Purpose To identify the role of both genetic (number of CGG repeats in the FMR1 gene) and autoimmune factors (antiovarian antibodies) in premature ovarian failure (POF). Methods In cross-sectional study, 78 women with POF were divided into 3 groups by the number of CGG repeats (less than 28, 28-36, more than 36) in any of the FMR1 gene alleles. We performed the detection of skewed Xchromosome inactivation, CGG repeats in the FMR1 gene, anti-ovarian antibodies (AOA) and sex hormones tests. Results Compared to a higher or lower number of CGG repeats the 28-36 triple CGG counts are strongly associated with the AOA detection (RR=19.23, 95 % CI=2.63-100.0). The women with autoimmune-driven POF have significantly higher anti-Mullerian hormone levels in comparison to women with non-autoimmune-driven POF. Conclusion The presence of AOA above 10 IU/mL is associated with the normal number of CGG repeats in regard to ovarian reserve and a better preservation of follicular primordial pool in the women with POF.
Purpose of the study. To develop clinical and laboratory criteria characteristic of the occult (hidden) form of premature ovarian failure. Material and methods. A prospective study included 22 women under 40 years old with an occult form of premature ovarian failure (POF). A comprehensive clinical and laboratory examination included: a hormonal profile on the 2-3rd day of the menstrual cycle (Anti-Muller hormone, Follicle-stimulating hormone, Luteinizing hormone, Estradiol), levels of biochemical and genetic markers (number of CGG repeats in the FMR1 gene). Results. 22 patients with an average age of 30±6.1 years were included in the study. As a result, we adopted diagnostic criteria for premature aging of the ovaries, based on the capabilities of modern clinical and laboratory markers of ovarian reserve, reflecting the primordial pool of follicles and predictors involved in predicting the onset of spontaneous pregnancy and premature aging of the ovaries. Conclusion. To date, there is no global consensus on the best test for an accurate assessment of the quantity and quality of eggs, and there is no consensus on the staging of premature ovarian aging, and the etiology of the disease. It is necessary to conduct full-scale multicenter, prospective, randomized, controlled studies, the results of which facilitated counseling patients and helping the clinician create an individualized treatment plan.
Since recently, the association of premature ovarian insufficiency (POI) with an increased risk of mortality and morbidity caused by cardiovascular diseases (CVD) has been extensively discussed in the context of early detection and prevention of CVD in these patients.Aim: to evaluate the relative cardiovascular risk (CV risk) before and after hormone replacement therapy (HRT) in women with POI.Materials and methods. The study included 170 women aged from 18 to 40; among them, 85 women with POI and 85 women with regular periods. We evaluated the usual CV risk factors: smoking habits, arterial blood pressure, total cholesterol (TC), low-density lipoproteins (LDL), high-density lipoproteins; in addition, we determined apolipoprotein B (Apo B), high-sensitivity C-reactive protein (hs-CRP), uric acid, and endotelin-1, as well as the functional markers: the right and left carotid intima-media thickness (CIMT) and the brachial artery flow-mediated dilatation (FMD). The CV risk was calculated using the relative risk SCORE scale before and after HRT lasted for 12 months.Results. In the POI group, there were 3.8 times more women with a moderate CV risk (per the SCORE scale), whereas in the POI-free group, women with a low CV risk dominated. In addition, the levels of CV risk markers were 4-fold higher in patients with POI (high levels of Apo B, hs-CRP and uric acid, increased CIMT bilaterally, decreased FMD in the brachial artery). Cyclic HRT during 12 months contributed to the lipid profile normalization, decrease in TC, LDL and FMD in the brachial artery as well as to the decrease of relative CV risk in general.Conclusion. The estrogen deficiency in patients with POI is an independent factor in the increased relative risk of CVD. The HRT has anti-atherogenic, antiinflammatory, and angioprotective effects, regulates the production of endothelium-dependent factors of vasoconstriction and vasodilation, leading to a reduction in the relative risk of CVD in general.
Potentialities of the flow cytometry method in studies of the qualitative and quantitative composition of endometrial immunocompetent cells are demonstrated. The studied leukocyte populations are found to occur in negligible quantities in the endometrium.
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