Objective. To compare the clinical efficacy of in vitro fertilization (IVF) programs in patients with functional ovarian cysts (FOC) depending on the treatment strategy (transvaginal aspiration of cysts or use of gonadotropin-releasing hormone (GnRH) antagonists). Patients and methods. This prospective randomized study included 99 reproductive-aged women. The study group (n = 66) comprised patients with anovulatory infertility and FOC. Two subgroups were also identified: group IA (n = 28) – patients who underwent pre-treatment with a GnRH antagonist; group IB (n = 38) – patients who underwent transvaginal cyst aspiration. After treatment, controlled ovarian hyperstimulation was administered according to a fixed GnRH antagonist protocol. In the comparison group, a standard IVF program was performed. Results. If the cyst diameter is >4 cm, transvaginal aspiration is preferred; for smaller diameters, the use of GnRH antagonists is preferred. This mechanism is probably mediated by increased fluid pressure on the wall of the cyst >4 cm, which leads to thinning, up to complete exfoliation of the granulosa layer and hence loss of sensitivity to the effect of GnRH antagonist. Conclusion. The main clinical criterion for choosing the optimal treatment strategy for FOC in assisted reproductive technology programs is the diameter of the ovarian cyst.

In this paper, we aimed to: 1) discuss the approaches for increasing the effectiveness of organ-preserving surgical treatment of uterine fibroids; 2) analyse pre-operative preparation options for the formation of a restitutive scar during myomectomy. The article addresses the epidemiology of uterine fibroids in women, particularly in the reproductive age, and discussed the role of inflammation, disrupted nutrition, and proteolysis in the development of myomatous nodules. We also consider the terminology, classification, primary clinical symptoms of uterine fibroids, and discuss the causes of uterine scar incompetence. Various growth factors and collagen types have a differential impact on myometrial and on the formation of a restitutive scar. Finally, we talk about the histological and immunohistochemical methods in the diagnosis of uterine scar incompetence.

The morphofunctional features of the ovaries were evaluated in rats with functional ovarian cysts model treated with gonadotropin-releasing hormone antagonist. Administration of the antagonist significantly ( p =0.009) reduced the number of cysts and the growth of follicles in the ovaries. The obtained results attest to a possibility of successful treatment of functional ovarian cysts with gonadotropin-releasing hormone antagonist.

The problem of the occurrence of malignant neoplasms in women of reproductive age has not only medical, but also extremely important social significance, as it affects the demographic potential of the country as a whole.The article presents an analysis of the current state of the problem of fertility and preservation of reproductive function in cancer patients. Currently, there are a sufficient number of methods of assisted reproductive technologies aimed at preserving fertility in women with cancer. Among them are the following: cryopreservation of embryos and oocytes, ovarian tissue, in vitro maturation of eggs, obtaining oocytes obtained by removing the ovaries with their subsequent maturation. In addition, auxiliary methods are also distinguished, the main purpose of which is ovarian protection: the use of gonadotropin-releasing hormone agonists, ovarian transposition, gonadal screening. Each method has its advantages and disadvantages. It should be noted that the very fact of the presence of oncological pathology makes its own adjustments to the use of each specific technique. It has been shown that in vitro maturation technology is the most optimal for the preservation and realization of reproductive function in cancer patients. One of its few disadvantages is the high cost and complexity of laboratory control and cultivation of oocytes, which undoubtedly requires highly qualified specialists and relevant experience.

We studied the expression of insulin-like growth factor 1 (IGF-1), androgen receptor (AR) and luteinizing hormone receptor (LHR) in the ovaries under the conditions of the modeling and subsequent treatment of functional ovarian cysts with gonadotropin-releasing hormone antagonist (ant-GnRH). The intensity of IGF-1, LHR, and AR expression in the generative elements of rat ovaries changed under conditions of functional ovarian cysts simulation, as well as during treatment with ant-GnRH. In both experimental groups, the expression levels of the studied markers in preantral follicles and epithelial lining of cysts were found to be related to the number of growing follicles and cysts. A divergence of LHR and AR expression indices and a more pronounced decrease in the number of cystic cavities were observed in the group receiving ant-GnRH. These changes demonstrate a positive effect of ant-GnRH on intra-ovarian regulatory factors and a therapeutic effect in functional ovarian cysts.

Aim. To study the response of retinal glial cells to constant irradiation of various intensity and to develop a mathematical model allowing to evaluate the dynamics of damage to radial glial cells and predict their photodamage depending on the duration and intensity of irradiation. Materials and methods. Outbred sexually mature white rats ( n = 50) weighing 180–200 g were exposed to constant round-the-clock light (200, 3,500 lux, days 1, 2, 7, 14, 30). The control group consisted of 25 non-irradiated animals. Using semi-thin sections stained with toluidine blue, we counted the number of pycnomorphic cells in the radial glial cells. Ultrastructural changes in the glial cells were studied using the JEM-100 CX-II electron microscope. Results. The study showed that after photodamage, oligodendrocytes and astrocytes were mainly characterized by mitochondrial swelling and expansion of endoplasmic reticulum cisterns. Microglial cells at the late stage of the experiment (day 30) were localized in the inner layers of the retina; their density depended on the intensity of irradiation. The earliest (days 1, 2) changes in the radial glial cells were noted in the subretinal space and were manifested by proliferation of scleral processes and phagocytosis of dead sensorineural cell fragments. The intensification of destructive changes in the radial glial cells led to disturbances in neuron – glia interactions in the retina and a decrease in regeneration of retinal neurons (day 7–14). The developed mathematical model allowed to assess the dynamics of damage to the radial glial cells in the retina and to predict photodamage depending on the duration and intensity of irradiation. Conclusion. Glial responses in the retina after photodamage depend on the intensity and duration of light exposure. As the duration of irradiation increases, degenerative changes in glial cells intensify and are more pronounced after high (3,500 lux) irradiation intensity.

The aim. To conduct a comparative analysis of clinical and anamnestic data in women of reproductive age after ovarian cyst surgery and with occult premature ovarian insufficiency (POI) to predict a poor ovarian response to stimulation. Materials and methods. We conducted a retrospective study of medical records of women (aged 18–40 years) with infertility at the Assisted Reproductive Technology Center of Siberian State Medical University from 2017 to 2020. The main group consisted of 84 patients who underwent ovarian cyst surgery. The comparison group consisted of 33 patients with biochemical signs of POI (follicle stimulating hormone (FSH) 10–12 mMU / ml) who did not undergo ovarian cyst surgery. Anti-Mullerian hormone (AMH), FSH, estradiol, the antral follicle count (AFC), and the ovarian response to stimulation were compared. Results. A correlation was established between AFC and a poor ovarian response both in the main group ( r = –0.7; p = 0.004) and in the comparison group ( r = –0.620; p = 0.000) in women under 35 years of age. A correlation was found between the concentration of estradiol and a poor ovarian response in the comparison group in women over 35 years of age ( r = –0.707; p = 0.001). A moderate negative correlation between AMH and a poor ovarian response was revealed only in the main group of women under the age of 35 years ( r = –0.589; p = 0.021). A moderate negative correlation between AMH and a poor ovarian response was revealed in the comparison group in women under the age of 35 years ( r = –0.648; p = 0.000), a weak negative correlation was found for women at the age of 35 years ( r = –0.500; p = 0.004). In both groups, the level of FSH did not determine the ovarian response to stimulation. Conclusion. The determination of AFC and AMH is more significant in predicting a poor ovarian response in women after ovarian surgery and in women with occult signs of POI under the age of 35 years, compared with FSH. In the group of women over 35 years with occult signs of POI, the concentration of estradiol may matter in predicting a poor ovarian response, which requires further research.

The problem of decreasing perinatal mortality is one of the pressing problems in modern obstetrics. Unfortunately, current methods of monitoring the intrauterine state of the fetus that are at the disposal of an obstetrician – gynecologist (сardiotocography, Doppler velocimetry) do not guarantee fetal wellbeing in the near-term outlook, and the number of tests is limited due to safety concerns. Consequently, there is ongoing search for alternative methods of obtaining information about the intrauterine state of the fetus (phonocardiography, electrocardiography). Using IT and mathematical data analysis has considerably enlarged the phonocardiography potential, including implementation of remote monitoring of the fetal health state. A Tomsk-based company Diagnostika + LCC developed software and hardware appliance FetalCare aimed at 24-hour monitoring of the intrauterine state of the fetus based on audio data on the fetal cardiovascular system. Cardiointervalograms (CIG) obtained by phonocardiography allow to estimate the state of the fetus based on standard assessment criteria: basal heart rate, heart rate variability, presence of accelerations and decelerations, short-term variation (STV), and long-term variation (LTV). The developed appliance is non-invasive, relatively cheap, portable, and safe both for the mother and the fetus.

This review deals with the current state of affairs in the diagnosis of cervical squamous intraepithelial lesions. Transformation of classifications of cervical pathologies is considered. The role of cytological (liquid-based and conventional cytology), molecular biological (Digene Hybrid Capture test), immunohistochemical (p16INK4α, Ki-67), and histologic methods in the diagnosis of cervical lesions is discussed. Particular attention is paid to the diagnosis of human papillomavirus infection. Performance indicators of screening programs based on primary determination of human papillomavirus (HPV) DNA in comparison with common cytological methods are presented. Tropism of HPV to various parts of the cervix, which predisposes to the formation of deep multifocal lesions, as well as the influence of the physical status of HPV on the treatment strategy and risks of relapse are considered.

Infertility is one of the most concerning issues in contemporary medicine. Infertility occurs in more than 40% of patients with benign ovarian tumors, and most of tumor-like lesions are represented by functional ovarian cysts. To date, there are different opinions about the impact of functional ovarian cysts on the effectiveness of assisted reproductive technology programs. This review is devoted to the peculiarities of managing in vitro fertilization programs in the presence of functional ovarian cysts. Epidemiological data on the prevalence of functional ovarian cysts in patients with infertility are presented. The pathogenetic mechanisms of functional ovarian cyst formation and their influence on the outcome of assisted reproductive technology programs are considered. Particular attention is paid to various approaches to their treatment prior to an in vitro fertilization, as well as to their impact on program outcomes. Key words: functional ovarian cysts, treatment, assisted reproductive technologies, in vitro fertilization, ovulation stimulation

This review presents data on estradiol, progesterone, and leptin as important hormones in reproductive medicine. The effects of these hormones in peripheral blood and follicular fluid on the outcomes of assisted reproductive technology programs are considered. Data on experimental studies and prospects for their use in clinical practice are presented. Given the established fact that the composition of follicular fluid has an influence on the quality of oocytes, estradiol, progesterone, and leptin contained in follicular fluid can serve as descriptors of embryo competence. There are conflicting results in the literature regarding the effect of these hormones on the outcomes of in vitro fertilization programs. Conclusion. The role of intrafollicular estradiol, progesterone, and leptin on the outcomes of in vitro fertilization programs need to be further investigated. Key words: follicular fluid, estradiol, progesterone, leptin, in vitro fertilization, embryo competence

Background. There are different opinions about the effect of functional ovarian cysts on the duration of controlled ovarian hyperstimulation, the dose of gonadotropins, the number and quality of collected oocytes and produced embryos, and the frequency of pregnancy. Aim. To analyze in vitro fertilization (IVF) programs in women with anovulatory infertility and ovarian retention. Materials and methods. A prospective study included 71 women aged 18–44 years. The main group (I) included patients ( n = 38) with anovulatory infertility and functional ovarian cysts (FOC) diagnosed by ultrasound before enrollment in the IFV program. Patients of this group underwent ultrasound-guided transvaginal puncture of ovarian cyst followed by cytology. The comparison group (II) ( n = 33) encompassed patients with anovulatory infertility without FOC, who went through the IVF program. The control group (III) included apparently healthy individuals ( n = 15). The study algorithm included collection of clinical and anamnestic data of the patients, data of laboratory and instrumental studies, parameters of a stimulated IVF cycle, characteristics of oogenesis and early embryogenesis, and assessment of IVF program effectiveness. Conclusion. It was established that in FOC and anovulatory infertility, the number of collected oocytes was smaller; however, the number of the best quality embryos and the frequency of pregnancy did not differ.

Objective. To study the expression of miR-181a and miR-146a in the blood serum obtained from an experimental animal model of autoimmune oophoritis on different days of the experiment to assess their role in primary ovarian insufficiency (POI) of autoimmune etiology. Materials and methods. Experimental animals were mature female outbred rats. The study group (n = 25) included the experimental animal model of autoimmune oophoritis, the control group (n = 20) – intact animals. Morphometry of ovarian samples with estimating the average number of follicles, corpora lutea and atretic corpora lutea was performed. Enzyme immunoassay was used to study the concentration levels of serum anti-Mullerian Hormone (AMH) and anti-ovarian antibodies (AOA). MicroRNAs were isolated from serum according to a standard protocol; a reverse transcription and real-time polymerase chain reaction were performed using specific primers, and the relative expression of miR-181a and miR-146a was calculated by the Pfaffle method. Results. The expression of miR-146a on different days of the experiment remained statistically insignificant, including when compared to the control group. The expression of miR-181a in the blood serum of experimental animals on day 15 was statistically significantly higher than similar values on days 5, 10, 30 and 60 and in the control group. Conclusion. MiR-181a showed high diagnostic value in POI of autoimmune etiology in the experiment performed and can serve as an early marker in the diagnosis of ovarian insufficiency. The role of miR-146a as a marker of POI of autoimmune etiology has not been experimentally confirmed. Key words: autoimmune oophoritis, microRNA, experiment, premature ovarian insufficiency

The review presents a description of the health status of children conceived using assisted reproductive technologies, identifies possible causes and risk factors for the development of pathology.

Several pathological and physiological processes in the body are accompanied by oxidative stress. At present, the data from many research studies on markers of the oxidant-antioxidant system status are known. In turn, the incidence of infertility in married couples is progressively increasing. Methods to overcome infertility are improved every year, and the reduction of oxidative stress levels is a promising new direction in this regard. The results of many studies indicate the influence of oxidantantioxidant imbalance on the results of assisted reproductive technologies, as well as their connection with various forms of infertility. Data from recent studies on the effect of oxidative stress on infertility in women are presented. Key words: infertility, oxidative stress, antioxidants, follicular fluid, assisted reproductive technologies, free radicals

АННОТАЦИЯВ исследование, посвященное изучению показателей овариального резерва у пациенток с функциональными кистами яичников (ФКЯ), включены 137 пациенток с бесплодием и хирургическим лечением ФКЯ в анамнезе.Проведен ретроспективный анализ историй болезни, проспективно определены показатели функционального овариального резерва: сывороточные значения антимюллерова гормона и фолликулостимулирующего гормона, ингибина В, эстрадиола; объем яичников, число антральных фолликулов (ФАС) при сонографии на 2-3-й день менструального цикла.Основную группу (n = 53) составили пациентки, отвечающие Болонским критериям бедного ответа, принятым Европейским обществом репродукции человека и эмбриологии (ESHRE, 2011); группу сравнения -женщины с хорошим ответом на контролируемую индукцию овуляции (n = 84).Контроль -условно здоровые женщины (n = 15).Наиболее выраженное снижение овариального резерва выявлено при осложненном клиническом течении ФКЯ (разрыв, кровоизлияние).Снижение показателей овариального резерва наблюдалось у пациенток с повторными инвазивными вмешательствами на яичниках, спаечным процессом 3-й и 4-й степени

*e-mail: margarita0708@yandex.ru революции конца XVII века Ренье де Грааф признал, что образование яйцеклеток происходит в яичнике. На протяжении полутора веков существовало ошибочное убеждение о фолликуле как собственно женской половой клетке. В 1827 г. Карл Эрнст фон Бэр обнаружил, что ооциты млекопитающих заключены внутри фолликулов яичника. Однако первое описаhttps://doi.org/10.17116/repro201723418-23