Specific features of molecular mechanisms of vaginal secretion in women with decline in sexual function in assisted reproductive technology programs


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Abstract

Women experiencing infertility compared to fertile women are more likely to have sexual dysfunction, including lack of genital arousal, dyspareunia. Sex steroids have a key effect on the morphological and functional condition of the urogen ital tract. Aim. To explore specific features of gene expression of vaginal transcellular secretion factors (AQP3, ESR1, VEGF121, and VEGF165) in ovarian stimulation (OS) for IVF and in natural cycle IFV (NC-IVF) in women with decline in sexual function. Materials and methods. The study included 47 women with decline in sexual function: 24 women underwent OS for IVF, and 23 women underwent treatment for NC-IVF. Female sexual function was assessed using clinical interviews and the FSFI questionnaire. Results. The patients in group 1 (OS for IVF) were younger (p <0.001) and duration of their infertility was shorter (p<0.001), the level of serum anti-Mullerian hormone (AMH) was higher (p<0.001) and the level of follicle-stimulating hormone (FSH) was lower (p<0.001) compared to patients in group 2 (NC-IVF). Group 1 showed higher median values for the female sexual function index (FSFI) in 3 domains “erousal” (p=0.05), “lubrication” (p=0.04), and “desire” (p=0.09). PCR analysis in patients with OS found a high level of ESR1 expression (p=0.012), VEGF121 (p=0.01), a tendency for high AQP3 values (p=0.09) compared to patients in group 2 (NC-IVF); the level of VEGF165 expression was comparable in both groups. High levels of ESR1, VEGF121, AQP3 expression in patients with OS were associated with higher FSFI scores in domains “erousal”, “lubrication”, “desire”. Conclusion. The obtained results allowed to determine some pathogenetic mechanisms of impairment of vaginal secretion, genital sexual arousal, as well as development of dyspareunia.

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About the authors

Natalia N. Stenyaeva

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: nataliasten@mail.ru
MD, PhD, Senior Researcher of the Department of Andrology and Urology

Alexey M. Krasnyi

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: a_krasnyi@oparina4.ru
PhD, Head of the Laboratory of Cytology

Dmitry F. Khritinin

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Corresponding Member of the RAS, Dr. Med. Sci., Professor of the Department of Psychiatry and Narcology, Faculty of General Medicine

Anna G. Burduli

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: burdulianna@gmail.com
MD, PhD, Senior Researcher of IVF Department

Alsu A. Sadekova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: sialsad@gmail.com
PhD (Bio), researcher of the Cytology Laboratory

Marina N. Kostava

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

PhD, obstetrician-gynecologist, doctor of the highest category

Elena A. Kalinina

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: e_kalinina@oparina4.ru
Dr. Med. Sci., Professor, Head of the Department of Assisted Technologies for the Treatment of Infertility, Scientific Secretary of the Dissertation Council

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