[Preparation for assisted reproductive technology in the course of infertility treatment in the female soldiers].

The level of obstetric morbidity in servicewomen remains high. Infertility occurs more often among the families of servicemen, than among the other families. The leading causative factor among the families suffering from infertility is tuboperitoneal or tubal (up to 85%). Assisted reproductive technologies are often the only possible mean to solve the problem of infertility in case of these forms of infertility.. The families of servicemen suffering from infertility were suggested the echelon principle of health care in military-medical institutions of the Ministry of Defence of the Russian Federation. Defined selection rules and directions, requiring the separation of the assisted reproductive technologies Clinic of Obstetrics and Gynaecology of the Kirov Military Medical Academy to carry out in vitro fertilization procedures.

[The reaction of the hypophysis to thyroliberin and metoclopramide in women with hyperprolactinemia]. / Reaktsiia gipofiza na tiroliberin i metoklopramid u zhenshchin s giperprolaktinemiei.

Functional tests with i.v. injection of metoclopramide (10 mg) and thyroliberin (200 micrograms) with a record of PRL and TSH levels for 120 min. were performed in 87 women of reproductive age (19 healthy nonpregnant women, 9 women in the early postnatal period, 10 patients with primary hypothyroidism, and 30 patients with PRL secreting chromophobe adenomas). Hyperprolactinemic anovulation was noted in 35 examinees. Comparison of the results of thyroliberin and metoclopramide tests in different groups of examinees was suggestive of a decrease in dopaminergic inhibition of the hypophysis in postnatal and adenomatous hyperprolactinemia. The presence and a degree of hyperprolactinemia in patients with primary hypothyroidism depends, probably, on the ratio of a stimulating effect of endogenous thyroliberin and inhibitory action of dopamine on hypophyseal lactotrophs.

[Hypothyroidism and hyperprolactinemia]. / Gipotireoz i giperprolaktinemiia.

Blood thyrotropic hormone, thyroxin, tri-iodothyronine, FSH, LH, estradiol and progesterone levels were examined in 14 patients with primary hypothyroidism and 11 normal women of reproductive age. All the women under study were subjected to functional tests with intravenous thyroliberin (TRH) and metoclopramide. All hypothyroid patients had anovulatory infertility. Hyperprolactinemia was detected in 8 of 14 patients. It is demonstrated that hyperprolactinemia, developing in cases of primary hypothyroidism, is associated with impaired dopaminergic inhibition of pituitary lactotropics. Substitution thyroidin therapy resulted in the recovery of the normal ovulatory cycle in all but one patient with secondary pituitary microprolactinoma, and 8 patients became pregnant. It is believed that damaged dopaminergic regulation of hypothalamic luliberin (RH) secretion is a direct cause of ovarian dysfunction associated with primary hypothyroidism.

[Sensitivity of pituitary gonadotropins to luliberin in women using intrauterine contraceptive devices]. / Issledovanie chuvstvitel'nosti gonadotrofov gipofiza k liuliberinu u zhenshchin, pol'zuiushchikhsia vnutrimatochnymi kontratseptivami.

PIP: Despite extensive practical use of IUDs investigations still need to be conducted concerning the reasons for their contraceptive effect. Even though the localized effect on the endometrium which prevent implantation of egg cells is a known cause, possible influence on the hormonal and ovulatory function of the ovaries should not be neglected. IUDs according to various authors either result in decreased ovulation or constant ovulation with a decreased production of ovulatory steroids. No change in the excretion of estrogens and pregnanediols, but increased luteinizing hormone and estrogen as well as prolactin content in the blood are reported. The current study pinpoints the mechanism of the IUD on the hypophysial ovulatory system in women aged 24-35 having used the IUD for 2-3 years. Determination of basal temperature was performed during 2-3 cycles. With 59/60 women, basal temperature was 2-phased and with 1 it was mono-phased. The histological picture of the endometrium was studied for 40 women and it reflected the corresponding phases of the menstrual cycle. Functional reserves of hypophysial gonadotrophs was studied using a test with intravenous injection of 100 micrograms of synthetic luliberin during the cyclic follicular phase for 9 women using the IUD and for 7 healthy women of reproductive age as a control group. The levels of luteinizing and follicle stimulating hormones in the blood serum and also prolactin, estradiol and progesterone in blood samples were determined by radio-immunology at regular intervals. The dynamics of the changes noted for the women in the 2 groups did not differ. The cycles of prolactin and progesterone content in the blood were the same. A slight tendency for decreased levels of estradiol in the blood for women using the IUD was noted, which may be connected with an insignificant stagnation in the growth and maturation of the follicles. The results support the findings that prolonged use of the IUD leaves the hypothalamic-hypophysial-ovulatory system intact.^ieng