No 3 (2016)

Objective. To carry out a systematic analysis of the data of Russian and foreign scientific literature on the choice of estimation success criteria in the use of assisted reproductive technologies. Subject and methods. The review included the data of foreign and Russian articles found in Pubmed on this topic among those published in the past decade. Results. The IFV success criteria affect the choice of embryo selection strategy. It is necessary to identify the best embryos if the conception success rate calculated for fresh embryo transfer is the most important criterion. Less importance is attached to embryo selection if the cumulative conception rate is a main criterion. Conclusion. The success criterion is one of the reproductive medicine needs. The cumulative conception rate calculated for transvaginal puncture become increasingly important; moreover, that estimated for fresh embryo transfer remains appropriate.

Objective. To determine the spectrum of serum autoantibodies against endothelial cells and components of the glycocalyx in patients with preeclampsia and to investigate their relationship. Subjects and methods. A prospective case-control study was conducted. The activity of antibody binding to endothelial EA.hy926 cells and the level of peripheral blood anti-hyaluronic acid antibodies were determined in 28patients with preeclampsia and 30 apparently healthy pregnant women in the third trimester. Results. In preeclampsia, there was an enhanced binding of immunoglobulin G antibodies to endothelial cell antigens, as well as an increased level of immunoglobulin G antibodies against hyaluronic acid [-4GlcA[31- 3 GlcNA eft!- In and its repeating disaccharide unit GlcA/31-3GlcNA eft. A negative correlation was found between the binding of anti-endothelial cell antibodies and anti-hyaluronic antibodies. Conclusion. The findings may expand knowledge of the pathogenesis of preeclampsia and its practical realization into the diagnosis and prognosis of the disease.

Objective. To establish the role of a fetus in the formation of a survival strategy mechanism in its hypotrophy on the basis of alcohol cholesterol determination. Subjects and methods. The amniotic fluid levels of alcohol cholesterol, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDP) cholesterol, and a-fetoprotein were studied in 34 parturients with different pregnancy complications and in 19 women with physiological pregnancy. Results. In fetal hypotrophy, there was a change in the amniotic fluid levels of alcohol cholesterol, LDL cholesterol, and ELD cholesterol, as well as modified а-fetoprotein metabolism that ensured impaired alcohol cholesterol supply for the fetus. Conclusion. The established relationship of the examined biologically active substances is a peculiar mechanism for fetal regulation of cholesterol metabolism as a survival strategy factor.

Objective. To study the frequency of different alleles of highly polymorphic CGG repeat in the FMR1 gene in patients with polycystic ovary syndrome (POS) and their relationship to the functional state of the reproductive system. Subjects and methods. The CGG-repeat alleles in the FMR1 gene were determined in 115patients with POS, by using a methylation-specific polymerase chain reaction (MS-PCR) assay, followed by a fragment analysis of the products conjugated with the fluorescence dye FAM. Results. The range (according to the results of previous investigations) of 28-36 CGG trinucleotide repeats in the FMR1 gene was taken as a conventional normal value in reference to the ovarian reserve in a Russian population. With this in mind, the investigators identified 3 groups of patients: who had a short (<28) allele a, who had a normal (28-36) allele b and who had a long (>36) allele c. There were 5 subgenotypes: aa in 7% of the patients; ab in 22.8%; bb in 50.9%; be in 14.9%; and ac in 4.4%>. The length of CGGrepeats in the FMR1 gene were in the reference values (bb) in 50.9% of the patients with POS; accordingly 49.1% had abnormal alleles (a and c). In accordance with the subgenotypes, there were 3 study groups: 1) 58 (50.9%) patients (bb); 2) 43 (37.7%) patients with one abnormal (short or long) allele (be, ab), and 3) 13 (11.4%) with two abnormal alleles (ac, aa). There was a two-fold increase in the incidence of amenorrhea in patients in Group 3 as compared to those in Groups 1 and (29% versus 13 and 15%, respectively; p<0.05). The mean level of anti-Mullerian hormone increased with abnormal alleles; in Group 3, it was significantly higher than in Groups 1 and 2(17.8+5.4pg/ml versus 12.1±2.6and 14.3±9.8pg/ml, respectively; p < 0.05). Longer CGG repeats were detectable in patients with infertility versus those with preserved fertility (32±4.08 versus 20.5±1.71 (1-CGG) and 33±5.04 versus 24±3.57(2-CGG) (p < 0.001). Conclusion. Regardless of the phenotype of POS, every two patients with this condition are found to have the abnormal number of CGG repeats in the FMR1 gene, which is associated with severer ovulatory dysfunction. The high rate of the presentation of abnormal alleles in the FMR1 gene, which is comparable with that in POS, may suggest that there is a similarity of molecular genetic changes in the pathogenesis of impaired folliculogenesis in these conditions.

Background. Immune response gene polymorphisms are an important predisposing factor for chronic allergic vulvovaginitis (CAW). Objective. To assess the prognostic role of cytokine gene expression and polymorphism in the development of CAW. Subjects and methods. The cross-sectional study enrolled 106 women: 55 patients with chronic vulvovaginitis (CW), including 19patients with CAW, as well as 51 patients without signs ofCVV. laboratory tests included Gram-stain swab microscopy; vaginal pH-metry; cytometric and microscopic determination of eosinophils in blood and vaginal swabs; and enzyme immunoassay for total IgE in sera and vaginal swabs. Gene polymorphisms in whole blood and cytokine mRNA expression in the cells of vaginal scrapes were determined using real-time polymerase chain reaction. Results. At baseline, the patients with CVV were found to have significantly more frequently the CC genotype of IL4 C.-590OT, less frequently the AA genotype of IL10 c,1082A>G; there was a significant increase in the expression of IL10, IFNG, and IL4. Those with CAW were detected to have significantly more often the TT genotype of IL4 C.-590OT, the GGgenotype of IL10 c.1082A>G, and theAA of IFNG c.874A>T; there was a significant increase in the expression of IL10 and a decrease in that of IFNG. Conclusion. A genetic predisposition to decreased IFNG gene expression (in AA genotype carriers) and increased IL10 gene expression (in GG genotype carriers) may be a risk factor for developing and maintaining genital allergic inflammation.

Objective. To analyze the data available in the modern literature in order to identify sociomedical determinants of the behavior of a mother in promoting and recovering the health of her newborn infant. Material and methods. The review included the data of foreign and Russian articles found in Pubmed and eLibrary on this topic. Results. The paper presents a diversity of sociomedical factors that can potentially affect the molding of the value system in mothers of our society, their awareness of their babies’ care, and prejudices and misconceptions. Conclusion. The behavior of parents, mothers in particular (their self-interest, activity, and compliance) is one of the most important factors for health promotion and disease prevention in infants during the first year of life.

Objective. To reveal the rate of human papillomavirus (HPV) infection among women who are in prison and to determine the prognostic value of high-risk (HR) HPV diagnosis using an Ovintip device. Subjects and methods. A total of 150 women aged 25-59years (mean age, 37.3+8.0years) who were in prison were examined. Vaginal discharge was collected using an Ovintip device and vaginal smear from the cervical canal was taken by a physician for a further HR HPV PCR test. Results. Among the 150examinees, there were HR HPV-infectedpatients (36.7%). HPV-posittve women (61.8%) were infected with several types of HR HPV. HPV16 concurrent with HPV31, 33, 39, 52, and 58 was detected in more than one third of the examinees. HPV16 prevailed in monoinfection. When the material was taken by a woman using an Ovintip device, the sensitivity and specificity of HR HPV diagnosis were 78.3 and 91.3%, respectively. Conclusion. The findings suggest that women who are in prison show a high rate of HR HPV infection. The vaginal discharge self-collection device is of high prognostic value and may be recommended for HpV detection.

Objective. To identify the major confounding factors of primary venous thromboses and embolisms in reproductive- aged women. Subjects and methods. Retrospective analysis of risk factors for venous thromboembolic events (VTEEs) was made in 53 reproductive-aged (18-45-year-old) women with no history of severe somatic diseases and thromboses. Results. In 67.9% of the patients, the major triggers of primary VTEEs were the use of combined oral contraceptive (COC) pills (43.4%) and pregnancy/postpartum (24.5%). The most common cofactors were lower extremity varices (79.2%>), over 35 years of age (62.4%), a sedentary lifestyle (60.4%), smoking (33.9%), obesity (33.9%), and positive family history of thromboses/genetically verified thrombophilia (20.8%). The mean number of background risk factors was 3.4±0.1 in COC users, 3.7+0.2 in pregnant women, and 5.0±0.1 in puerperas. Conclusion. When prescribing COC pills, planning, and managing pregnancy/postpartum, it is necessary to keep in mind that the risk of VTEEs is increased, to thoroughly assess the already existing risk factors, and to take every measure for their prevention.

Objective. To investigate the efficacy and safety of gel with bacteriophages for nasopharyngeal sanitation in the medical staff of an obstetric facility in order to prevent nosocomial infections caused by S. aureus. Subjects and methods. The investigation enrolled 55 workers from the Neonatal Departments of the Center and a maternity room who had bacteriologically verified S. aureus carriage. The nasopharynx of the medical workers was sanitized with the gel and bacteriophages Otofag (Mikromir, Russia) for 7 days. Results. Microbiological monitoring showed the efficiency of nasopharyngeal sanitation in 94% of the medical workers in the first control test 1-2 weeks after sanitation and in 75.5% of the examinees in the second control test 1-2 months after this procedure. Adverse events were noted in none of the study participants. Conclusion. Otofag showed its efficacy and safety in sanitizing staphylococcus carriers in the obstetric facilities and may be used for periodic preventive sanitation of the nasopharynx of medical staff.