In the present review, a new approach to studying the pathogenesis and predicting the development of preeclampsia (PE) – namely, the determination of matrix metalloproteinases (MMPs) – is discussed. Currently, the major cause of PE is thought to be an incomplete remodeling of spiral arteries because of an insufficient number of invading cytotrophoblasts or the absence/inactivation of crucial lysing enzymes, i.e. matrix metalloproteinases. The role of MMP-1, MМP-2, MМP-3, MМP-7, MМP-9 in the placenta formation, the development of oxidative stress and endothelial dysfunction is described. We propose that in the future, the MMPs may be used for differentially predicting early and late PE.
Эндометриоз-это эстрогензависимое, прогестеронрезистентное воспалительное заболевание, ассоциированное с тазовой болью и бесплодием, наблюдаемое у женщин преимущественно репродуктивного возраста. В структуре гинекологической заболеваемости эндометриоз находится на 3-м месте, уступая воспалительным заболеваниям органов малого таза и миоме матки [1], встречается у 7-15% женщин репродуктивного возраста [2]. По данным статистики, эндометриоз сочетается с бесплодием у 30-50% женщин. Частота выявления эндометриоза при лапароскопии, в том числе проводимой с целью уточнения причины бесплодия, составляет 20-55% [3, 4]. Частота наступления спонтанной беременности у женщин с эндометриозом ректовагинальной перегородки достигает 30,6%, с эндометриозом яичников-всего лишь 18% [5], возрастая после хирургических вмешательств до 42,3-76,5% [6]. Однозначного мнения о влиянии эндометриоза на результаты применения вспомогательных репро
Эндометриоз встречается у 15% женщин репродуктивного возраста. Данные большинства исследований позволяют говори ть о повышенном риске развития рака яичников у данной группы пациенток. Эндометриоз-ассоциированные опухоли чаще всего представлены эндометриоидным и светлоклеточным подтипами рака, меньшую долю составляют серомуцинозные опухоли. В данном обзоре обсуждаются генетические и молекулярные факторы, лежащие в основе злокачественной трансформации эндометриоза.
The issue of fertility preservation in patients with cervical cancer is getting more and more common considering the improved effectiveness of early diagnosis and treatment of cancer. There is a number of evidence-based tactics available to the patients with diagnosed cervical cancer. These tactics have been proved effective and include methods such as ovarian transposition; oocyte, embryo and ovarian tissue cryopreservation. Nonetheless, there are no existing medical algorithms to define the priority of actions that should be taken in such cases of restricted time. The objective of this clinical case report is to highlight an existing concern towards the decision-making process regarding fertility preservation in patients with cervical cancer.In this paper we report a clinical case of fertility preservation tactics in a patient undergone ovarian transposition. We pay attention to particular features of the controlled ovarian stimulation (COS) and oocyte retrieval process typical for such patients. The article discusses the subject of COS and oocyte retrieval effectiveness compared to patients who did not undergo ovarian transposition. The 35-year old patient presented 9 month after ovarian transposition to perform oocyte cryopreservation. As a result of COS 3 oocytes were aspirated, compared to 20 oocytes in another patient of comparable age and medical history, but with no ovarian transposition performed.Regarding particular conditions constraining ovarian stimulation and oocyte retrieval after ovarian transposition, we recommend to consider the possibility of performing oocyte/embryo cryopreservation before ovarian transposition in patients with cervical cancer. Prioritizing oocyte and embryo cryopreservation in case of having sufficient time before treatment could significantly improve possibilities of achieving genetically related offspring in a long-term perspective.
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