Aromatase is the key enzyme, which converts androgens into estrogens. To study the role of aromatase in pathogenesis of endometriosis 57 patients and 15 healthy women of reproductive age were examined. Aromatase activity was detected by reaction of estrogens on aromatase inhibitor letrozol intake. Ovarian source of detected aromatase activity was proved by suppression of reaction on letrozole intake during therapy with gonadotropin- releasing hormone agonist. Aromatase activity in recalculation on antral follicle in endometriosis patients withII–IV stages was higher than in healthy women, though total ovarian aromatase activity was not differed from control group because of low number of antral follicles in endometriosis patients. The disturbance of folliculogenesis in endometriosis is connected probably with hyperestronaemia, which has ovarian and extragonandal origin.
Endometriosis is estrogen- dependent disease. Aromatase P450 is the key enzyme in estrogen biosynthesis. The aim of the study was to compare therapeutic efficiency of gonadotropin-releasing hormone analogue (aGnRH) with ovarian aromatase activity. 64 women with endometriosis were examined after laparoscopic coagulation of endometrioid lesions. The examination included determination of FSH, LH, prolactin, antimüllerian hormone, estradiol, estrone and androstendione by immune-enzyme assay in peripheral blood and determination of ovarian aromatase activity by test with aromatase inhibitor letrozole. Laparoscopic coagulation of endometrioid lesions and following six- month course of aGnRH have lead to decrease of clinical manifestations of the disease and recovery of normal ovulatory menstrual cycle in most (72.5 %) of the patients. Therapeutic efficiency of combined therapy did not depend on basal blood estradiol level and ovarian aromatase activity.
There are data about the influence of pregnancy on clinical course of genital endometriosis and about the influence of endometriosis on pregnancy and the genesis of complications in this article.
Premature ovarian insufficiency is a syndrome characterized by hypergonadotropic ovarian insufficiency and the reduction of ovarian function before age 40. This leads to reproductive failures, metabolic changes, and a decrease in quality of life. Currently, occult and initial forms of premature ovarian insufficiency, which have their own diagnostic features and management tactics, can be figured out. The frequency of this syndrome is between 1.1 and 3.7% and the tendency for incidence to increase can be seen. This article is a literature review of the data available in the PubMed database (20052020), with international clinical guidelines taken into consideration. The genetic causes of premature ovarian insufficiency, clinical signs of this pathology and treatments options for such patients are included into the review. In addition, some features of assisted reproductive technology within this group are described.
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