Khmil S. V., Pravak Y. B.

ASSESSMENT OF THE CLINICAL CONDITION OF INFERTILE WOMEN WITH POLYCYSTIC OVARY SYNDROME AND METABOLIC SYNDROME UNDERGOING DIFFERENT TYPES OF PRECONCEPTION PREPARATION

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About the author:

Khmil S. V., Pravak Y. B.

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CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

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Polycystic ovary syndrome (PCOS) is one of the leading causes of female infertility due to chronic oligo/anovulation, hyperandrogenism, and insulin resistance, which lead to menstrual cycle disorders, reduced egg quality and endometrial implantation potential, as well as a high frequency of early reproductive losses (biochemical pregnancies, spontaneous miscarriages). PCOS is often associated with metabolic syndrome (MetS), which complicates the course of the disease, creates an unfavorable cardiometabolic background, and reduces the effectiveness of assisted reproductive technologies (ART). A comprehensive assessment of anamnestic data allows for more accurate risk stratification and adaptation of pre-protocol preparation for the correction of metabolic and inflammatory disorders, which can be considered a promising approach to improving the effectiveness of infertility treatment in this cohort of patients. The aim of the study was to evaluate the effect of metabolic optimization on the clinical condition of patients with PCOS and MetS before the start of the IVF cycle. For this purpose, insulin sensitizers (metformin, inositol), nutraceuticals (alpha-lipoic acid, vitamin D), dietary recommendations, and physical activity were used. Analysis of anamnestic, clinical, and biochemical indicators revealed a high prevalence of endocrine, metabolic, and psychoemotional disorders among patients with PCOS. Family history often indicated a hereditary predisposition to MetS and cardiovascular disease. Given the susceptibility to cardiometabolic complications when PCOS is combined with MetS, the effect of pre-pregnancy metabolic optimization 8-12 weeks before the cycle of in vitro fertilization (IVF) on anthropometric and biochemical indicators was investigated. The assessment was performed twice: at the initial examination stage and before the start of ART. The results showed that metabolic preparation significantly improves anthropometric parameters, glucose and insulin levels, HOMA-IR, lipid profile, and blood pressure. Optimization of preparation reduces systemic inflammation and improves metabolic balance, which in turn has a positive effect on reproductive outcomes.

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Bibliography:

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Publication of the article:

«Bulletin of problems biology and medicine», 2025 Issue 3,178, 285-297 pages, index UDC 618.177-089..888.11::618.11-006.2-031.14:616-008.9-06:618.2-082

DOI:

10.29254/2077-4214-2025-3-178-285-297