Vol 4, No 3 (2017)

Herpes simplex virus of two types - HSV-1 and HSV-2, which can manifest as a primary and recurrent infection is the etiological factor of genital herpes. Herpes simplex virus is one of the most common sexually transmitted infections, in connection with which there is an increase in physical and psychological morbidity, which often remains an underestimated medical problem. With the vertical transmission of HSV during labor, diseases that are dangerous to the life and health in newborns can occur. Pregnant women with a primary infection of genital herpes belong to the high-risk group for the transmission of HSV to the newborn. Prophylaxis and prevention of vertical transmission of HSV are implemented in three directions: prevention of the recurrence of maternal genital HSV infection; prevention of transmission of the virus during pregnancy and childbirth; puerperal prophylaxis of the disease in a neonate infant born of a mother belonging to a high-risk group. This review focuses on such important aspects as laboratory diagnosis of HSV, antiviral therapy and prevention of viral infection during pregnancy, delivery and in the early neonatal period.

Free radical reactions are aconcurrent part of the homeostasis of any system, including reproductive one. The imbalance of free radical production systems and antioxidants leads to pathological consequences, known as oxidative stress. In recent years, there have been actively executed successful studies, in which attempts are made to identify the impact of local oxidative stress in the follicle on the quality of the embryo and the outcome of «in vitro fertilization» (IVF). Despite both the inadequacy of data and the difficulty of comparing them, free radicals and the state of the antioxidant system of the follicular fluid have been proven to have a significant effect on oocyte and embryo development in subsequent IVF.

In the article there is presented information about 9 patients of young age who delivered a child after the treatment in the P.A. Herzen Moscow Research Oncological Institute for malignant breast neoplasms. Oncological aspects of the treatment in patients, data on subsequent pregnancy and lactation were analyzed in detail. The length of the follow-up period for patients and children amounted to 12 to 84 months. Only one (11.1%) of the nine patients had breast cancer progression after delivery in the form of a metastatic ovarian lesion. Dynamic following up this group of patients is carried out.

The aim of the study is to evaluate the antioxidant properties of the follicular fluid with a new chemiluminescent method in women with a reduced ovarian reserve and tubal factor of the infertility, undergoing in vitro fertilization (IVF) procedure, and to compare the obtained data with embryo quality. Material and methods. Samples of the follicular fluid were obtained during oocyte sampling in 16 women with a reduced ovarian reserve and 16 women with a tubal peritoneal factor of the infertility. Patients in both groups were matched for the age, body mass index and hormonal stimulation protocol (short protocol). The antioxidant activity of the follicular fluid was measured by the method of luminol-activated chemiluminescence using 2,2’-azobis (2-amidinopropane) dihydrochloride as a source of radicals. The total antioxidant activity (AOA) and antioxidant activity due to the action of proteins (AOA-b) were determined. Results. The kinetic curve of chemiluminescence of the follicular fluid is similar in shape to the curve of the antioxidant activity of the blood plasma. As in blood plasma, antioxidant activity is caused by uric acid and proteins - albumins and globulins. As a result of the study, three groups of patients were identified, whose AOA significantly differed: patients with low embryo quality and decreased antioxidant activity, AOA 11.4 ± 2.5 mM ascorbate (n = 16); patients with a good quality embryo, AOA 21.4 ± 3.8 mM (n = 10); patients with a low embryo quality and an elevated AOA of 33.7 ± 2.9 mM (n = 6). Conclusions. Based on the comparison of AOA (in ascorbate units) with the quality of the embryo, three areas can be proposed: 1) a zone of reduced antioxidant activity (less than 15 μM, oxidative stress) - these patients had embryos of poor quality; 2) the zone of normal AOA (15-30 μM) - the patients received good quality embryos; 3) zone of increased AOA (more than 30 μM, antioxidant stress) - embryos of poor quality. Thus, it can be assumed that optimal development of embryos in the follicle requires the optimal value of antioxidant activity, since both its reduction (oxidative stress) and increase (antioxidant stress) adversely affect the quality of the embryo and the outcome of IVF. These data correspond to the modern concept that optimal development of the oocyte requires an optimal level of production of reactive oxygen species.