ФГБНУ «НИИ акушерства, гинекологии и репродуктологии им. Д.О. Отта», Санкт-Петербург, Россия ■ С целью изучения овариальной ароматазной активности при синдроме поликистозных яичников (СПЯ) обследовано 49 больных СПЯ и 33 здоровые женщины репродуктивного возраста. Ароматазную активность определяли с помощью коэффициента эстрадиол/число антральных фолликулов в обоих яичниках (Э 2 /n). Значения овариальной ароматазы положительно коррелировали (р < 0,05) с результатами ее определения с помощью теста с ингибитором ароматазы летрозолом при СПЯ. Сниженная ароматазная активность антральных фолликулов имелась у 59 % больных СПЯ. Полученные данные указывают на то, что коэффициент Э 2 /n позволяет оценивать овариальную ароматазу и что абсолютный или относительный дефицит овариальной ароматазы лежит в основе патогенеза СПЯ. ■ Ключевые слова: синдром поликистозных яичников; овариальная ароматаза. ■ In order to study ovarian flavor ase activity in polycystic ovary syndrome (PCOS) examined 49 patients with PCOS and 33 healthy women of reproductive age. Aromatase activity determined using estradiol/number of antral follicles in both ovaries ratio (Е 2 /n). Values ovarian aromatase positively correlated (p < 0.05) with the results of its determination by a test with the aromatase inhibitor letrozole in PCOS. Reduced aromatase activity of antral follicles was present in 59 % of patients with PCOS. These data indicate that Е 2 /n ratio allows to evaluate ovarian aromatase and that an absolute or relative deficiency of ovarian aromatase underlies the pathogenesis of PCOS.■
Resent data concerning the role of insulin resistance, hyperinsulinemia and ovarian aromatase deficiency in pathogenesis of polycystic ovary syndrome are presented.
Polycystic ovary syndrome is one of the most common pathologies in the practice of an obstetrician-gynecologist. Overcoming infertility characteristic of this syndrome is an important problem of endocrinology, gynecology, and reproductive medicine. Innovative therapeutic and surgical methods of treatment can correct hormonal and metabolic disorders, induce ovulation and achieve a long-awaited pregnancy. Early gestation periods in patients with polycystic ovary syndrome often occur with miscarriage, and the risks of developing gestational diabetes mellitus, cervical insufficiency, gestational arterial hypertension, preeclampsia, and placental insufficiency increase. We have analyzed modern ideas about the effect of various pathogenetic links of polycystic ovary syndrome on the course of pregnancy.
This literature review is devoted to the use of focused ultrasound in gynecological practice as an alternative to the traditional surgical treatment of uterine fibroids and deep infiltrating endometriosis. According to available data, the effectiveness of the treatment of uterine fibroids with focused ultrasound varies widely, ranging from 16.4% to 93.0%. Due to the lack of prospective studies, it is not possible to draw reliable conclusions about the effect of ablation of uterine fibroid with focused ultrasound on fertility. However, unplanned pregnancies after such treatment occurred up to 19.5%, and in 66.3% of cases, pregnancies ended with the childbirth. Research results demonstrate that in 87% of cases, treatment of retrocervical infiltrative endometriosis using focused ultrasound is feasible. Further data accumulation is required to determine the range of patients with uterine fibroids and deep infiltrating endometriosis, to whom the treating technique could be most effective and safe.
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