Endometrium receptivity in premature ovarian insufficiency – how to improve fertility rate and predict diseases?

Abstract

More empathized approach is required and is obligatory to women with premature ovarian insufficiency (POI) interested for pregnancy. In order to improve fertility rate in POI patients our suggestions would be: (1) To decrease FSH value to 10-15 IU/L by increasing estrogen. Oocyte donation can be suggested after a minimum of six month interval from FSH between 10-15 IU/L and when no dominant follicles are found. (2) To perform oral glucose tolerance test (OGTT). Insulin sensitizing agents has to be included, when indicated, 3-6 month before pregnancy. (3) TSH has to be 1-2.5 mM/L during 3-6 months before pregnancy. (4) Tests for thrombophyllia (Leiden V, FII, MTHFR, PAI) have to be obligatory. They are less expensive than those repeated in vitro fertilizations. Therapy has to be included according to the indications. (5) In order to regulate disturbed immune response in POI patients with endometriosis oral contraceptive therapy is needed for atleast six months prior to the pregnancy. (5) Encourage the patients and advice them about healthy life style and eating habits. (6) Add other drugs, when they are indicated. Complex interplay between endocrine, immunological, haematological, and psychological factors are very often underdetected in POI patients. It is very important to find out the real time for oocyte donation after correcting all the disturbances, improving endometrium receptivity and reaching women's acceptable psychological status. Untreated disturbances induce cardiovascular diseases, diabetes mellitus, thyroid diseases, coagulopathioes etc.

Circular RNA sequencing reveals the molecular mechanism of the effects of acupuncture and moxibustion on endometrial receptivity in patients undergoing infertility treatment

“…The significantly enriched terms embryonic digestive tract morphogenesis (GO:0048557) and regulation of smooth muscle cell differentiation (GO:0051150) indicate the possibility of altering the endometrial thickness and influencing ER. Notably, estrogen and progestogen are two important hormones involved in regulating the growth and development of the endometrium (18,19). Estrogen and progestogen are both aromatic compounds, and the degradation of the aromatic compound pathway (PATH:01220) was significantly enriched.…”

Female infertility in the era of obesity: The clash of two pandemics or inevitable consequence?

“… 69 A possible explanation could be that plasminogen activator inhibitor (PAI) activity is increased in women with PCOS compared to healthy controls; IR and hyperinsulinism impact fertility and pregnancy by increasing androgen and PAI levels and decreasing uterus vascularization. 70 …”

“…69 A possible explanation could be that plasminogen activator inhibitor (PAI) activity is increased in women with PCOS compared to healthy controls; IR and hyperinsulinism impact fertility and pregnancy by increasing androgen and PAI levels and decreasing uterus vascularization. 70 The correlation between hereditary thrombophilia and the higher risk of recurrent pregnancy loss has been well-established; in this regard, patients with PCOS could exhibit more frequently homozygosity for methylenetetrahydrofolate reductase gene mutations, 71 activated protein C resistance ratio (APC R) and factor V Leiden, which were found to be associated with recurrent pregnancy loss.…”

“…Baseline intrinsic IR found in lean women with PCOS gets superimposed if these patients gain weight, and it seems further exacerbated by entry into pregnancy 69 . A possible explanation could be that plasminogen activator inhibitor (PAI) activity is increased in women with PCOS compared to healthy controls; IR and hyperinsulinism impact fertility and pregnancy by increasing androgen and PAI levels and decreasing uterus vascularization 70 …”

Ginsenoside Rg1 improves pathological damages by activating the p21‑p53‑STK pathway in ovary and Bax‑Bcl2 in the uterus in premature ovarian insufficiency mouse models

“…The pathogenesis of POI remains poorly understood (6). At present, follicle donation and hormone replacement therapy (HRT) are the primary treatment methods for POI (7). In particular HRT can also relieve the symptoms of POI.…”