Infertility is an important socio-economic problem due to the fact that planned childbearing occurs much later than three decades ago. In recent years, more attention has been paid to the role of uterine leiomyoma in the development of infertility. Uterine leiomyoma is a benign monoclonal, well-demarcated encapsulated tumor originating from the smooth muscle cells of the cervix or body of the uterus. Uterine leiomyoma is the most common uterine tumor in the reproductive age group, affecting 20-50 % of women. With conceptual changes in marriage and childbearing, the number of women over 35 with leiomyoma who want to have children has also increased significantly. The need to treat submucosal fibroids is widely recognized, but fibroids of other locations and sizes remain a clinical mystery. The purpose of the literature review was to determine the role of uterine fibroids in predicting infertility. It has been established that the incidence of uterine leiomyoma in women of reproductive age is on average about 40 %, infertility associated with this pathology occurs in 5-10 % of women. In 10 % of cases of infertility, uterine leiomyoma is the only established cause of infertility. Uterine leiomyoma is common among women of reproductive age, and as women continue to delay childbearing, an increasing number of patients will require fertility-preserving treatment options. Leiomyoma affects not only fertility but also obstetric outcomes. Women with intramural fibroids without cavity deformity have a 21 % reduction in live birth rates after in vitro fertilization compared with controls without fibroids. Despite advances in fundamental understanding of the biology of leiomyomas, the role of different fibroid variants remains a matter of discussion. The question of the negative impact of submucosal nodes on infertility today is not in doubt, and the effect of subserous and intramural nodes requires further study.
Uterine leiomyoma, along with endometriosis, occupies a leading position in the structure of gynecological diseases associated with hyperproliferation. The disease can negatively affect the reproductive potential, gynecological health, somatic status and quality of life of women. The only radical "cure" for the disease is hysterectomy. Therefore, clinical research and assessment of the effectiveness of drug therapy for uterine leiomyoma is one of the most important tasks of modern gynecology, primarily for the health improvement of young women striving to preserve reproductive function. From the point of view of world demography (declining birth rates in the world and depopulation in European countries), the search for new pharmacological agents for the treatment of fibroids is not only a medical problem, but also a global socio-economic problem
Aim. To perform a systematic review of common risk factors and prognostic markers of gestational diabetes mellitus (GDM) and hypothyroidism (HT), as well as maternal and perinatal complications in these diseases. For achieving this task, we screened and analysed the relevant data from the publications in a PubMed database over the past 6 years.Key Points. A common risk factor for both diseases is obesity, which is characterized by pregestational insulin resistance, as well as the combination of by low-grade chronic inflammation and metabolic dysfunction termed as meta-inflammation. Antibodies to the thyroid-stimulating hormone receptor (TSHR) are associated with the reduced the risk of GDM. Studies on pathogenesis of pre-eclampsia in patients with GDM and HT have shown unequivocal results, although most of them suggest both HT and GDM as risk factors for the development of this pregnancy complication. Elevated levels of thyroid-stimulating hormone are associated with reduced antioxidant capacity and long-term endothelial activation. The heterogeneity of the anemia in GDM requires a rigorous differential diagnosis.Conclusion. GDM and HT are the most common endocrine diseases during pregnancy which significantly increase the risk of maternal and perinatal complications. Common risk factors, interrelationship, and ambiguous data on GDM and HT development mechanisms indicate the need for screening and detailed monitoring of patients with thyroid dysfunction for early detection and correction of hyperglycemia.
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