Alexander M. Gzgzyan

• Professor
• Head of Department at Research Institute of Obstetrics and Gynecology named after D.O. Ott

Introduction. Conventional semen analysis offers limited insights into a man’s reproductive potential and does not always adequately explain male infertility. According to the literature, about 15% of infertile patients have normal sperm parameters. Sperm DNA fragmentation may be one of the causes of male infertility. According to the latest editio...

Background: The introduction of time-lapse incubators into assisted reproductive technology practices provides a detailed examination of human pre-implantation embryo development. The continuous time-lapse filming technology is used to determine prognostic markers of embryo viability and implantation potential based on morphokinetic parameters. At...

Background: The treatment strategy for patients with a history of multiple failures in in vitro fertilization cycles remains a subject of active research. Embryo transfer in cryocycles is known to be more successful than “fresh” embryo transfer, when ovarian stimulation, follicle puncture, fertilization, and embryo culture were performed but the ov...

BACKGROUND: The adipokines leptin, adiponectin, and ghrelin are expressed not only in adipose tissue but also in the hypothalamic-pituitary-gonadal axis organs and the uterus. They regulate the gonadotropin-releasing hormone and gonadotropin secretion, steroidogenesis, folliculogenesis, and implantation, and serve as promising markers of assisted r...

BACKGROUND: The effectiveness of in vitro fertilization cycles / frozen-thawed embryo transfer cycles depends on a number of factors, the endometrial one being of great importance. Adequate endometrial and subendometrial blood supply is considered necessary for successful implantation. Currently, the possibilities of non-invasive assessment of the...

Background and Aims: Despite keen development of ART, recurrent implantation failure (RIF) remains a challenging dilemma for fertility specialists. As it contains significant growth factors involved in delicate process of implantation, platelet–rich plasma (PRP) therapy should promote endometrial receptivity and improve ART. Objective: To evaluate...

The effectiveness of the use of a modified intrauterine gel form of granulocyte colony stimulating factor in the complex treatment of Ascherman syndrome is evaluated. The study involved 31 patients with a history of Ascherman syndrome. For 6 months, the patients underwent weekly intrauterine administration of 1 ml of gel with a concentration of gra...

Objective. To determine the correlation between fatty acid (FA) levels in follicular fluid (FF) and outcomes of assisted reproductive technology (ART) programs depending on body mass index (BMI). Patients and methods. A total of 120 patients with infertility undergoing ART protocols were divided into three groups: normal BMI (group 1; n = 40), over...

BACKGROUND: Approximately two thirds of all implantation failures are due to impaired endometrial receptivity. The lack of implantation may be due to an implantation window failure found in approximately 25-30% of women with a history of failure to perform assisted reproductive technology protocols. The receptivity phase in such patients can be shi...

BACKGROUND: A high percentage of the infertile couples are classified as having unexplained infertility. At the same time, male partners may have both normozoospermia and high level of sperm DNA fragmentation. The investigation of the selectivity of the oocyte zona pellucida for spermatozoa with fragmented DNA is an extremely promising direction. T...

BACKGROUND: Alteration in the composition and function of endometrial immune cells, in particular NK cells, are associated with implantation and placentation pathology, which is considered as one of the causes of reproductive losses. However, data regarding abnormalities in the number and activity of NK cells in repeated implantation failures, incl...

The impact of coronavirus on the reproductive health of men attracts the special attention of many researchers. While studies suggest changes in sperm parameters and the possibility of testicular inflammation, further studies are needed to elucidate any potential age-related changes in these findings, which is the purpose of the present study. The...

BACKGROUND: Sufficient endometrial blood supply in the mid-secretory phase of the menstrual cycle is a key to a successful pregnancy achievement, and a decreased spiral artery blood flow resistance determined by the Doppler is known to be positively associated with successful in vitrofertilization outcome. Particular aspects of endometrial blood fl...

The search for simple morphological predictors of oocyte quality is an important task for assisted reproduction technologies (ARTs). One such predictor may be the morphology of the oocyte nucleus, called the germinal vesicle (GV), including the level of chromatin aggregation around the atypical nucleolus (ANu)—a peculiar nuclear organelle, formerly...

Study question To evaluate if the intrauterine perfusion with autologous PRP enhances frozen-thawed embryo transfer effectiveness in patients with recurrent implantation failure (RIF) after PGT-A. Summary answer The intrauterine perfusion (IP) with autologous PRP should be considered perspective, effective and safe therapeutic tool for patients wi...

Predicting the clinical outcomes of intracytoplasmic sperm injection (ICSI) cycles that use the testicular spermatozoa of azoospermic patients presents a challenge. Thus, the development of additional approaches to assessing the competence of a testicular-sperm-derived embryo without causing damage to gametes or the embryo is necessary. One of the...

Passive transfer of antithyroid antibodies in mice leads to reproductive disorders. The purpose was to assess the placental tissue of experimental animals under the influence of the circulating thyroperoxidase antibodies. We performed an immunohistochemical examination of murine placentae after a passive transfer of thyroperoxidase antibodies. Plac...

Background. The epigenome of gametes is formed under the control of the developmental programme and the influence of environmental factors. How cytosine oxidation patterns are formed and altered in human spermatogenesis remains obscure so far. The aim of the study was to assess 5-formylcytosine (5fC) and 5-carboxylcytosine (5caC) patterns in human...

Из известных причин маточного фактора бесплодия наиболее часто выделяют синдром Ашермана или так называемые внутриматочные синехии, хронический эндометрит и гипопластические процессы эндометрия. Синдром тонкого эндометрия характеризуется снижением его толщины до 7 мм и менее в пролиферативную фазу менструального цикла и кратным снижением частоты им...

The endometrium has traditionally been considered sterile. Nowadays, active studies are performed on the female upper genital tract microbiota. Bacteria and/or viruses colonizing the endometrium are known to alter its functional properties, including receptivity and embryo implantation. Uterine cavity inflammation caused by microorganisms leads to...

BACKGROUND: According to reports, the efficiency of in vitro fertilization and intra cytoplasmic sperm injection protocols is decreased in patients positive for various autoantibodies, as opposed to autoantibody negative patients. However, there are contradictory data indicating no autoantibody effect on the outcome of infertility treatment using a...

Autoimmune thyroid disease (AITD) is one of the most common endocrinopathies and is more prevalent in women. It becomes evident that the circulating antithyroid antibodies that often follow AITD have effects on many tissues, including ovaries, and therefore that this common morbidity might have an impact on female fertility, the investigation of wh...

Background. Throughout folliculogenesis the oocyte is surrounded by cumulus cells that regulate its growth and maturation through a series of signaling molecules transmitted via multiple gap junctions. Mitochondrial dysfunction in both the oocyte and cumulus cells can lead to impaired oocyte fertilization and ultimately result in the production of...

BACKGROUND: It is common a wide range of reproductive disorders in couples with structural chromosome aberration in one of the partners, such as infertility, miscarriage, unsuccessful assisted reproductive technologies attempts. In this regard, predicting the reproductive outcome in a particular couple is an extremely difficult task. To solve it, i...

Aim. To evaluate the effectiveness of Alloferon (Allokin-alfa) in the complex treatment of virus-associated chronic endometritis (CE) in patients with infertility, papillomavirus infection (PVI) persisting in the uterine cavity, and recurrent herpes-virus infection localized in the genital area. Materials and methods. A prospective (n=33) open ran...

BACKGROUND: At present, the knowledge on initial human embryogenesis stages is limited to the period of development from zygote to blastocyst. The creation of models based on the interaction between the embryo and endometrium in vitro, which accurately imitate the in vivo processes, represents the major way for implantation and post-implantation ev...

BACKGROUND: Mitochondria play vital roles in oocyte functions and they are critical indicators of oocyte quality which is important for fertilization and development into viable offspring. Quality-compromised oocytes in which mitochondrial dysfunction plays a significant role are correlated with infertility, developmental disorders and embryo loss....

This paper suggests an approach for the use of a single paucicellular histological sample to investigate two characteristics indicative of the cell’s functional potential: 1) the content of telomerase reverse transcriptase (TERT) and 2) the telomere length. An algorithm has been suggested for the successive detection of the catalytic telomerase sub...

SARS-CoV-2 negatively affects semen characteristics, impairs various biochemical processes in seminal fluid and within spermatogenic cells ultimately leading to male fertility decline. However, the distinct mechanisms, in particular, the role of oxidative stress on the consequences of coronavirus infection, have not been well investigated, which is...

Иммуноглобулины для внутривенного введения (ВВИГ) применяют в терапии бесплодия. Предполагается влияние ВВИГ на цитотоксическую функцию NK-клеток, однако механизм действия ВВИГ остается неясным. Цель: Оценка влияния препарата ВВИГ на цитотоксичность NK-клеток в отношении клеток-мишеней линии К-562 и клеток трофобласта линии JEG-3. Материалы и метод...

Study question Which follicular fluid (FF) autoantibodies influence oocyte quality and its fertilization potential in the settings of IVF-ICSI? Summary answer The measured follicular fluid levels of anti-thyroperoxidase and anti-aromatase antibodies are associated with lower number of mature oocytes and fertilization rate in IVF-ICSI cycles. What...

BACKGROUND: Cell therapy is a promising trend in treating characterized by inflammation and sclerosis diseases such as genital tuberculosis, marked by pelvic inflammatory disease and uterine tube occlusion. AIM: Efficacy evaluation of combined mesenchymal stem cells and specific polychemotherapy treatment of the experimental genital tuberculosis. M...

BACKGROUND: According to most studies, the efficacy of IVF/ICSI protocols in patients with suboptimal response was significantly lower than in women with normal response. However, methodological approaches optimizing the efficacy of IVF/ICSI protocols in patients with suboptimal response have not been developed. AIM: The aim of this study was to ev...

Currently, there is sufficient evidence that the presence of antithyroid antibodies (ATA), even in patients with euthyroidism, could be an independent risk factor for a complicated pregnancy. However, the mechanisms of the pathogenic effects of ATA on the reproductive system remain unclear. The purpose of this chapter is to review the possible mech...

The current trend of late pregnancy planning produced increases the need for ART programs, which effectiveness is largely determined by the personalization of existing protocols due to the burden of obstetric-gynecological and somatic anamnesis of patients. Recent studies have shown that full-fledged proliferation and secretory transformation of th...

According to reports, the efficiency of IVF/ICSI protocols is decreased in antithyroid antibodypositive patients as opposed to antibody negatives. However, there are opposite data indicating the absence of the antibody’s impact on the outcome of infertility treatment with assisted reproductive technologies. The prospective study enrolled 90 patient...

Introduction Adipokines are involved in the regulation of the female reproductive system. The purpose was to study the possibility of using adipokines levels in the follicular fluid to predict IVF efficiency. Materials and methods Four groups of women were studied: pregnant during IVF, with normal (PN, n = 9) and increased (BMI > 25 kg/m²) body we...

T-lymphocytes are present in the endometrium before pregnancy and their number varies depending on menstrual cycle stage. Despite T-lymphocyte population heterogeneity, there is no clear vision of general mechanisms of decidua T-lymphocyte pool formation. One of the assumed variants is T-lymphocyte proliferation in situ. The study objective is to e...

Aim. To study a stress-protective efficacy of micronized progesterone (MP) in pregnant women with anxiety disorders after in vitro fertilisation (IVF). Materials and methods. We conducted a prospective, comparative open-label randomized trial in two IVF-clinics. A total of 98 pregnant women after IVF with anxiety disorders were recruited at the 9t...

Study question Can the adipokines levels and ratios in the follicular fluid (FF) be used to predict in vitro fertilization (IVF) outcomes? Summary answer The leptin level and ratios leptin/ghrelin and leptin/adiponectin in FF are reliable prognostic factors for IVF outcomes in women with normal body mass index (BMI). What is known already The adi...

The human lifespan is strongly influenced by telomere length (TL) which is defined in a zygote—when two highly specialised haploid cells form a new diploid organism. Although TL is a variable parameter, it fluctuates in a limited range. We aimed to establish the determining factors of TL in chromosomes of maternal and paternal origin in human tripl...

Hypothesis/Aims of study: According to the number of oocytes retrieved in IVF/ICSI protocols, the ovarian response to controlled ovarian stimulation is divided into: poor (03 oocytes), suboptimal (49 oocytes), normal (1015 oocytes) and excessive (15 oocytes) response. However, the effectiveness of IVF / ICSI programs in women with a suboptimal resp...

Hypothesis/Aims of study. Currently, the frequency of suboptimal response (4-9 retrieved oocytes) to controlled ovarian stimulation (COS) in woman is quite high; however, its efficacy is poorly studied. The aim of this study was to evaluate the main characteristics of IVF / ICSI programs in patients with a suboptimal response to COS. Study design,...

We studied the impact of age and the serum anti-Müllerian hormone (AMH)/follicle-stimulating hormone (FSH) levels on the number of cumulus–oocyte complexes (COCs) retrieved from female reciprocal and Robertsonian translocation carriers after controlled ovarian hyperstimulation (COH). The number of COCs retrieved after COH was retrospectively analyz...

Hypothesis/aims of study. To date, one of the most important avenues of research in the field of reproductive medicine is the searching for new biochemical markers of oocyte quality and the prediction of the effectiveness of in vitro fertilization (IVF) protocols. The aim of this study was to assess the effect of relaxin levels in blood serum and f...

Objective The present study was to estimate the role of cytokines for trophoblast death in NK cells presence. Methods This study involves assessment of NK-92 line NK cell cytotoxic activity against JEG-3 line cells, in presence of cytokines. We also assessed the effect of secretory placenta products on NK cell cytotoxic activity toward JEG-3 line...

The unique physical properties considered of graphene to be especially perspective for photothermal therapy complex, drug address delivery to the target organs, and some other fields. Objective The objective of our study was to explore the possible graphene impact on microorganism growth as well as on laboratory animal overall condition. Materials...

This article reviews the literature data on the mechanisms of the obesity effect on the in vitro fertilization (IVF) clinical efficacy and discusses the main directions of improving assisted reproductive technology data for overweight women. It was noted that the multi-level effect of obesity is manifested by a decrease in the frequency of clinical...

Problem: Antibody-mediated-autoimmune diseases such as autoimmune thyroid diseases (ATD), systemic-lupus-erythematosus (SLE) and antiphospholipid-syndrome (APS), often are associated with recurrent fetal loss. One of the ATD is Hashimoto's thyroiditis which recently showed association with complications of pregnancy with increased levels of circul...

Hypothesis/aims of study. Ovarian insufficiency is present in more than 30% of reproductive-age obese women. The role of leptin in the pathogenesis of ovarian insufficiency is not yet established and has to be clarified. It is of interest to study the effect of obesity therapy on hyperleptinemia, hormonal and ovulatory function in reproductive-age...

Hypothesis/aims of study. The management of poor responders to ovarian stimulation for in vitro fertilization (IVF) has always been a challenge. It is difficult for both doctors and patients to make decision to proceed to oocyte donation or abandon fertility treatment. More predictors of successful IVF treatment in poor responders are needed. The a...

Hypothesis/aims of study. Poor ovarian response is still considered one of the most challenging tasks in reproductive medicine. Poor responders have decreased circulating androgens during spontaneous cycles. Androgens are known to play an important role in follicular growth and development. Hence, the use of various androgens and androgen inhibitor...

The adipose tissue is an essential endocrine organ. The adipokines produced by this tissue, which include leptin, adiponectin, apelin, visfatin and resistin, regulate many body functions. Being an endogenous regulator and modulator of the male and female reproductive systems, leptin acts on all components of the hypothalamic-pituitary-gonad axis. I...

Autoimmune gonadal lesions represent a highly heterogenous conditions affecting men and women of reproductive age and resulting in loss of endocrine function and, eventually, infertility. Well-known and well-documented risk factors exist, and the presence or suspicion of autoimmune disorder should be regarded as an important one. For the purpose of...

There is evidence suggesting that autoimmune mechanisms may influence fertility, manifesting as infertility or pregnancy loss. Numerous autoimmune diseases, including but not limited to systemic lupus erythematosus, anti-phospholipid syndrome and Hashimoto thyroiditis may be associated with infertility and pregnancy loss through different putative...

In the early 2000s, the determination of inhibin levels was used actively for the diagnosis of ovarian tumors, as a diagnostic marker for prenatal screening of Down syndrome, as well as a prognostic marker for ovarian reserve when conducting assisted reproductive technologies. However, to date, inhibin is rarely used as a marker for reproductive fu...

We report on the phenotype and the reproductive history of an adult female patient with an unbalanced karyotype: 8p23 and 18p11.3 terminal deletions and 8p22 duplication. The indication for karyotyping of the 28-year-old patient was a structural rearrangement in her miscarriage specimen: 45,ХХ,der(8;18)t(8;18)(p23;p11.3). Unexpectedly, the patient...

While overt hypothyroidism is a well-known risk factor for infertility, the association of subclinical hypothyroidism (SCH) or thyroid autoimmunity with reproductive failure has been still not cleared. This literature review focuses on the most current data linking SCH and/or thyroid autoimmunity with human reproduction, starting with the parameter...

While overt hypothyroidism is a well-known risk factor for infertility, the association of subclinical hypothyroidism (SCH) or thyroid autoimmunity and reproductive failure has been still not elucidated. In this literature review, the current data on the effect of SCH and/or thyroid autoimmunity and human reproduction is presented. The main ART out...

The trial objective was to determine the peripheral blood NK cells cytotoxic activity effect on trophoblast cells at recurrent pregnancy loss (RPL). The investigation involved non-pregnant women with PRL in proliferating and secretory menstrual cycle phases (PMCPh and SMCPh, respectively); women of 6–7 weeks pregnancy with RPL in past medical histo...

Study question: Does past or persistent chlamydial infection affect the response to controlled ovarian stimulation in women with tubal factor infertility undergoing in vitro fertilization (IVF)? Summary answer: IgG-antibody positivity to C.trachomatis, as serological evidence of past infection, is associated with both ‘expected’ and actual poor ova...

The article presents an overview of current data regarding reproductive health in female athletes, rationale and possibility of hormonal contraception use, as well as the role of licit hormonal agent use in reproductive health maintenance and restoration among female athletes.

Granulocyte colony-stimulating factor (G-CSF) promotes proliferation, survival, and differentiation of myeloid-lineage cells, as well as normal hematopoietic cells. The immunomodulating effects of G-CSF, which consist in stimulating the Th2 biased type immune response, prevent the development of graft-versus-host disease (GvHD) and, as a special ca...

Metabolic fingerprinting is a powerful analytical technique, giving access to a high-throughput identification and relative quantification of multiple metabolites. Due to short analysis times, MALDI-TOF-MS is the preferred instrumental platform for fingerprinting, although its power in analysis of free fatty acids (FFAs) is limited. However, these...

The immunofluorescent study of genomic distribution of 5-formylcytosine and 5-carboxylcytosine in human preimplantation development – from the zygote up to the blastocyst stage – suggests a timeline of epigenetic reprogramming of the chromatin regions with different structure and functions.

Poster Discussion Session

The necessity for comprehensive assessment of endometrial morphology and function in women with repeated IVF failure along with the lack of the non-invasive assessment methods oblige us to perform an invasive intrauterine procedure to get endometrial samples. However, even the minimally invasive intrauterine procedures carry a slight risk of infect...

Background. Pelvic inflammatory disease (PID), including chronic endometritis (CE), is a factor leading to endometrial receptivity disorder and in vitro fertilization (IVF) failures. The role of microorganisms in colonizing the endometrium, the pathogenesis of chronic inflammation, and associated infertility require further study. Aims: To determin...

The purpose of the study. To determine the main indicators of the effectiveness of IVF programs in over-weight and obese patients. Based on the Research Institute of obstetrics, gynecology, and reproductology D.O. Ott, we conducted an analysis involving women aged 18–39 years who were treated in the IVF program in the department of assistive techno...

Introduction. Cytochrome P450 aromatase is a key enzyme in the biosynthesis of estrogens from androgens. Some gynecological diseases are accompanied with changes in the activity of ovarian aromatase. Moreover, changes in the acti vity of ovarian aromatase are associated with the response to standard gonadotrophin stimulation in women undergoing in...

Hypothesis/aims of study. Questions regarding the pathogenesis of urine incontinence and methods of treatment are acti vely discussed by gynecologists, urologists, and neuropathologists. Urine incontinence often has multifactor origins: the causes of urine incontinence are connected, as a rule, with the violation of urine continence functional mech...

Изобретение относится к области медицины, а именно к репродуктивной медицине, и может быть использовано для оценки риска невынашивания беременности. Для этого определяют цитотоксическую активность NK-клеток периферической крови в секреторной фазе менструального цикла в отношении клеток трофобласта линии Jeg-3, и, если значение цитотоксической актив...

A new procedure for the analysis of saturated fatty acids by the MALDI-TOF method was developed using Langmuir–Blodgett technology and myristic, palmitic and stearic acids as examples. The advantages of proposed procedure include simplicity, rapidness, and high sensitivity of the analysis.

Preimplantation genetic testing performed to analyze the chromosomal structural rearrangements, monogenic/single gene defects and aneuploidies. The aim of this study is to show the discussion of a clinical case of preimplantation genetic testing in the family of SMN1 gene mutation carriers with the subsequent birth of a healthy child. (For citation...

Hypothesis/aims of study. Questions of urine incontinence pathogenesis and ways of treatment are actively discussed by gynecologists, urologists and neuropathologists. Urine incontinence often has multifactor origin: the causes of urine incontinence are connected, as a rule, with violation of urine continence functional mechanisms, anatomical and t...

Context: Worldwide clinical application of blastocyst cryopreservation is explained by relatively high pregnancy rates, but is as well associated with cycle cancellation due to reduced embryo quality or failure of blastulation. At the stage of morula embryo requires less technical manipulations during cryopreservation process, thus, might have bett...

Context: Worldwide clinical application of blastocyst cryopreservation is explained by relatively high pregnancy rates, but is as well associated with cycle cancellation due to reduced embryo quality or failure of blastulation. At the stage of morula embryo requires less technical manipulations during cryopreservation process, thus, might have bett...

Context: Stem cells homing, the process of stem cells (SC) delivery to the site of injury, is one of the key aspect of cell-based therapies. А competitive tropism of SC to different tissues complicates our understanding of the mechanisms of the site-specific SC recruitment and precludes the process management for therapeutic purposes. Objective: To...

To estimate the efficacy of growth hormone (GH) co-treatment within an antagonist protocol in IVF/ICSI cycles in poor responders. A prospective observational study involving 50 patients underwent a standard antagonist protocol with or without GH co-treatment. GH was administered by a daily subcutaneous injection of 1,33 mg (equivalent to 4 IU) star...