| 1. |
- Kirilovas, Dmitrijus, et al.
(författare)
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Granulosa cell aromatase enzyme activity : Effects of follicular fluid from patients with polycystic ovary syndrome, using aromatase conversion and [11C]vorozole-binding assays
- 2006
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Ingår i: Gynecological Endocrinology. - : Informa UK Limited. - 0951-3590 .- 1473-0766. ; 22:12, s. 685-691
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Tidskriftsartikel (refereegranskat)abstract
- The local regulation of ovarian aromatase enzyme in polycystic ovary syndrome (PCOS) was studied with aromatase conversion and [C-11]vorozole-binding assays to analyze aromatase activity, substrate-enzyme affinity and number of aromatase binding sites in non-cultured human granulosa cells (GC) incubated with different sources and preparations of follicular fluid (FF). Incubation with FF from women stimulated in in vitro fertilization cycles with follicle-stimulating hormone yielded higher conversion activity than with FF from healthy women and PCOS patients, paralleled with higher substrate affinity (lower K-d) than with FF from healthy women. In PCOS women, charcoal-pretreated FF yielded higher conversion, whereas the ether-pretreated FF yielded lower conversion activity, than with untreated PCOS FF. Both preparations of FF yielded higher affinity to substrate (lower Kd values) and the ether-pretreated FF a lower number of binding sites (B-max). It seems that steroids with the presence of proteins in PCOS FF reduced aromatase conversion activity through decreased substrate affinity, whereas FF preparations devoid of proteins reduced the aromatase conversion activity mainly through blocking of aromatase active sites. Identification of specific agents responsible for this rapid regulation of aromatase function might help to understand normal regulation of the menstrual cycle and supposed imbalances of inhibitors/activators in PCOS.
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| 2. |
- Kushnir, Mark M, et al.
(författare)
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Steroid profiles in ovarian follicular fluid from regularly menstruating women and women after ovarian stimulation
- 2009
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Ingår i: Clinical Chemistry. - : Oxford University Press (OUP). - 0009-9147 .- 1530-8561. ; 55:3, s. 519-526
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Information on the concentrations of steroids in ovarian follicular fluid (FF) from regularly menstruating (RM) women has been limited because of the absence of methods for the simultaneous quantification of multiple steroids in small volumes of FF. We studied steroid profiles in FF during the early follicular phase of the menstrual cycle and after ovarian stimulation for in vitro fertilization (IVF), and compared concentrations with published values obtained by immunoassay (IA). METHODS: We used liquid chromatography-tandem mass spectrometry (LC-MS/MS) to measure 13 steroids in 40-microL aliquots of FF samples from 21 RM women and from 5 women after ovarian stimulation for IVF. Relationships between concentrations of steroids and their ratios (representations of the enzyme activities) were evaluated within and between subgroups. RESULTS: The concentrations of testosterone (Te), androstenedione (A4), and estradiol (E2) measured by LC-MS/MS were lower than those previously reported in studies with IAs. In RM women, androgens were the most abundant class of steroids, with A4 being the major constituent. The concentrations of 17-hydroxyprogesterone (17OHP), total androgens, and estrogens were 200- to 1000-fold greater in FF than in serum. Compared with RM women, FF samples from women undergoing ovarian stimulation had significantly higher concentrations of E2 (P = 0.021), pregnenolone (P = 0.0022), 17OHP (P = 0.0007), and cortisol (F) (P = 0.0016), and significantly higher ratios of F to cortisone (P = 0.0006), E2 to estrone (P = 0.0008), and E2 to Te (P = 0.0013). CONCLUSIONS: The data provide the first MS-based concentration values for 13 steroids in ovarian FF from RM women, from estrogen- and androgen-dominant follicles, and from women after ovarian stimulation for IVF.
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| 3. |
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| 4. |
- Mogilevkina, Iryna, et al.
(författare)
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Effectiveness of emergency obstetric care training at the regional level in Ukraine : a non-randomized controlled trial
- 2022
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Nature. - 1471-2393 .- 1471-2393. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Emergency obstetric care training, using Advances in Labour and Risk Management (ALARM) International Program (AIP) was implemented in Ukraine, a country with universal access to skilled perinatal and obstetric care but restricted resources. A total of 577 providers (65.5% of total) from 28 maternal clinics attended a 5-day training session focused on the five main causes of maternal mortality, with hands-on skill workshops, pre- and post- tests, and an objective structured clinical examination. The effects of this emergency obstetric care training on maternal outcomes is the subject of this paper. Methods A non-randomized controlled trial was conducted. The pilot areas where the training was implemented consisted of 64 maternity clinics of which 28 were considered as cases and 36 non-participating clinics were the referents. Data on maternal outcomes were collected for a 2-year span (2004-2005) prior to the trainings, which took place 2006-2007 and again after implementation of the trainings, from 2008 to 2009. Information was collected from 189,852 deliveries. Outcomes for the study were incidences of operative delivery and postpartum hemorrhage. Non-parametric statistics, meta-analyses, and difference in difference (DID) estimation were used to assess the effect of the AIP on maternal indices. Results DID analysis showed that after the training, compared to the referents, the cases had significant reduction of blood transfusions (OR: 0.56; 95%CI: 0.48-0.65), plasma transfusions (OR: 0.70; 95%CI: 0.63-0.78), and uterus explorations (OR: 0.64; 95%CI: 0.59-0.69). We observed a non-significant reduction of postpartum hemorrhage >= 1000 ml (OR: 0.92; 95%CI: 0.81-1.04; P = 0.103). Utilization of vacuum extraction for vaginal delivery increased (OR: 2.86; 95%CI: 1.80-4.57), as well as forceps assisted delivery (OR: 1.80; 95%CI: 1.00-3.25) and cesarean section (OR: 1.11; 95%CI: 1.06-1.17). There was no change in the occurrence of postpartum hysterectomy and maternal mortality. Conclusions After one week of Emergency Obstetrics Care training of the obstetric staff in a setting with universal access to perinatal and obstetric care but restricted resources, an association with the reduction of postpartum hemorrhage related interventions was observed. The effects on the use of vacuum extraction and cesarean section were minimal.
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| 5. |
- Mogilevkina, Iryna, et al.
(författare)
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Some reproductive and sexual health indicators in rape victims in Ukraine
- 2006
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Ingår i: Central European Journal of Medicine. - : Walter de Gruyter GmbH. ; 1:4, s. 399-415
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Tidskriftsartikel (refereegranskat)abstract
- The objective was to study the demographics and some reproductive health indicators in Ukrainian women who reported having been raped. On the basis of responses to a questionnaire, we evaluated factors associated with a history of rape by a case-referent approach, using women reporting rape (n=177) as the dependent variable in comparison to those without such an experience (n=1444). Women reporting rape were more often younger than those without a history of rape. There was an association between a history of rape and three or more induced abortions. Rape victims were more likely to have a history of sexually transmitted infections and pelvic inflammatory diseases. A history of rape was more often associated with smoking and previous drug use. Women who had experienced rape more often reported more than one sexual partner during the last six months as well as during the previous year. On the other hand, these women reported sexual intercourse less frequently than did those without a history of rape. Rape victims more often reported sexual harassment at where they work or socialize as well as sexual abuse in childhood or within their family. Thus, a history of rape was common and associated with several negative health indicators. Sexual violence needs to be acknowledged in all parts of the Ukrainian society as a serious threat that requires urgent attention for the improvement of women’s reproductive and general health and human rights.
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| 6. |
- Mogilevkina, Iryna, 1958-
(författare)
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Some reproductive health indicators in Ukraine : A study with special emphasis on factors behind induced aboartion and perinatal mortality
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: To study indicators specifically reflecting the reproductive health of Ukrainian women and to analyse factors behind the indicators. Methods: Induced abortion and maternal mortality were studied in some countries/regions of the former Soviet Union, using official statistics. Abortion rates, contraceptive practices and intentions in Ukrainian women were analysed by a large self-completion survey in 1996, and by a classroom questionnaire to first year medical students in 1999 in Donetsk, Ukraine. Totally, 1694 women and 689 students participated. Perinatal mortality was studied, applying the Nordic-Baltic perinatal death classification to all cases in the Donetsk region in 1997-98 (n=1126) and in Denmark in 1996 (n=540). Clinical guidelines, use of technology and rates of interventions in the two regions were analysed. Results: Abortion remains a major method of fertility control and abortion-related mortality contributes to maternal deaths. Perinatal mortality rate is twice as high in the Donetsk region as in Denmark. A substantial proportion of sexually active women do not practice contraception. Modern methods of contraception are not widely used. There is a lack of knowledge in reproductive health issues and negative attitude to OCs. There is a positive attitude towards abortion as an acceptable fertility control method and of having abortion instead of using OCs or IUD. Poor economy is an obstacle to the use of contraceptive methods associated with a cost. Lack of experience with contraception reduces the intention to use any method in the future. Being single, younger than 19 years, living with parents, having a positive attitude towards abortion as fertility control method, having a history of previous childbirth and/or abortion are important factors associated with pregnancy termination. Antepartum deaths of growth-retarded fetuses, intrapartum and neonatal deaths associated with asphyxia are more common in Ukraine than in Denmark, particularly among premature infants. Lack of evidence-based clinical guidelines and adequate resources for fetal monitoring during pregnancy and labour, together with negative attitudes towards, and limited resources for, instrumental delivery, contribute to high perinatal mortality.Conclusion: Better reproductive education/information of all strata of society is needed. Implementation of evidence-based guidelines in perinatal medicine, where international collaboration can be of great value, should be a matter of high priority.
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| 7. |
- Mogilevkina, Iryna, et al.
(författare)
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Ukrainian medical students’ attitudes to parenthood and knowledge of fertility
- 2016
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Ingår i: European journal of contraception & reproductive health care. - : Informa UK Limited. - 1362-5187 .- 1473-0782. ; 21:2, s. 189-194
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of our study was to investigate Ukrainian medical students’ intentions andattitudes in relation to future parenthood, and their knowledge about fertility. Methods: Aclassroom survey was carried out of randomly selected groups among 3568 Russian-speakingmedical students. The response rate was 88.8%; 858 were female and 407 were male; the mean agewas 20.6 (standard deviation [SD] 2.4) years. Results: One in four male and 16% of femalerespondents did not want to have children, 3.3% had children and 17% wanted one child only.Female respondents wished to have their first child when they were 24.4 (SD 2.4) years of age, andmale respondents when they were 26.8 (SD 3.4) years of age. Around 60% of respondents reportedthere was a pronounced decline in female fertility after the age of 45 years. Conclusions: The desireto have children in the future is not apparent among medical students, especially not among men.Gaps in students’ knowledge about fertility need to be addressed by sexual and reproductiveeducation.
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| 8. |
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| 9. |
- Naessén, Tord, et al.
(författare)
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Steroid profiles in ovarian follicular fluid in women with and without polycystic ovary syndrome, analyzed by liquid chromatography-tandem mass spectrometry.
- 2010
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Ingår i: Fertility and Sterility. - : Elsevier BV. - 0015-0282 .- 1556-5653. ; 94:6, s. 2228-2233
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE To compare steroid concentrations and steroid product-to-precursor ratios in ovarian follicular fluid (FF) from women with polycystic ovary syndrome (PCOS) and from regularly menstruating women in their early follicular phase, using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Polycystic ovary syndrome involves abnormal regulation of the steroidogenic enzymes, leading to arrest of follicle development. DESIGN Case-control study. SETTING University hospital clinic. PATIENT(S) Follicular fluid from size-matched ovarian follicles (5-8 mm) in 27 nonstimulated women with PCOS and in 21 women without PCOS was sampled. Thirteen steroids were quantitated from 40 muL of FF, using LC-MS/MS. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Concentrations of steroids in the FF and product-to-precursor ratios (enzyme activity) were compared between the groups. RESULT(S) In women with PCOS, ovarian FF contained higher concentrations of individual and total androgens, lower individual and total estrogens (E), and a lower total E-to-androgen ratio, compared with regularly menstruating women. The product-to-precursor concentration ratios indicated higher CYP17-linked and lower CYP19-linked (aromatase) enzyme activity. Receiver operating characteristic plots indicated the early CYP17 step (17-OH5P/5P) being highly important for the prevalence of PCOS (c = 0.95). CONCLUSION(S) The women with PCOS had higher ovarian CYP17-linked and lower CYP19-linked (aromatase) enzyme activity, confirming previous data. Multiple steroid assessments from minute volumes including FF from nonstimulated ovaries, using LC-MS/MS, might be useful in research, clinical endocrinology, and in IVF.
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| 10. |
- Sijpkens, Meertien K., et al.
(författare)
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Results of a Dutch national and subsequent international expert meeting on interconception care
- 2020
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Ingår i: The Journal of Maternal-Fetal & Neonatal Medicine. - : TAYLOR & FRANCIS LTD. - 1476-7058 .- 1476-4954. ; 33:13, s. 2232-2240
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The potential value of preconception care and interconception care is increasingly acknowledged, but delivery is generally uncommon. Reaching women for interconception care is potentially easier than for preconception care, however the concept is still unfamiliar. Expert consensus could facilitate guidelines, policies and subsequent implementation. A national and subsequent international expert meeting were organized to discuss the term, definition, content, relevant target groups, and ways to reach target groups for interconception care.Methods: We performed a literature study to develop propositions for discussion in a national expert meeting in the Netherlands in October 2015. The outcomes of this meeting were discussed during an international congress on preconception care in Sweden in February 2016. Both meetings were recorded, transcribed and subsequently reviewed by participants.Results: The experts argued that the term, definition, and content for interconception care should be in line with preconception care. They discussed that the target group for interconception care should be "all women who have been pregnant and could be pregnant in the future and their (possible) partners". In addition, they opted that any healthcare provider having contact with the target group should reach out and make every encounter a potential opportunity to promote interconception care.Discussion: Expert discussions led to a description of the term, definition, content, and relevant target groups for interconception care. Opportunities to reach the target group were identified, but should be further developed and evaluated in policies and guidelines to determine the optimal way to deliver interconception care.
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