Aim. Comprehensive epidemiological assessment of factors affecting the effectiveness of the infertility treatment in medical organizations of St. Petersburg. Materials and Methods. The effectiveness of assisted reproductive technology programs in St. Petersburg reproductive centers was evaluated by analyzing the respective database for infertility treatment in 2013-2017. We retrospectively examined 843 patient records that were submitted to one of the St. Petersburg reproductive centers in 2014-2017 with the following survey and in-depth clinical examination of 129 couples before in vitro fertilisation. Results. Risk factors of infertility included vaginal dysbiosis (OR = 7.5 (95% CI 1.04-54.1)), Trichomonas vaginalis infection (OR= 2.6 (95% For citation:
Assisted reproductive technologies (ART) are one of the most effective ways in fighting infertility, but their effectiveness is influenced by various factors. Our study focuses on examining importance of risk factors underlying ART failure related to altered microbiome pattern in the female reproductive system. The case-control study was based on conducting a laboratory examination of 129 infertile couples applied to the Department of Assisted Reproductive Technologies due to failure of in vitro fertilization (IVF), whereas control group consisted of females with successful progressive pregnancy after ART. Chlamydia, herpes virus and cytomegalovirus were assessed by using PCR and ELISA, whereas culture method was used to detect Trichomonas vaginalis in vaginal swabs and ejaculate applying Trichomonas Modified CPLM Medium (HiMedia, India) followed by microscopy. In addition, the qualitative and quantitative composition of the vaginal biocenosis was studied with multiplex RT-PCR by using Femoflor-16 kit (DNA-technologies, Russia). Serological tests were based on measuring IgG and IgA antibodies against Chlamydia trachomatis in ELISA (diagnostic kits purchased from Vektor Best, Russia; NovaTec, Germany; ImmunoComb, Israel) as well as antibodies against immediate early HSV-1/2 proteins (BioService, Russia) and immediate early HHV-5 proteins (Vector Best, Russia). C. trachomatis and herpesvirus DNA was measured by using PCR diagnostic kits Amplisens (Interlabservice, Russia). It was found that sexually transmitted infection agents were highly prevalent in infertile couples applying to the hospital for IVF. Significant factors for non-pregnancy were vaginal dysmicrobiocenosis (OR = 7.5 (95% CI 1.04—54.1), p = 0.02) and detected T. vaginalis (OR = 2.6 (95% CI 1.12—6.4), p = 0.01). Dysbiosis of the reproductive system, including those occurring due to trichomonas infection is associated with lowered ART effectiveness. It is evident to timely detect urogenital infections and dysbiosis while preparing infertile couples for IVF cycles.
BACKGROUND: Gestational diabetes mellitus is a significant medical and social problem in most countries. Despite the relatively high level of development of modern medicine, following the growth of obesity and type 2 diabetes, the prevalence of gestational diabetes mellitus is also increasing worldwide.
AIM: To identify the frequency and structure of carbohydrate metabolism disorders and to compare the level of blood pressure in a random sample of pregnant women registered in the Perinatal center.
MATHERIALS AND METHODS: The analysis of the data of examination of carbohydrate metabolism of pregnant women who are registered in the Perinatal Center (Leningrad region, Gatchina), has been carried out. The analysis of medical documentation, survey, endocrinological and gynecological examination, calculation of the body mass index and the study of carbohydrate metabolism have been carried out.
RESULTS: There is an increase in the number of pregnant women with impaired carbohydrate metabolism over the years of observation. Gestational diabetes on diet therapy was 64.4% in 2019, 31.0% in 2020, 65.1% in 2021, on insulin therapy 32.2, 62.3, 28.9% respectively. There was an increase in the number of women with type 1 and type 2 diabetes diagnosed before pregnancy and newly diagnosed diabetes during pregnancy. Body mass index and blood pressure levels are higher and glycated hemoglobin levels are lower in diet-treated pregnant women with gestational diabetes compared with insulin therapy. An increase in glycated hemoglobin was found annually in a group of women with gestational diabetes mellitus on insulin therapy.
CONCLUSIONS: The high prevalence of carbohydrate metabolism disorders and the associated increase in blood pressure in pregnant women in Saint Petersburg and the Leningrad Region justifies a targeted search for carbohydrate metabolism disorders in pregnant women.
Women were placed in one of four groups according to their vaginal pathological state. 77 patients with classical bacterial vaginosis (BV) were included in the first group. The second group included 63 women with BV and leukocytes in the vaginal smear. The third group consisted of 157 patients without clinical and laboratory criteria of BV, but with bacterial vaginitis. The fourth group (control group) totalized 193 people without any of the above pathological processes in the vagina or other diseases of the pelvis.
Chlamydia, Mycoplasma, Ureaplasma and Trichomonas were found significantly more often in women with BV that in those without (4,3; 15,2; 2,6; 5,9 times accordingly). Chlamydia and Ureaplasma in diagnostic levels were identified more often in the patients with BV and leukocytes than in those with the classical variant (1,8 and 1,4 times accordingly). Trichomonas was found only in the patients with BV and leukocytes; and M.himinis in diagnostic levels was identified in both variants equally.
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