• Peculiar properties of hormonal relationships in women of different age groups with failed attempts of in vitro fertilization treatment in anamnesis
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Peculiar properties of hormonal relationships in women of different age groups with failed attempts of in vitro fertilization treatment in anamnesis

HEALTH OF WOMAN.2015.5(101):150–153
 

Peculiar properties of hormonal relationships in women of different age groups with failed attempts of in vitro fertilization treatment in anamnesis
 

Kotsabyn N. V., Makarchuk A. M.

Ivano-Frankivsk national medical University
 

Steady trend of increasing the number of women who want to become pregnant after age 35, unfortunately, does not meet the physiology of women. According to epidemiological studies of infertility in marriage the ability to conceive after age 35 is reduced by 3-4 times [4], so the age is considered to be a major risk factor for reproductive function. In addition, women after 35 have significantly increased risk of prenatal losses caused by both genetic and external factors [4].

Scientific research indicates that reducing of fertility begins with a 32-year life, progressing in each subsequent cycle and approaching zero in 44-46 years.

We conducted the study and analysis of oscillations in steroid (estradiol diol, progesterone and testosterone) and protein (lyutropina, follitropin and prolactin) hormones, as well as determine the content of AMH, FSH and inhibin B inserum of 60 women with unsuccessful attempts of assisted reproductive technologies. In our studies we used not only general clinical, functional, hormonal, but ultrasound and Doppler study. The survey was conducted in the first phase (3-5 days) and in the second phase (21-23 th days) of menstrual cycle. At the same time to women with preserved menstrual cycle on day 4 or 5 of menstruation was performed transvaginal ultrasound examination of the pelvic organs.

All patients were divided according to age into the following groups: the first basic research group consisted of women from 20 to 35 years (20 patients), the second main research group – women aged 36 to 40 years (20 women) and comparison group consisted of women over 40 (20 people). The control group consisted of 20 somatic healthy patients with preserved reproductive function who gave birth in a timely manner through natural birth canal.

The degree of steroid hormones imbalance according to data of hormonal status evaluation in study groups wasincreased due to the duration of infertility, age and multifactorial leading causes.

In all women with unsuccessful attempts of IVF, as well as in women of control group, was observed a cyclical rhythm of prolactin secretion with it’s increased level in the second phase, but in the background of the original hyperprolactinaemia. Significant infraction of pituitary function of prolactine secretion in this category of patients also causes significant disturbances in the regulation of ovarian function: dererred follicular maturation and decreased functional activity of the corpus luteum, what probably explains the fairly high percentage of infertility.

In women of the first and second groups despite the presence of abnormalities in the secretion of gonadotrophins and prolactin compensatory reactions of the organism provide the state of homeostasis in half of patients, although their reproductive function is significantly impaired even when ovulation is preserved.

More significant infraction of steroidogenesis were observed in women of comparison group. The results of hormonal status indicators together clearly describe low ovarian reserve in this category of patients and may be the prognostic markers of negative results of IVF.
 

Key words: infertility, age, hormone levels, assisted reproductive technologies.
 

REFERENCES

1. Ruess ML, Kline J, Santos R, Levin B, Timor-Tritsch I. 1996. Age and the ovarian follicle pool assessed with transvaginal ultrasonography. J Obstet Gynecol. 174(2):624–627.

2. Syrop CH, Dawson JD, Husman KJ, Sparks AE, Van Voorhis BJ. 1999, Jul. Ovarian volume may predict assisted reproductive outcomes better than follicle stimulating hormone concentration on day 3. Hum Reprod. 14(7):1752–6.

3. Syrop CH, Willhoite A, Van Voorhis BJ. 1995, Dec. Ovarian volume: a novel outcome predictor for assisted reproduction. Fertil Steril. 64(6):1167–71.

4. Haadsma ML, Groen H, Mooij TM, Burger CW, Broekmans FJ, Lambalk CB, Leeuwen FE, Hoek A. 2010, Feb. Miscarriage risk for IVF pregnancies in poor responders to ovarian hyperstimulation. OMEGA Project Group. Reprod Biomed Online. 20(2):191–200.

5. Haadsma ML, Mooij TM, Groen H, Burger CW, Lambalk CB, Broekmans FJ, van Leeuwen FE, Bouman K, Hoek A. 2010, Feb. A reduced size of the ovarian follicle pool is associated with an increased risk of a trisomic pregnancy in IVF-treated women. Hum Reprod. 25(2):552–8.

6. May-Panloup P, Chrйtien MF, Jacques C, Vasseur C, Malthiйry Y, Reynier P. 2005, Mar. Low oocyte mitochondrial DNA content in ovarian insufficiency. Hum Reprod. 20(3):593–7.

7. Choi B, Bosch E, Lannon BM, Leveille MC, Wong WH, Leader A, Pellicer A, Penzias AS, Yao MW. 2013, Jun. Personalized prediction of first-cycle in vitro fertilization success. Fertil Steril. 99(7):1905–11.

8. de Koning CH, McDonnell J, Themmen AP, de Jong FH, Homburg R, Lambalk CB. 2008, Jun. The endocrine and follicular growth dynamics throughout the menstrual cycle in women with consistently or variably elevated early follicular phase FSH compared with controls. Hum Reprod. 23(6):1416–23.

9. Стрелко Г.В. 2012. Клінічне значення оцінки оваріального резерву в жінок, які страждають на безпліддя. Здоров’я України. Темат. номер: Гінекологія. Акушерство. Репродуктологія: Мед. газета 1:35–36.

10. Сенаторова ГС, Ріга ОО, Седая ЮС, Шевченко МА. 2010. Медико-соціологічний портрет сучасної жінки репродуктивного віку. Актуальні питання педіатрії, акушерства та гінекології: наук.-практ. журн. 1:66–68.