancy but wanted fertility preservation in future. Materials and methods. The analysis of latest publications on this topic has been carried out. Results. Ovarian endometriosis is associated with infertility due to several factors including potential gonadotoxic effect per se and ovarian reserve decline after surgical treatment. Medical treatment is the first-line therapeutic option for patients with pelvic pain and no desire for immediate pregnancy in absence indications for the urgent surgery, for prevention disease progression. Postoperative long-term medical therapy has been effective in the prevention of endometrioma recurrence, repeated surgery, additional ovarian reserve decline and preserve fertility in future. Conclusion. Ovarian endometriosis management should be individualized according to the patients intentions and priorities. Long-term progestins most appropriate therapy for fertility preservation in women prior to performing surgery or provide assisted reproductive technologies, if needed.

Ovarian endometriosis associated infertility: a modern view to the problem

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 44-49
Author(s):  
Mekan R. Orazov ◽  
Marina B. Khamoshina ◽  
Marianna Z. Abitova ◽  
Lyudmila M. Mikhaleva ◽  
Snezhana V. Volkova ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Assisted Reproductive Technologies ◽  
Negative Impact ◽  
Ovarian Tissue ◽  
Reproductive Function ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
Ovarian Endometriosis ◽  
Surgical Interventions ◽  
Ovarian Endometriomas

This review summarizes current understanding of the pathogenesis of one of the most common forms of external genital endometriosis ovarian endometriomas. Due to their frequent occurrence in young women of reproductive age and extremely negative impact on the morphophysiological state of the ovaries, this disease makes a significant contribution to the structure of endometriosis-associated infertility. The main determinant of the negative effect of ovarian endometriomas on reproductive function is a decrease in ovarian reserve, which can occur either due to the direct gonadotoxic effect of the endometriod cyst itself, or due to the unintentional removal of healthy ovarian tissue during surgery or the use of aggressive methods of electrosurgery. Hence, the question of methods for achieving hemostasis during surgery in terms of iatrogenic effects on healthy ovarian tissue is debatable. The management strategy for patients with infertility associated with ovarian endometriosis consists of two components: surgical treatment and/or the use of assisted reproductive technologies. Laparoscopic cystectomy is indicated for cysts larger than 3 cm. Repeated surgical interventions in case of endometriosis do not improve fertility outcomes. Assisted reproductive technologies methods should be considered as a priority tactic in patients of older reproductive age with low ovarian reserve indicators or infertility duration of more than 2 years, as well as in cases of recurrent ovarian endometriomas. Management of such patients must be personalized and take into account the age, state of the ovarian reserve, duration of infertility, stage and number of surgical interventions for this disease.

scholarly journals Alteration of Genomic Imprinting after Assisted Reproductive Technologies and Long-Term Health

Life ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 728
Author(s):  
Eguzkine Ochoa
Keyword(s):  
Embryonic Development ◽  
Experimental Evidence ◽  
Genomic Imprinting ◽  
Animal Studies ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Early Embryonic Development ◽  
Global Methylation ◽  
The Impact

Assisted reproductive technologies (ART) are the treatment of choice for some infertile couples and even though these procedures are generally considered safe, children conceived by ART have shown higher reported risks of some perinatal and postnatal complications such as low birth weight, preterm birth, and childhood cancer. In addition, the frequency of some congenital imprinting disorders, like Beckwith–Wiedemann Syndrome and Silver–Russell Syndrome, is higher than expected in the general population after ART. Experimental evidence from animal studies suggests that ART can induce stress in the embryo and influence gene expression and DNA methylation. Human epigenome studies have generally revealed an enrichment of alterations in imprinted regions in children conceived by ART, but no global methylation alterations. ART procedures occur simultaneously with the establishment and maintenance of imprinting during embryonic development, so this may underlie the apparent sensitivity of imprinted regions to ART. The impact in adulthood of imprinting alterations that occurred during early embryonic development is still unclear, but some experimental evidence in mice showed higher risk to obesity and cardiovascular disease after the restriction of some imprinted genes in early embryonic development. This supports the hypothesis that imprinting alterations in early development might induce epigenetic programming of metabolism and affect long-term health. Given the growing use of ART, it is important to determine the impact of ART in genomic imprinting and long-term health.

scholarly journals IMPACT OF MULTIPLE BIRTHS ON THE OUTCOME IN EXTREMELY LOW BIRTH WEIGHT NEWBORNS

2021 ◽  
Vol 27 (3) ◽  
pp. 3985-3991
Author(s):  
Victoria Atanasova ◽  
◽  
Petar Ivanov ◽  
Elitsa Gyokova ◽  
Desislava Georgieva ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Assisted Reproductive Technologies ◽  
Ductus Arteriosus ◽  
Intraventricular Haemorrhage ◽  
Reproductive Technologies ◽  
University Hospital ◽  
Extremely Low Birth Weight ◽  
Gastrointestinal Problems

Objective: To evaluate the outcome of the extremely low birth weight newborns (ELBWNs) from single and twin pregnancies. Material and methods: The study lasts from 2005 to 2017 and includes all life born ELBWNs treated in University Hospital, Pleven, Bulgaria. Patients' groups: singletons (1) and twins (2); twins conceived naturally(2.1) and after assisted reproductive technologies – ART(2.2). Results: One hundred and eighty two (182) ELBWNs are examined, 65 (35.7%) of them are twins. The twins, compared to singletons, are significantly more often conceived by ART (47.7 vs 4.3%, p<0.001) and significantly more rarely infected prenatally (18 vs 41%, p 0.002). The survival rate is 51.3% for singletons and 56.6% for twins, NS. Survived twins (n 37) achieve later their optimal nutritive tolerance (30±11 vs 25±10 days, p 0.046), require more blood transfusions (3.6±1.9 vs 2.6±1.8 per patient, p 0.009) and longer mechanical ventilation (16±15 vs 9±12 days, p 0.03) than survival singletons (n 60). The twins suffer more often from intraventricular haemorrhage (46 vs 18%, p 0.004), patent ductus arteriosus (35 vs 15%, p 0.02) and long-term complications (51 vs 30%, p 0.04) than singletons. ART-twins (n 31)compared to the subgroup 2.1 (n 34) are more frequently intubated in the delivery room (81 vs. 50%, p 0.01)but suffer less frequently from nosocomial infections (53 vs. 85%, p 0.03). Conclusions: According to our data, ELBW-twins frequently suffer from respiratory, haemorrhagic, and gastrointestinal problems than ELBW-singletons, resulting in more long-term complications. Our study proves that ART does not influence the outcome in multiples.

Long-term complications of assisted reproductive technologies

2011 ◽  
Vol 14 (2) ◽  
pp. 77-87 ◽  
Author(s):  
Mostafa Metwally ◽  
William L. Ledger
Keyword(s):  
Assisted Reproductive Technologies ◽  
Reproductive Technologies

scholarly journals Negative impact of high doses of follicle-stimulating hormone during superovulation on the ovulatory follicle function in small ovarian reserve dairy heifers†

2020 ◽  
Author(s):  
Kaitlin R Karl ◽  
Fermin Jimenez-Krassel ◽  
Emily Gibbings ◽  
Janet L H Ireland ◽  
Zaramasina L Clark ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Assisted Reproductive Technologies ◽  
Negative Impact ◽  
Follicle Stimulating Hormone ◽  
Prostaglandin F2α ◽  
Reproductive Technologies ◽  
Corpora Lutea ◽  
Ovulatory Follicle ◽  
High Doses ◽  
Stimulating Hormone

Abstract When women with small ovarian reserves are subjected to assisted reproductive technologies, high doses of gonadotropins are linked to high oocyte and embryo wastage and low live birth rates. We hypothesized that excessive follicle-stimulating hormone (FSH) doses during superovulation are detrimental to ovulatory follicle function in individuals with a small ovarian reserve. To test this hypothesis, heifers with small ovarian reserves were injected twice daily for 4 days, beginning on Day 1 of the estrous cycle with 35, 70, 140, or 210 IU doses of Folltropin-V (FSH). Each heifer (n = 8) was superovulated using a Williams Latin Square Design. During each superovulation regimen, three prostaglandin F2α injections were given at 12-h interval, starting at the seventh FSH injection to regress the newly formed corpus luteum (CL). Human chorionic gonadotropin was injected 12 h after the last (8th) FSH injection to induce ovulation. Daily ultrasonography and blood sampling were used to determine the number and size of follicles and corpora lutea, uterine thickness, and circulating concentrations of estradiol, progesterone, and anti-Müllerian hormone (AMH). The highest doses of FSH did not increase AMH, progesterone, number of ovulatory-size follicles, uterine thickness, or number of CL. However, estradiol production and ovulation rate were lower for heifers given high FSH doses compared to lower doses, indicating detrimental effects on ovulatory follicle function.

scholarly journals Endometriosis: Correlation of Severity of Pain with Stages of Disease

2017 ◽  
Vol 34 (3) ◽  
pp. 135-139
Author(s):  
Tanzeem S Chowdhury ◽  
Nusrat Mahmud ◽  
TA Chowdhury
Keyword(s):  
Pelvic Pain ◽  
Assisted Reproductive Technologies ◽  
Stage Iv ◽  
Reproductive Technologies ◽  
Disease Stage ◽  
Common Symptom ◽  
Strong Positive Correlation ◽  
Ovarian Endometriosis ◽  
Positive Correlation ◽  
Stage Iv Disease

Objective: To assess the prevalence and severity of pain in patients with endometriosis and to evaluate the relationship between the severity of pelvic pain with different stages of endometriosis.Methods: A prospective observational study conducted among 65 patients diagnosed with endometriosis during surgery in Infertility Management Center Dhaka, a specialized center for treatment of infertility and assisted reproductive technologies from January 2008 to January 2009.Result: Majority of the patients were between 26-30 years. Pelvic pain was the predominant symptom in 78.5% patients and the rest were asymptomatic. Among the symptomatic patients, most common symptom was dysmenorrhoea (n=47, 92.1%).When severity of pain was graded; it was observed that most (37%) presented with moderate pain. Infertility was present in 85% patients, mostly (n- 47 =74%) in primary sub fertility group. The commonest site of endometriosis was uterosacral ligament (n-58=89%) and ovarian endometriosis is noted in (63%) cases. Most of the lesions (35%) were black, haemosiderin deposits. When r-ASRM staging system was applied, majority (58.4%) of the patients was in stage IV disease and most of the patients (31%) with endometrioma were in stage IV disease. The study revealed a strong positive correlation between severe pain and stage IV disease (Correlation co efficient 0.711). Moderate forms of pain and severity of disease did not show any positive correlation in this study (Correlation co efficient 0.390). There was negative correlation between milder forms of pain with severity of disease.Conclusion: There was no relationship between frequency and severity of pain symptoms and disease stage of endometriosis.J Bangladesh Coll Phys Surg 2016; 34(3): 135-139

scholarly journals Transitioning from Infertility-Based (ART 1.0) to Elective (ART 2.0) Use of Assisted Reproductive Technologies and the DOHaD Hypothesis: Do We Need to Change Consenting?

2018 ◽  
Vol 36 (03/04) ◽  
pp. 204-210 ◽  
Author(s):  
Amanda Adeleye ◽  
Paolo Rinaudo
Keyword(s):  
Family Planning ◽  
Glucose Intolerance ◽  
Animal Studies ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Parents And Children ◽  
Health And Disease ◽  
Infertile Patients ◽  
Art Techniques

AbstractThe use of assisted reproductive technologies (ARTs) has increased significantly in recent years. While this is partially due to improved access for infertile patients, another contribution to the growth of ART utilization is represented by individuals without infertility, who electively chose to freeze their gametes and embryos for future use, before ever attempting conception spontaneously. Overall, the safety of ART for parents and children is well described and the risks are modest. However, while long-term health consequences for offspring as postulated by the Developmental Origin of Health and Disease (DOHaD) hypothesis are unknown, numerous animal studies suggest a predisposition for chronic diseases like hypertension and glucose intolerance. In this article, we argue that a key difference exists between infertile patients, who need to use ART as the only means to achieve pregnancy, and (likely) fertile patients who elect to use ART techniques as a family planning option. We believe that these two sets of patients are different and their risks–benefit ratios are different. We propose that while all patients should be aware of the risks, patients planning to utilize ART techniques without a diagnosis of infertility should be encouraged to think critically about the additional risks, particularly the “potential” long-term risks that may be imposed from these elective procedures.

scholarly journals From egg to embryo: a peripatetic journey

Reproduction ◽  
2005 ◽  
Vol 130 (6) ◽  
pp. 825-828 ◽  
Author(s):  
Richard M Schultz
Keyword(s):  
Gene Expression ◽  
Assisted Reproductive Technologies ◽  
Egg Quality ◽  
Reproductive Technologies ◽  
Molecular Signature ◽  
High Quality ◽  
Long Term Consequences ◽  
The Uk ◽  
Effect Gene

The recent surge of interest in oocyte development has been spurred in large part by the increasing implementation of assisted reproductive technologies (ART) to treat human infertility. What is becoming apparent is that ‘egg quality’ is a primary factor in the success of ART (Sauer 1998), and yet we know virtually nothing about the molecular signature of a ‘high quality’ oocyte, i.e., an oocyte that is capable of maturing, being fertilized and supporting development to term. We are gaining marked insights, however, into how sperm activate eggs and the changes in gene expression that accompany preimplantation development. Nevertheless, embryo culture is known to effect gene expression (Rinaudo & Schultz 2004), the long-term consequences of which are only recently being unmasked. This review will briefly highlight these topics that were presented during the Biennial Joint Meeting of the UK Fertility Societies at Warwick University in April 2005.

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