Dolgushina N.V. Dolgushina

Functional hypothalamic amenorrhea (FHA) is a condition that occurs as a result of a malfunction of the hypothalamic-pituitary-ovarian axis in women of reproductive age due to effects of environmental factors, many of which are widely known. However, the factors that determine the individual predisposition to this condition, as well as the duration and severity of its course, remain unexplored. Epigenetic modifications that alter gene activity without altering DNA structure are among the most promising markers of many diseases, including those involving the hypothalamus-pituitary system. The pathogenetic role of one of the key epigenetic regulators in the genesis of these diseases – non-coding RNAs – is actively being studied. Also, the potential of using non-coding RNAs as therapeutic agents in some conditions is being investigated. The purpose of the review was to systematize the literature data on the potential role of microRNAs as one of the most actively studied epigenetic regulators in the pathogenesis of FHA. The main types of epigenetic modifications and current data on their role in the development of diseases involving the hypothalamus-pituitary system, as well as conditions associated with FHA, are described. The study of epigenetic regulators whose activity is altered by external factors in FHA development is highly promising. Moreover, further studies are needed to evaluate the potential of epigenetic regulators as therapeutic agents in patients with FHA to improve treatment effectiveness and minimize the adverse consequences of the disease on reproductive and somatic health.

The aim of the study. To assess the possible impact of trophectoderm biopsy on obstetric and perinatal outcomes of pregnancies resulting from the transfer of a thawed embryo in assisted reproductive technology programs. Material and methods. A retrospective single-center study was conducted, including analysis of medical records and a telephone survey of patients with confirmed clinical pregnancy after single thawed embryo transfer in 2020—2021. The possible impact of trophectoderm biopsy performed during preimplantation genetic testing for aneuploidies (PGT-A) on the course of pregnancy, obstetric and perinatal outcomes was analyzed. The study included data from 190 patients: 95 patients in the PGT-A group and 95 in the control group. Results. Isthmic-cervical insufficiency was observed more frequently in the PGT-A group (OR=2.54; 95% CI 1.04–6.21, p=0.034). A borderline statistically significant increase in placenta previa incidence was also noted (OR=6.34; 95% CI 0.75–53.69, p=0.054). No statistically significant differences were found between the PGT-A and control groups in terms of cesarean section rates, major obstetric syndromes, neonatal anthropometrics, or frequency of fetal malformations. Conclusion. Trophectoderm biopsy during preimplantation genetic testing may increase the risk of placenta previa and accreta, as well as isthmic-cervical insufficiency. Additional studies are needed to confirm or refute these results.

Благодаря грудному вскармливанию у ребенка образуется целый ряд защитных барьеров, которые не только ограждают его от инфекционных заболеваний, но и повышают защитные функции организма. Раннее начало грудного вскармливания также оказывает положительное влияние на мать, способствуя успешному восстановлению сил после родов. В статье рассмотрены клинические рекомендации «Нормальный послеродовой период (послеродовая помощь и обследование)» [1], разработанные Российским обществом акушеров-гинекологов в 2024 г., в контексте поддержки грудного вскармливания.