Gestational diabetes mellitus (GDM) is the most common pregnancy complication globally. GDM prevalence ranges from <3% to >20%. One in 5 livebirths is affected by hyperglycemia in pregnancy (HIP), and 1 in 6 is explicitly affected by GDM. HIP is classified as pregestational diabetes, gestational diabetes, and diabetes in pregnancy. 75%-90% of HIP cases are GDM. Diverse environmental, socioeconomic, and individual risks play a pivotal role in the global rise in GDM. Environmental risks affect the gut microbiome, causing oxidative stress, inflammation, insulin resistance, neurohormonal/β-cell dysfunction, and genetic/epigenetic modification. These factors are associated with an increased risk of GDM and its short-term/long-term complications. A “neglected pollutant” (artificial light/noise) causes significant damage to women’s health. Light pollution (screen light, streetlights, artificial light at night) causes circadian rhythm and sleep disorders that lead to GDM. Mothers with low socio-economic status (an index assessing educational level and employment) have an increased risk of GDM. There is a wide range of individual risks – reversible (obesity, passive lifestyle, unhealthy diet, smoking, stress, etc) and irreversible (maternal age, family history of DM/GDM, miscarriages/stillbirth in previous pregnancies, etc). The more risk factors a woman has, the higher her risk of GDM. Undiagnosed/ untreated GDM is associated with a wide range of maternal complications during pregnancy, labor, postpartum, and beyond, and fetal congenital/neonatal complications. Though GDM is not preventable, its risk can be lowered – the ideal time to influence GDM risks is around pregnancy. Elimination of reversible risks is essential to halt the global rise of GDM. Its screening, treatment, and management reduce feto-maternal morbidity/mortality.
Background: Recurrent implantation failure (RIF) represents a serious challenge in reproductive medicine, limiting the effectiveness of assisted reproductive technology (ART) programs. Contemporary research demonstrates the pivotal role of endometrial microbiome and receptivity disorders in the pathogenesis of implantation failure, substantiating the need for comprehensive diagnosis of maternal factors. Objective: To evaluate the effectiveness of an individualized approach to correcting endometrial microbial imbalance and optimizing embryo transfer timing in women with recurrent implantation failure. Materials and Methods: A prospective controlled study of 107 patients with RIF undergoing vitrified embryo transfer was conducted. Participants were stratified into a study group (n=54) with molecular genetic ERA and EMMA testing (Igenomix, Spain) followed by personalized therapy, and a control group (n=53) with standard protocol. Implantation rates, clinical pregnancy rates, and live birth rates were analyzed. Multivariate analysis of endometrial disorder predictors was performed. Results: Molecular genetic testing revealed a displaced implantation window in 51.85% of study group patients; microbial imbalance with Lactobacillus spp. deficiency was registered in 74.08% of subjects. The study group achieved significantly higher efficacy parameters regardless of preimplantation genetic screening application (p<0.05). Statistically significant associations were established between invasive intrauterine procedures and dysbiosis development (p=0.0053), as well as between chronic endometritis and receptivity impairment (p=0.006).
Pregnancy introduces a complex interplay of physiological and immunological adaptations that significantly influence the course of allergic diseases. This review article synthesizes current understanding of allergies during gestation, focusing on its prevalence, the unique risks posed to both mother and fetus, and evidence-based strategies for diagnosis, management, and prevention. The maternal immune system undergoes a crucial shift towards a Th2-dominant state, essential for fetal tolerance but potentially exacerbating allergic manifestations. Hormonal fluctuations further modulate immune responses, contributing to variable disease courses. Uncontrolled allergic conditions, particularly asthma, are associated with substantial maternal complications such as preeclampsia and increased rates of cesarean delivery, and adverse fetal outcomes including hypoxia, preterm birth, and low birth weight. Diagnosis in pregnancy prioritizes fetal safety, favoring in vitro methods over skin or provocation tests. Management emphasizes a multidisciplinary approach, combining non-pharmacological interventions with carefully selected pharmacotherapies, where the risks of uncontrolled disease generally outweigh those of appropriate medication.
Background: Persistent infection with high-risk human papillomavirus (HPV) after surgical management of high-grade squamous intraepithelial lesions (HSIL-CIN 2) is recognized as a major driver of recurrence and progression to cervical cancer.⁶ ¹⁰ Despite advances in screening and surgical techniques, recurrence rates remain clinically significant.⁵ ⁹ ¹⁰ Globally, cervical cancer continues to be one of the most common cancers affecting women, particularly in low- and middle-income countries.⁶ Although prophylactic HPV vaccines such as Gardasil® and Gardasil 9® were initially developed for primary prevention,³ ⁷ ⁸ emerging evidence suggests that they may also serve a secondary preventive role when administered after surgical treatment by reducing reinfection and supporting clearance of residual viral particles.¹ ² ⁴ ⁵ ⁹ Objective: This study aimed to assess whether postoperative administration of the quadrivalent HPV vaccine (Gardasil®) in reproductive-age women treated with CO₂ laser conization and vaporization for HSIL-CIN 2 could reduce recurrence of HPV infection and associated cytological abnormalities, thereby improving recurrence-free survival.
Background: Poor ovarian response (POR) remains a substantial challenge in assisted reproductive technologies (ART), especially in women older than 35 years. Regenerative therapies such as platelet-rich plasma (PRP) and exosomes have emerged as promising interventions. Objective: To evaluate the clinical impact of intraovarian injections of PRP enriched with mesenchymal stem cell (MSC) – derived exosomes on in vitro fertilization (IVF) outcomes in poor responders. Materials and Methods: A retrospective controlled study was conducted with 126 women aged 35-43 years undergoing IVF. Patients were divided into two subgroups: 35-40 years and 40-43 years. The intervention group received intraovarian PRP plus exosome treatment; the control group received standard stimulation only. Primary outcomes included metaphase II (MII) oocyte count, fertilization rate, blastocyst development, and clinical pregnancy rate. Results: The PRP plus exosome group showed a 35% increase in MII oocytes, 20%-30% higher fertilization, and 15%-20% improved blastocyst development. Clinical pregnancy rates rose by 15%-17%, with better outcomes in the younger subgroup. Conclusions: Regenerative therapy using PRP and MSC-derived exosomes may improve ovarian response and IVF outcomes in poor responders.
Background: Assisted reproductive technology (ART) has transformed fertility treatment, providing opportunities for many couples who otherwise would face difficulty conceiving. A critical factor in ART success is the selection of viable embryos. Preimplantation genetic testing for aneuploidy (PGT-A) has emerged as a widely used method to improve embryo selection, enhance pregnancy outcomes, and reduce the risk of miscarriage. Aim: To compare pregnancy outcomes between genetically tested (PGT-A) and non-tested embryos to assess the clinical value of PGT-A in optimizing ART outcomes. Materials and Methods: A retrospective comparative study included 225 patients under 35 years of age, including recipients, patients of advanced maternal age, and those with recurrent miscarriage. All underwent ovarian stimulation with a GnRH-antagonist protocol. Blastocysts in the PGT-A group were tested using next-generation sequencing (NGS). Outcomes included biochemical pregnancy, miscarriage, and live birth. Results: In the PGT-A group (n=110), 116 embryos were transferred. Fifty-nine pregnancies (53.6%) were achieved; 4 miscarriages (6.8%) and two biochemical pregnancies (3.4%) occurred. In total, 53 pregnancies continued to delivery (89.8% of pregnancies, 48.2% of all transfers). In the non-PGT-A group (n=115), 220 embryos were transferred, resulting in 41 pregnancies (35.7%). Of these, seven miscarried at 6 weeks (17.1%), 2 miscarried at 14–16 weeks (4.9%), and one fetus (2.4%) had a chromosomal abnormality. Thirty-two patients delivered healthy babies (78% of pregnancies, 27.8% of transfers).
Threatened miscarriage represents one of the most frequently encountered complications of early pregnancy, characterized predominantly by vaginal bleeding, cramps, and occasional cervical change without the expulsion of fetal tissue. Despite advances in obstetric management, the optimal therapeutic approach remains a subject of ongoing debate, particularly concerning the route of progesterone administration. Vaginal and rectal progesterone formulations are frequently used to support early gestation, yet comparative evidence on their relative efficacy remains limited. This prospective randomized controlled study aimed to evaluate and compare the effectiveness of vaginal versus rectal micronized progesterone administration in women with threatened miscarriage, focusing on pregnancy continuation, symptom resolution, and patient satisfaction. The study further sought to explore patient acceptability, tolerability, and the impact of treatment route on anxiety levels associated with early pregnancy complications. By adopting a multicenter design and incorporating patient- centered outcomes, the trial introduces valuable insight into both clinical and psychosocial dimensions of threatened miscarriage care. Findings demonstrated that vaginal administration resulted in higher pregnancy continuation rates (90.0% vs. 76.7%), faster symptom resolution, and markedly greater patient satisfaction compared with rectal administration. Moreover, the use of vaginal progesterone was associated with improved adherence and reduced discontinuation rates, emphasizing the importance of delivery comfort in early pregnancy therapeutics. The results suggest that tailoring treatment not only to physiological effectiveness but also to personal preference may enhance outcomes in women experiencing threatened miscarriage. These findings underscore the clinical utility of vaginal progesterone in the management of threatened miscarriage and support its preferential use in routine obstetric practice.
We studied the rheological profile and fibrinogen in healthy pregnant women in the I, II, and III trimesters, and a control group of women in the 2nd phase of the menstrual cycle. It turned out that rheological changes in different trimesters are heterogeneous and do not always correlate with the percentage changes in fibrinogen. Having discussed the data, we concluded that studying the full spectrum of rheological status is advisable to determine blood fluidity.
Objective: To evaluate 20-year outcomes of a structured quality improvement (QI) and risk-management program in a single IVF laboratory, with emphasis on never events, near misses, and longitudinal performance on predefined quality indicators (QIIs). Design: Longitudinal, single-center quality improvement study (2004–2024). Setting: Large healthcare network -affiliated IVF laboratory operating under CAP accreditation. Patients/Cycles: 15,956 ART cycles (8,320 fresh IVF; 7,636 frozen embryo transfer). Interventions: Implementation and continuous refinement of a laboratory QI framework comprising high-risk process mapping; QIIs with thresholds; standardized reporting (verbal escalation → SBAR); structured investigations (RCA) with corrective/preventive actions (CAPA); competency-based staff training; electronic/dual witnessing; cryoinventory reconciliation; equipment maintenance and alarm testing; and a non-punitive reporting culture. Main Outcome Measures: Incidence of never events and intercepted near misses; protocol non-compliance; report errors; cryoinventory accuracy (QIR07); gamete/embryo traceability (QIR10); equipment/handling issues affecting care (QIR16). Results: Across 20 years, one true “never event” occurred (erroneous discard of an embryo intended for cryopreservation with freezing of a lower-quality embryo instead; ≈0.006% of cycles). The event was disclosed, investigated via RCA, corrected per SOPs, and remediated with a no-cost IVF cycle. One intercepted near miss (thaw of an undesired-gender embryo detected pre-transfer) was identified, disclosed, and resolved (refreeze and correct embryo transfer) without clinical impact. Protocol non-compliance declined from 8 cases (2004) to 0 by 2008 and remained at or near zero thereafter. Report errors decreased to 0% in recent years. Cryoinventory performance remained near 0% error with one easily resolved misplacement. Gamete/embryo traceability (QIR10) stayed well below thresholds with no significant missing/untraceable specimens. QIR16 recorded one handling incident (faulty pipette), causing loss of several oocytes, prompting protocol revision, equipment checks, and retraining via RCA/CAPA.Conclusions: A structured, data-driven QI program–embedding SBAR, RCA/CAPA, traceability safeguards, and a just culture–was associated with sustained near-zero serious events and progressive reliability gains over two decades. This reproducible model can inform benchmarking and multi-center learning aimed at further reducing latent risk in IVF laboratories.
Background: Despite available data on the influence of gynecological pathologies on sexual dysfunction, there is no clear scientific evidence on the influence of sexual disorders, such as anorgasmy, on the development of gynecological pathologies. Objective: The objective of the study was to examine the relationship. The Objective of the study was the detection of the relationship between women’s sexual functions (orgasm and libido) and gynecological pathologies. Methods: Six hundred seventy-six sexually active women (aged 18-55 years; mean age, 31.7 ± 3 years) were investigated.. They were divided into three groups: I gr. – 148 women OVVC, II gr. – 125 women with DMV and III gr. – 403 women with other gynecological pathologies. In all groups, the frequency of orgasms and the level of libido were assessed through interviews. Results: In I group rate of women with anorgasmy (70,9%) and rare orgasms (20,9%) was significantly higher (P<0.01) than rate women, who had orgasms often (6,1%) or always (2,0%). In II group rate of women with anorgasmy (39,2%) and rare orgasms (44,0%) was significantly higher (P<0.01) than women, who had orgasms often (12,8%) or always (4,0%). In III group generally was observed prevalence of women without absolute absence or presence of orgasms. As of relationship between intensity of sexual drive (libido) and frequency of orgasms – in all groups there was direct dependence - women with anorgasmy and rare frequency of orgasms mainly had low or medium libido and in women, who had orgasms often or always libido was mainly medium or high. Conclusions: Orgasmic dysfunctions (anorgasmy) can promote a congestive process in the pelvis, development of varicosis of ovarian and pelvic veins (with corresponding other gynecological complications), which themselves can determine chronic pelvic pain that deepens the anorgasmic process.In younger ages and early stages of the beginning of sexual life, timely management of anorgasmy might be a good prevention for further development of gynecological pathologies. The issue needs further investigation to reveal the cause-and-effect relationship.
Egg donation is a critical component of assisted reproductive technology, but its success hinges on optimal donor selection and stimulation protocols. This article summarizes a retrospective analysis of egg donor preparation strategies at a single fertility center. The study evaluated donor selection criteria, oocyte quantity and quality, the role of preimplantation genetic testing for aneuploidy (PGT-A), and the comparative efficacy and safety of different follitropin preparations. Key findings indicate that while age is a significant factor, anti-Müllerian hormone (AMH) is a more crucial marker for ovarian reserve. A substantial proportion of cycles experienced “unmet expectations”, highlighting the physiological variability of AMH and the importance of considering antral follicle count (AFC) in cases of discordance. The data suggest no statistically significant difference in oocyte quantity or quality in younger donor age groups (≤30 years). Furthermore, PGT-A did not improve live birth rates in this donor oocyte population, though it did prevent transfers in cycles with no euploid embryos. The use of follitropin delta demonstrated a higher safety profile in terms of ovarian hyperstimulation syndrome (OHSS) risk. These findings underscore the need for a personalized approach to donor stimulation, with AMH as the primary guide for selection and dose determination, while also acknowledging the value of other markers and protocols.
Background: Vitamin D deficiency was highly prevalent in female patients hospitalized due to COVID-19. Elderly female patients are characterized by higher values of hospitalization and lower values of survival. Objective: This study aimed to evaluate the effect of menopause on vitamin D deficiency and COVID-related health outcomes (hospitalization, transfer to ICU unit, requirement of oxygen therapy, and treatment with glucocorticoids). Materials and Methods: A retrospective cross-sectional study was conducted, based on the data of the National Center for Disease Control and Public Health (NCDC) of Georgia. After obtaining the written informed consent, 291 persons registered in the NCDC database have been included in the study group. Study’s female subjects were divided into two age groups: group 1 – patients with menopause – n=123; group 2 – patients without menopause, n=168. Results: Mean levels of serum 25(OH)D in the study groups did not differ significantly. But these values were significantly lower in hospitalized female patients of both groups. The odds of hospitalization and oxygen therapy in group 1 were significantly higher compared to group 2. The odds of transfer to the ICU unit and treatment with glucocorticoids between the groups were not significant. Conclusions: Our study revealed significantly worse COVID-19-related health outcomes in patients with menopause compared to patients without menopause. Moreover, the difference between the mean 25(OH)D levels of hospitalized and non-hospitalized patients of both age groups was statistically significant. However, the effect of menopause on the mean 25(OH)D levels was not revealed.
Objective: Ovarian granulosa cell tumors (GCTs) are rare malignancies that can profoundly affect fertility, particularly in young women. This case report describes a successful fertility preservation strategy in an 18-year-old female diagnosed with a Stage I ovarian granulosa cell tumor. Methods: A multidisciplinary team implemented a fertility preservation protocol involving preoperative ovarian stimulation, oocyte retrieval, and cryopreservation. This was followed by staging laparotomy and unilateral salpingo-oophorectomy. Results: A total of 10 mature oocytes were successfully cryopreserved. Histology confirmed a Stage I granulosa cell tumor with no evidence of metastasis. The patient tolerated adjuvant therapy well and remains disease-free at follow-up. Conclusion: The successful application of controlled ovarian stimulation and oocyte cryopreservation prior to definitive surgery demonstrates the feasibility of proactive fertility preservation in hormonally active tumors when managed with careful monitoring. Furthermore, the patient’s positive postoperative course and continued disease-free status at 18 months reinforce the safety and efficacy of fertility-sparing surgical strategies in Stage I GCTs.
Background: Persistent infection with high-risk human papillomavirus (HR‑HPV) is the necessary cause of the vast majority of cervical cancers and the driver of cervical intraepithelial neoplasia (CIN).1 Fourteen genotypes are considered oncogenic, with HPV16 and HPV18 accounting for the largest share of the global cervical cancer burden.2 While the cervix has been the focus of screening and prevention for decades, the anal canal – lined by a vulnerable transformation zone analogous to the cervix – can also harbor HR‑HPV, develop anal intraepithelial neoplasia (AIN), and progress to squamous cell carcinoma.3 Anal cancer incidence has risen in many settings, and women constitute a growing proportion of cases.4Despite these parallels, routine gynecologic care rarely includes anal assessment.5 The natural history of anal HPV infection in immunocompetent, HIV‑negative women with cervical disease remains poorly characterized, and evidence regarding concurrent high‑grade disease at both sites is limited.6 A more precise estimate of the prevalence of AIN 2/3 among women with CIN 2/3, coupled with HPV genotype concordance data, could inform whether targeted anal evaluation should be integrated into follow‑up.7 Addressing this knowledge gap is particularly important in regions where cervical screening is established but anal screening is not standard of care.
Chronic endometritis is defined as mild persistent inflammation of the endometrium, characterized histologically by inflammatory cells in the endometrial stroma, including plasma cells, lymphocytes, eosinophils, and even lymphoid follicles. Diagnosing chronic endometritis is difficult for a variety of reasons. Most patients are asymptomatic, and ultrasound features are nonspecific. Microbiological examination is often not informative because most pathogens are non-cultivable. A hysteroscopy can diagnose chronic endometritis by detecting specific endometrial changes, such as focal or diffuse hyperemia, stromal edema, and micro polyps. Histopathological identification of plasma cells in endometrial biopsy specimens is considered the gold standard for the diagnosis of chronic endometritis. There is a hypothesis that chronic endometritis may be related to endometriosis, although studies in this direction are very scarce. There are different opinions about the persistence and progression of chronic endometritis, which require further research.
Background: The menopausal transition (MT) marks the end of a woman’s reproductive years, characterized by hormonal changes, irregular menstrual cycles, and various symptoms impacting health and quality of life. Objective: To understand the hormonal fluctuations during MT and the clinical implications for managing symptoms. Method and Materials: The article synthesizes findings from various studies and consensus workshops, particularly the Stages of Reproductive Aging Workshop (STRAW), detailing hormonal changes and clinical presentations during early and late MT. Results: MT involves erratic estradiol levels, decreased progesterone, and increased follicle-stimulating hormone (FSH), leading to irregular cycles, with notable events like luteal out-of-phase (LOOP) cycles. Symptoms often include abnormal uterine bleeding, hot flashes, sleep disturbances, and mood disorders. Hormonal therapies, including estrogen and selective serotonin reuptake inhibitors (SSRIs), are effective but should be administered cautiously due to associated risks. Discussion: The hormonal chaos of MT complicates infertility and symptom management. Non-hormonal therapies and lifestyle modifications are beneficial but often less effective than hormone therapy. Conclusion: A personalized approach to managing MT is crucial, integrating hormonal and non-hormonal strategies, lifestyle changes, and mental health support. Continuous research aims to optimize these interventions for better outcomes in women during MT.
Background: Two-dimensional shear wave elastography (2D-SWE) is a modern diagnostic meth-od for evaluating liver fibrosis. It is non-invasive, performed in real-time, and results are availa-ble immediately. 2D-SWE is integrated into the diagnostic apparatus of ultrasound imaging and allows us to determine the overall distribution of fibrosis in the liver during the examination. Therefore, it is possible to use this technique during the treatment process in chronic liver disease to monitor fibrosis assessment. Objective: Revealing the diagnostic capabilities of shear wave elastography in the process of treating diffuse liver disease. Materials and Methods: The examination included 52 patients with chronic liver disease. Before and 24 weeks after the treatment, we performed an ultrasound examination of the abdominal, 2D-SWE, conducted several laboratory analyses, and compared the obtained results. Results: At 24 weeks after treatment, liver stiffness values detected by 2D-SWE decreased from 17.51 kPa to 15.45 kPa (p < 0.001). Also, spleen length (p<0.05), ALT (p < 0.001), and AST (p<0.01) in blood serum were decreased. There was a statistically significant increase in hemoglobin (p<0.001) and serum albumin (p<0.001) levels. Platelet count increased (p<0.001). Conclusion: 2D-SWE helps monitor liver fibrosis during the treatment period.
Ovarian borderline malignancies are heterogeneous in 80-90% of cases and are characterized by a favorable prognosis, while in 10-20% of cases, peritoneal implants form and relapse occurs. The presence of peritoneal implants has uncertain predictive value. According to some authors, they undergo regression, and in some instances, long-term survival is observed despite the presence of disseminated implants. Implants are also classified into invasive and non-invasive types. Such a classification may have predictive value, so it is an active study area. According to recent studies, cytokines secreted by macrophages induce angiogenesis by ovarian tumors and evade immune surveillance. The frequency of macrophage distribution in the mesothelium may indicate disease spread and be associated with broader tumor dissemination. The role of the peritoneum in tumor dissemination processes is an active area of research. The development and metastasis of ovarian epithelial carcinoma are associated with fibrosis, one of the driving forces in the epithelial-mesenchymal transition process. Therefore, deciphering the regulators of epithelial-mesenchymal transition in ovarian epithelial tumors is necessary to develop new therapies to prevent metastatic spread and improve patient survival rates. Thus, the correct identification of peritoneal implants is an essential factor. Although there are histological criteria to distinguish invasive from non-invasive implants, differentiation can be difficult. Additionally, little is known about the molecular-genetic basis of implants. This issue requires further research to determine diagnosis, treatment methods, and prognosis accurately.
Background: Premature ovarian insufficiency (POI) is a condition defined by loss of ovarian activity before the age of 40 years, accompanied by menopausal symptoms. It is marked by amenorrhea or oligomenorrhea, absence of ovulation, elevated gonadotropins, and low estradiol levels. POI can be classified into spontaneous non-iatrogenic and iatrogenic forms. The prevalence of non-iatrogenic POI in the population ranges from 1% to 3.5%. The X chromosome’s Numerical and structural abnormalities are key etiological factors. Objective: To determine the clinical peculiarities and types of POI caused by X chromosome anomalies. Material and Methods: The study included 26 patients aged 16 to 24 with non-iatrogenic spontaneous POI. Of these, 12 patients were diagnosed with numerical or structural abnormalities of the X chromosome based on clinical, laboratory, and instrumental studies. In some cases, x-chromosome abnormalities were detected using G-banding in peripheral blood lymphocyte cultures; fluorescence in situ hybridization (FISH) and molecular cytogenetic methods were employed. Results: Among the 26 patients with non-iatrogenic spontaneous POI, four were diagnosed with Turner syndrome. These patients exhibited severe growth retardation, somatic anomalies typical of Turner syndrome, and sexual development according to Tanner’s scheme (Ma0PaAx0Me0), including markedly elevated gonadotropins and decreased estradiol levels, By US – streak gonads and uterus, without follicles. Two patients were identified with a 45, X karyotype, while another had a 46, X, i(Xq) karyotype. Additionally, a mosaic karyotype with a 45, X cell line was detected in 5 patients (4 with 45, X/46, XX and 1 with 45, X/47, XXX). Structural abnormalities of the X chromosome, specifically deletions, were found in 2 patients. Patients with mosaicism and structural abnormalities of the X chromosome exhibited mild growth retardation and premature ovarian failure, which was characterized by primary amenorrhea, hypergonadotropinemia, and a significantly reduced number of antral follicles. Only one patient with a 45, X /47, XXX mosaic karyotype experienced secondary amenorrhea and spontaneous puberty. One patient with tetrasomy X (karyotype 48, XXXX) and POI presented with tall stature, mental retardation, secondary amenorrhea, hypergonadotropinemia, and a few follicles in the ovaries. To initiate puberty, all patients were treated with monotherapy using natural estrogen analogs, followed by replacement therapy with estrogen-gestagens until the age of natural menopause. Conclusion: • For all patients with non-iatrogenic premature ovarian insufficiency, despite the absence of subjective signs of estrogen deficiency and the characteristic signs of Turner’s syndrome, karyotyping is recommended. • Oocyte donation is the optimal method to achieve fertility in patients with premature ovarian insufficiency and numerical and structural anomalies of the X chromosome. • In patients with X chromosome anomalies at an early stage of diagnosis of chromosomal anomalies and in cases of an acceptable number of ovarian follicles, cryopreservation of reproductive materials may be considered with the using genetic testing of the embryo.
In contemporary society, many women are prioritizing their careers and personal growth, often leading to the postponement of parenthood. This delay, however, presents challenges due to the biological limitations imposed by age on fertility. Oocyte cryopreservation has emerged as a vital technique for women to safeguard their reproductive potential. This paper reviews recent innovations in oocyte preservation, focusing on advancements in cryopreservation techniques, including vitrification and closed system vitrification, novel cryoprotectants, and the integration of emerging technologies such as automation and nanotechnology. Additionally, it explores the development of ovarian tissue cryopreservation and its applications in preserving fertility for women undergoing medical treatments or facing premature ovarian failure. The review also highlights cutting-edge techniques like artificial ovaries and in vitro activation (IVA), which promise to revolutionize fertility preservation. By examining these advancements, the paper aims to provide insights into how modern innovations address delayed parenthood challenges and enhance fertility preservation options.
