Kazan medical journalKazan medical journalКазанский медицинский журнал0368-48142587-9359Eco-Vector10572610.17816/KMJ2022-761Theoretical and clinical medicineТеоретическая и клиническая медицинаResearch ArticleOvarian hyperstimulation syndrome in assisted reproductive technology programs in the ­Republic of BashkortostanСиндром гиперстимуляции яичников в программах вспомогательных репродуктивных технологий в Республике Башкортостанhttps://orcid.org/0000-0003-0980-629XSugurovaAlfiya T.СугуроваАльфия Тлешевна
Russian Federation

PhD Stud., Depart. of Obstetrics and Gynecology

аспирант, каф. акушерства и гинекологии с курсом ИДПО

alf84@bk.ruhttps://orcid.org/0000-0002-7045-8215MinniakhmetovIldar R.МинниахметовИлдар Рамилевич
Russian Federation

Cand. Sci. (Biol.), Assoc. Prof.

канд. биол. наук, доц., каф. медицинской генетики и фундаментальной медицины ИДПО

minniakhmetov@gmail.comhttps://orcid.org/0000-0001-6657-8081TyurinaAlla A.ТюринаАлла Алексеевна
Russian Federation

M.D., Cand. Sci. (Med.), Assistant, Depart. of Obstetrics and Gynecology

канд. мед. наук, ассистент, каф. акушерства и гинекологии с курсом ИДПО

alla.0888@mail.ruhttps://orcid.org/0000-0002-8643-850XKhusainovaRita I.ХусаиноваРита Игоревна
Russian Federation

D. Sci. (Biol.), Prof., Depart. of Medical Genetics and Fundamental Medicine

докт. биол. наук, проф., каф. медицинской генетики и фундаментальной медицины ИДПО

ritakh@mail.ruhttps://orcid.org/0000-0003-2645-1662YashchukAlfiya G.ЯщукАльфия Галимовна
Russian Federation

M.D., D. Sci. (Med.), Prof., Head, Depart. of Obstetrics and Gynecology

докт. мед. наук, проф., зав. каф., каф. акушерства и гинекологии с курсом ИДПО

alfiya_galimovna@mail.ruBashkir State Medical UniversityБашкирский государственный медицинский университет0310202210357617723103202221092022Copyright ©; 2022, Eco-VectorCopyright ©; 2022, Эко-Вектор2022Eco-VectorЭко-Векторhttps://kazanmedjournal.ru/kazanmedj/article/view/105726

Background. Ovarian hyperstimulation syndrome is a fatal complication of unknown etiology. In connection with the increase in the frequency of this complication, it is necessary to identify prognostically significant markers to discover the risk of its development.

Aim. To analyze the frequency of ovarian hyperstimulation syndrome and search for the association of genes for differential growth factor 9, luteinizing hormone/horiogonadotropin receptor, and follicle-stimulating hormone receptor with different responses to ovulation stimulation.

Material and methods. A retrospective single-center cohort study of the frequency and clinical parameters of early ovarian hyperstimulation syndrome was carried out in 147 patients, the average age was 36.5 [33–38] years, who underwent an in vitro fertilization program in the period 2006–2021 in the Department of Assisted Reproductive Technologies of the Republican Medical Genetic Center in Ufa. The study of polymorphic loci of the genes for differential growth factor 9, luteinizing hormone/choriogonadotropin receptor, and follicle-stimulating hormone receptor was performed using TaqMan technology and real-time polymerase chain reaction. Deoxyribonucleic acid was isolated from peripheral blood samples. Statistical analysis was performed using the Kruskal–Wallis criteria, median test, Pearson's χ2 test, using the Statistica 12 software package.

Results. 7577 procedures of assisted reproductive technologies were performed. 147 (2.3%) cases of ovarian hyperstimulation syndrome were registered, 53 (0.8%) cases of moderate and severe degree, 84 (1.3%) cases of mild degree. The *CT genotype of the rs254286 polymorphic locus of the differential growth factor 9 gene was associated with a poor ovarian response 15 (0.75); (χ2=4.00; p=0.02; odds ratio 3.4; 95% confidence interval 1.13–10.27). The distribution of allele and genotype frequencies of the other studied genes did not differ statistically significantly in all the studied groups.

Conclusion. The frequency of ovarian hyperstimulation syndrome in the Republic of Bashkortostan was 2.3%; the *CT genotype of the rs254286 polymorphic locus of the differential growth factor 9 gene, as well as the level of anti-Müllerian hormone, can serve as markers of a poor response and ovarian hyperstimulation to ovulation stimulation.

Актуальность. Синдром гиперстимуляции яичников — осложнение, приводящее к смертельным исходам, этиология которого неизвестна. В связи с ростом частоты данного осложнения необходимо идентифицировать прогностически значимые маркёры, позволяющие выявить риск его развития.

Цель. Провести анализ частоты синдрома гиперстимуляции яичников и поиск ассоциации генов дифференциального фактора роста 9, рецептора лютеинизирующего гормона/хориогонадотропина, рецептора фолликулостимулирующего гормона с различным ответом на стимуляцию овуляции.

Материал и методы исследования. Проведено ретроспективное одноцентровое когортное исследование частоты и клинических параметров раннего синдрома гиперстимуляции яичников у 147 пациенток, средний возраст составил 36,5 [33–38] года, проходивших программу экстракорпорального оплодотворения в период 2006–2021 гг. в отделении вспомогательных репродуктивных технологий Республиканского медико-генетического центра г. Уфы. Изучение полиморфных локусов генов дифференциального фактора роста 9, рецептора лютеинизирующего гормона/хориогонадотропина, рецептора фолликулостимулирующего гормона проводили с использованием технологии TaqMan и полимеразной цепной реакции в реальном времени. Дезоксирибонуклеиновая кислота выделялась из образцов периферической крови. Статистический анализ выполнен с применением критериев Краскела–Уоллиса, медианного теста, критерия χ2 Пирсона, использовали пакет программ Statistica 12.

Результаты. Проведено 7577 процедур вспомогательных репродуктивных технологий. Зарегистрировано 147 (2,3%) случаев синдрома гиперстимуляции яичников, 53 (0,8%) случая средней и тяжёлой степени, 84 (1,3%) случая лёгкой степени. Генотип *СТ полиморфного локуса rs254286 гена дифференциального фактора роста 9 ассоциировался с бедным ответом яичников — 15 (0,75); (χ2=4,00; р=0,02; отношение шансов 3,4; 95% доверительный интервал 1,13–10,27). Распределение частот аллелей и генотипов остальных изученных генов статистически значимо не различалось во всех исследованных группах.

Вывод. Частота синдрома гиперстимуляции яичников в Республике Башкортостан составила 2,3%; генотип *СТ полиморфного локуса rs254286 гена дифференциального фактора роста 9, а также уровень антимюллерова гормона могут служить маркёрами бедного ответа и гиперстимуляции яичников на стимуляцию овуляции.

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