Preliminary Results for Personalized Therapy in Pregnant Women with Polycystic Ovary Syndrome During the COVID-19 Pandemic

IF 2.9 4区 医学 Q3 IMMUNOLOGY Archivum Immunologiae et Therapiae Experimentalis Pub Date : 2022-03-24 DOI:10.1007/s00005-022-00650-z
Małgorzata Jerzak, Monika Szafarowska
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Abstract

Increased androgen level, hyperinsulinemia, diabetes, impaired fibrinolysis, obesity, hypertension, chronic inflammation, abnormal immune response to infections and hyperhomocysteinemia are the most common abnormalities related to polycystic ovary syndrome (PCOS) women and are the factors predisposing to the severe course of COVID-19. The SARS-Cov-2 infection during pregnancy is associated with an increased risk of complications (spontaneous abortion), similar to those in PCOS. The treatment of PCOS pregnant women with a history of fertility failures raises many doubts, especially during the COVID pandemic. However, due to the increasing incidence of infections among reproductive people and the potentially more serious course in pregnant women, numerous questions about the safety and effectiveness of the treatment are still very current. In our study we presented a series of cases of recurrent miscarriages or recurrent implantation failure PCOS pregnant women with confirmed COVID-19. The diagnosis of infertility confirmed the presence of plasminogen activator inhibitor type 1 and/or 5,10-methylenetetrahydrofolate reductase polymorphisms in each of them. Moreover, some of the women presented immune dysfunction associated with infertility. We have described the personalized treatments of each pregnant patient included: metformin, enoxaparin and tacrolimus. The treatment applied had the expected effect, supporting the implantation processes. Furthermore, despite the ambiguous data according to immunological therapy of infertile women during the COVID pandemic, we observed a mild or asymptomatic COVID-19 course and we noticed no pregnancy complications.

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COVID-19大流行期间孕妇多囊卵巢综合征个体化治疗的初步结果
雄激素水平升高、高胰岛素血症、糖尿病、纤维蛋白溶解功能受损、肥胖、高血压、慢性炎症、对感染的异常免疫反应和高同型半胱氨酸血症是与多囊卵巢综合征(PCOS)女性相关的最常见异常,是导致COVID-19严重病程的因素。怀孕期间感染SARS-Cov-2与并发症(自然流产)的风险增加有关,类似于多囊卵巢综合征。有生育失败史的多囊卵巢综合征孕妇的治疗引起了许多疑问,特别是在COVID大流行期间。然而,由于在生育人群中感染的发生率不断增加,并且孕妇可能出现更严重的病程,关于治疗的安全性和有效性的许多问题仍然非常紧迫。在我们的研究中,我们报告了一系列确诊为COVID-19的PCOS孕妇复发性流产或复发性植入失败的病例。不孕症的诊断证实了纤溶酶原激活物抑制剂1型和/或5,10-亚甲基四氢叶酸还原酶多态性的存在。此外,一些妇女出现与不孕有关的免疫功能障碍。我们描述了每个孕妇的个性化治疗包括:二甲双胍,依诺肝素和他克莫司。所采用的治疗方法达到了预期的效果,支持了种植过程。此外,尽管关于COVID大流行期间不孕妇女免疫治疗的数据不明确,但我们观察到轻度或无症状的COVID-19病程,并且没有发现妊娠并发症。
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来源期刊
CiteScore
5.90
自引率
0.00%
发文量
26
审稿时长
>12 weeks
期刊介绍: Archivum Immunologiae et Therapiae Experimentalis (AITE), founded in 1953 by Ludwik Hirszfeld, is a bimonthly, multidisciplinary journal. It publishes reviews and full original papers dealing with immunology, experimental therapy, immunogenetics, transplantation, microbiology, immunochemistry and ethics in science.
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