Pathogenesis of ovarian dysfunction in women with diabetes mellitus 1 type

Abstract

The main ideas about the pathogenesis of ovarian dysfunction in women with diabetes mellitus (DM) type 1 are presented. The role of increased opioid and dopaminergic tone in the pathogenesis of reducing the synthesis of the gonadotropin-releasing hormone by the hypothalamus in women with type 1 diabetes was analyzed. Presented the data of relationship between ovarian hormonal insufficiency in women with type 1 diabetes with possible damage of positive feedback mechanism of the ovaries and the pituitary gland, which intactness is necessary for the maturation of the dominant follicle and ovulation. The results of studies, suggested that the high doses of exogenously administered insulin in type 1 DM lead to stimulation of androgen synthesis in teca cells and ovarian stroma and the development of ovarian hyperandrogenemia, as well as polycystic ovary syndrome, are reduced. In addition to exogenous hyperinsulinemia, in the pathogenesis of ovarian dysfunction, the value of the deficiency of endogenous insulin, leading to a violation of steroidogenesis in the tissues of the ovary and anovulation, is proved. The role of insulin deficiency and hyperglycemia in the development of metabolic stress lead to ovarian dysfunction in patients with type 1 diabetes was analyzed.

In vitro fertilization as a method of infertility treatment in women with type 1 diabetes mellitus

“…Сахарный диабет 1 типа (СД1) оказывает неблагоприятное влияние на репродуктивную систему женщины. Частота нарушений менструального цикла колеблется от 29,7 до 74,9% у женщин с СД1 [1][2][3]. В своем исследовании A. Daltsidou и соавт.…”

“…(2010) показали, что при СД1 нарушения менструального цикла встречаются в 7,8 раза чаще, чем у женщин без СД [4]. Гормональная недостаточность функции яичников у больных СД1 обусловлена усилением опиоидного и дофаминергического торможения продукции гонадотропин-рилизинг-гормона гипоталамусом и повреждением механизма положительной обратной связи между яичниками и гипофизом [2].…”