https://repo.odmu.edu.ua:443/xmlui/handle/123456789/801 2026-08-31T20:09:03Z https://repo.odmu.edu.ua:443/xmlui/handle/123456789/20278 Impact of endometriosis on ovarian reserve and female reproductive function: a review of current evidence Volianska, A. G.; Shytova, H. V.; Lavrynenko, G. L.; Kormilets, O. Yu.; Волянська, А. Г.; Шитова, Г. В.; Лавриненко, Г. Л.; Кормілець, О. Ю. Objective. To evaluate the impact of endometriosis on ovarian reserve and to analyze the mechanisms underlying its detrimental effects on ovarian function based on current literature. Materials and Methods. This review included original studies, systematic reviews, meta-analyses, and clinical guidelines published in Ukrainian and English. Relevant publications were identified by searching PubMed, Scopus, Google Scholar, and the Cochrane Library using keywords such as endometriosis, fertility, pathophysiology, endometrioma, ovarian reserve, and surgery. Results and Discussion. The review summarizes current evidence on endometriosis-associated infertility, focusing on the impact of endometriomas on ovarian reserve. Ovarian endometriosis negatively affects ovarian reserve and reproductive outcomes. Anti-Müllerian hormone (AMH) is a key marker in clinical assessment. Most studies demonstrate reduced AMH levels in patients with endometriomas even before surgery, indicating primary ovarian damage caused by chronic inflammation, oxidative stress, fibrosis, and mechanical follicular loss. Comparative analyses show that combined surgical approaches are associated with lower recurrence rates and higher spontaneous pregnancy rates than ablative techniques. However, reproductive prognosis should not rely solely on AMH. Evidence suggests its limited predictive value for spontaneous conception, while a comprehensive assessment of infertility factors provides more accurate prediction of reproductive outcomes. Conclusions. Endometriosis-associated infertility is multifactorial. Management should be individualized and based on an integrated evaluation of clinical, historical, hormonal, ultrasonographic, and surgical factors to improve reproductive outcomes.; Мета роботи – оцінити вплив ендометріозу на оваріальний резерв і механізми впливу захворювання на стан яєчників за даними літератури. Проаналізовано оригінальні дослідження, огляди, метааналізи та клінічні настанови (PubMed, Scopus, Google Scholar та Cochrane). Результати дослідження показали, що ендометріоз яєчників негативно впливає на оваріальний резерв і репродуктивні результати пацієнток із безпліддям. Рівень АМГ знижений у пацієнток з ендометріомами до оперативного втручання, що свідчить про ураження оваріальної тканини через запалення, оксидативний стрес, фіброз тканини яєчника та його механічне руйнування. Комбіновані хірургічні технології мають кращі результати щодо рецидивів і вагітності. Прогноз настання спонтанної вагітності не слід базувати лише на показниках АМГ. Пацієнки з ендометріоз-асоційованим ендометріозом потребують мультифакторного підходу. 2026-01-01T00:00:00Z https://repo.odmu.edu.ua:443/xmlui/handle/123456789/20226 Perinatal mental health and reproductive behavior among women in wartime Ukraine: a cohort study protocol Krupelnytska, L.; Yatsenko, N.; Molotokas, A.; Morozova-Larina, O.; Vavilova, A.; Baratiuk, A.; Kazakov, S.; Artyomenko, V. War reshapes the conditions under which reproductive decisions are made and pregnancy is experienced. Prolonged insecurity, displacement, economic instability, disruption of healthcare, and reduced social support may lead women and families to postpone pregnancy or face pregnancy and childbirth under constrained conditions. These challenges highlight the need for research on how war-related stress and trauma affect women’s reproductive behavior and perinatal mental health. Method: This prospective cohort study will recruit at least 328 women through healthcare institutions providing reproductive and perinatal care. Eligible participants will include non-pregnant women, pregnant women, and women within the first year postpartum. Where feasible, partners of enrolled women will also be included to provide complementary dyadic data. Participants will be followed from baseline to 3, 6, and 12 months. Data will be collected through web-based questionnaires and routine clinical records. No experimental intervention will be delivered, and participation in the study will not modify standard clinical care. Repeated measures will capture mental health, reproductive intentions and behavior, war-related and perinatal experiences, and key sociodemographic and obstetric characteristics. Primary analyses will use mixed-effects models to examine mental-health trajectories, with reproductive status modeled both as a baseline cohort characteristic and, where participants change status during follow-up, as a time-varying covariate; reproductive transitions will also be examined as secondary longitudinal outcomes. Discussion: This protocol addresses an important gap by using a longitudinal design to examine women’s experiences in a wartime setting. By situating mental health within disrupted reproductive plans, insecurity, healthcare strain, and family-level experiences, the study may help identify how armed conflicts shape both psychological vulnerability and reproductive decision-making. The findings may inform more responsive care for women affected by war. 2026-01-01T00:00:00Z https://repo.odmu.edu.ua:443/xmlui/handle/123456789/20205 The psychosomatic status of pregnant and puerperal women in a crisis situation of military actions in Ukraine: results of 10 months of the health and social project of the odesa branch of the association of ob/gynecologists of Ukraine Manasova, G.; Zhovtenko, O.; Shpak, I.; Shpatakovskaya, G. The socio-political state of any society determines the culture and quality of maternity care, determines the development and psychophysical health of the nation for generations to come. With the start of Russia's full-scale invasion of Ukraine on February 24, 2022, Ukraine's basic safety and security needs, especially for pregnant/puerperal women, have been disrupted. Aim: Study of the psychosomatic state of pregnant /puerperal women who found themselves in f military operations, with the aim of stabilizing and improving the demographic situation in Ukraine. 2024-01-01T00:00:00Z https://repo.odmu.edu.ua:443/xmlui/handle/123456789/20192 Ukrainian students’ conceptualisations of sexual and reproductive health and rights within a transformative learning programme during wartime: a qualitative study Klimanska, M.; Borneskog, C.; Haletska, I.; Erlandsson, K.; Klos, L.; Herasym, H.; Mogilevkina, I.; Marichereda, V.; Borshch, V.; Nitochko, K.; Klymanska, L. Sexual and reproductive health and rights (SRHR) education is particularly important in wartime Ukraine, where young people face disrupted access to services, persistent socio -cultural taboos, and increased vulnerability related to conflict. However, little is known about how Ukrainian students and future professionals understand and make sense of SRHR. Objective: This study explored how SRHR was conceptualised in pre -course written responses and articulated in post -course focus group reflections, and how these framings related to students’ future professional readiness in wartime Ukraine. Methods: A qualitative exploratory design was used. Data comprised pre -course open -ended responses (n = 15) and post -course focus group discussions (three groups; n = 16) from voluntary participants of the same international SRHR course. The two datasets were analysed using framework analysis and treated as complementary qualitative sources rather than as matched individual -level pre -post data. Results: Pre-course written responses showed that students mostly understood SRHR in biomedical and informational terms, focusing on reproductive health, contraception, sexually transmitted infections, and access to medical services. In post -course focus group reflections, SRHR was discussed more broadly, with attention to psychological, social, ethical, institutional, and rights -based dimensions: students reflected on professional responsibility, youth -friendly services, structural barriers, and the importance of SRHR in the context of war. Conclusions: Transformative learning-based SRHR education provided a useful context for broader reflection on sexual and reproductive health and rights among future professionals. Integrating such courses into higher education may support professional reflection and preparedness for SRHR-related practice during war and post-war recovery in Ukraine. 2026-01-01T00:00:00Z https://repo.odmu.edu.ua:443/xmlui/handle/123456789/20145 Institutional experience with laparoscopic anterior vaginocervicopexy using a mesh implant in patients with anterior compartment defect and apical prolapse of varying severity Chekhanov, Yu. O.; Chekhanov, O. Yu.; Gladchuk, I. Z.; Чеханов, Ю. О.; Чеханов, О. Ю.; Гладчук, І. З. In reconstructive pelvic floor surgery using synthetic implants, several laparoscopic techniqueshave evolved as alternatives to sacrocolpopexy. Laparoscopic vaginocervicopexy is intended to correct apical descent together with anterior compartment failure. Since its first publication, the techniquehas been repeatedly modified, emphasizing the need to evaluate outcomes of different technical refinements across clinical scenarios. The aim of this study was to report a single-center experience with a modified laparoscopic vaginocervicopexy technique and to assess its effectiveness in relation to defect location and severity.; У реконструктивно-пластичній хірургії генітального пролапсу із застосуванням сітчастих імплантів сформувався спектр лапароскопічних методик, що розглядаються як альтернатива сакрокольпопексії. Лапароскопічна вагіноцервікопексія спрямована на корекцію апікального пролапсу та дефекту переднього компартменту. Від моменту першої публікації ця техніка неодноразово змінювалася й удосконалювалася, що підкреслює необхідність оцінки результатів її модифікацій у різних клінічних ситуаціях. Мета дослідження – представити власний досвід застосування модифікованої лапароскопічної вагіноцервікопексії та проаналізувати ефективність методики залежно від ступеня важкості й локалізації дефекту. 2026-01-01T00:00:00Z https://repo.odmu.edu.ua:443/xmlui/handle/123456789/20144 Metabolic diseases and mental disorders in female subfertility: effectiveness of cognitive behavioral therapy intervention Artyomenko, V.; Zhelezov, D.; Lahoda, D.; Derishov, S.; Velichko, G.; Kugel, V.; Baratiuk, A.; Ioan Dumitru Suciu Women with impaired fertility and metabolic disturbances often experience anxiety, depressive symptoms, emotional overeating, and dysfunctional beliefs related to body weight and self-image. This study evaluated the effectiveness of a structured cognitive behavioral therapy program in this patient group. A total of 609 women with metabolic disturbances were initially screened, including 314 women with primary or secondary subfertility; 240 eligible women aged 25–44 years were subsequently included in the prospective randomized controlled trial. Participants were randomized to standard care combined with a 12-week cognitive behavioral therapy program or to standard care alone. Psychological, behavioral, anthropometric, and laboratory parameters were assessed at baseline and after 12 weeks. The intervention group showed a greater reduction in depressive and anxiety symptoms than the control group. Cognitive behavioral therapy was also associated with fewer maladaptive automatic thoughts, reduced emotional overeating, increased physical activity, better dietary adherence, and moderate improvements in body mass index, waist circumference, glucose metabolism, and lipid profile. Cognitive behavioral therapy may be an effective component of interdisciplinary care for women with subfertility and metabolic disturbances. 2026-01-01T00:00:00Z https://repo.odmu.edu.ua:443/xmlui/handle/123456789/20139 Fertility intentions among medical students in war-torn Ukraine: a cross-sectional survey Mogilevkina, I.; Matts Olovsson; Getsko, O.; Marichereda, V.; Tanja Tyden Ukraine’s total fertility rate was 0.9 in 2022, among the lowest in Europe. Amid the ongoing fullscale invasion, understanding reproductive intentions is important for informing future pronatalist policies. This study assessed fertility intentions and attitudes toward parenthood, with a focus on sex differences, and subjective determinants of reproductive decision-making among undergraduate medical students in wartime Ukraine. Methods A cross-sectional, confidential, online survey was conducted among students at Odesa National Medical University in May 2024. The Swedish Fertility Awareness Questionnaire was used, supplemented with a question on contraceptive use. Data were analysed using descriptive statistics, univariable, multivariable and stepwise logistic regression. Results The mean age was 20 years among the participants: 655 women and 191 men. Overall, 75% intended to have children, with a preferred family size of two children. Women preferred to have their first child at a younger age than men (26.1 vs. 28.1 years; p < 0.001). No sex differences were observed in the perceived importance of having children. Oral and long-acting reversible contraceptive use was relatively low. Furthermore 62% of participants indicated that they would support a hypothetical pregnancy to birth, mainly for moral or religious reasons. Among those opting for abortion, the most commonly cited reasons were financial constraints and war-related concerns. In the case of infertility, more women than men were willing to consider IVF or adoption (p < 0.001). Key prerequisites for parenthood included adequate housing (93%) and financial stability (92%). Women were more likely to anticipate emotional benefits of parenthood (OR 1.66), whereas men were more likely to anticipate negative impacts on personal time (OR 1.91) and finances (OR 1.72). Intention to have children was associated with psychological readiness, emotional fulfilment, life priorities, and perceived housing adequacy (aOR 3.02), as a key independent predictor of overall readiness for parenthood. Conclusions Despite the ongoing war, fertility intentions among medical students remain relatively optimistic, equally for women and men. As adequate housing was an important prerequisite for parenthood, post-war pronatalist policies may benefit from integrating housing support into broader family well-being strategies, while also addressing sexuality education and cultural influences on family formation and parenthood decisions. 2026-01-01T00:00:00Z https://repo.odmu.edu.ua:443/xmlui/handle/123456789/20138 Maternal and perinatal outcomes during successive and overlapping crises in Ukraine, 2019–2024: a nationwide population-based ecological study Mogilevkina, I.; Marichereda, V.; Khadginova, N.; David Southall; Dobryanskyy, D. Ukraine has experienced overlapping shocks from the COVID-19 pandemic and a full-scale war, with potential impacts on maternal and perinatal health. We examined national-level changes in these outcomes between 2019 and 2024. Methods In this population-based ecological study, publicly available Ministry of Health data were analysed to examine trends in deliveries, births, and maternal and perinatal outcomes. Changes were assessed using pairwise comparisons, absolute risk differences, and effect sizes. Annual estimates were compared with prepandemic, preceding-year, and wartime estimates. Findings Deliveries and births declined by approximately 40%, predominantly during the first wartime year. Between 2019 and 2024 (298,066 and 176,842 deliveries, respectively), the prevalence of diabetes in pregnancy increased from 0.88% (n = 2634) to 2.66% (n = 4707), hypertensive disorders from 3.80% (n = 11,332) to 5.45% (n = 9633), severe postpartum haemorrhage from 0.36% (n = 1070) to 0.53% (n = 941). Among 302,190 and 179,192 births, respectively, preterm births increased from 5.59% (n = 16,907) to 6.25% (n = 11,195), very low birthweights from 1.05% (n = 3184) to 1.29% (n = 2305), and extremely low birthweights from 0.44% (n = 1335) to 0.60% (n = 1068). Pregnancy-related and perinatal mortality, particularly stillbirths, were higher during the second year of the pandemic but not during wartime. Early neonatal mortality did not change throughout. Interpretation Overlapping crises were associated with fewer births and increased maternal morbidity. Although pregnancy-related and perinatal mortality increased during the pandemic, their relative stability during wartime may suggest preservation of maternal and newborn services, potentially supported by international assistance. Continued support for maternal and neonatal healthcare services remains important in crisis-affected settings. 2026-01-01T00:00:00Z https://repo.odmu.edu.ua:443/xmlui/handle/123456789/19997 Possible reasons for failed induction of labor Posokhova, S.; Kucherenko, O.; Parubina, D. The failed induction of labor is associated with a higher rate of maternal and fetal morbidity because it increases the unwanted effect of emergency cesarean section. It is also associated with an increased risk of numerous adverse maternal and perinatal outcomes such as uterine rupture, nonreassuring fetal heart rate tracing, postpartum hemorrhage, stillbirth, and severe birth asphyxia. Objective. To identify the reasons for failed labor induction. 2026-01-01T00:00:00Z https://repo.odmu.edu.ua:443/xmlui/handle/123456789/19996 The birth canal as a determinant of vaginal birth outcomes: physiological adaptation, trauma prevention, and recovery strategies Manasova, G.; Shapoval, N.; Stasii, Ya. Perineal trauma complicates up to 70–85% of vaginal births and represents a major contributor to long-term pelvic floor dysfunction. Obstetric anal sphincter injuries (OASI) occur in approximately 3–11% of vaginal deliveries and are associated with chronic pain, urinary and fecal incontinence, pelvic organ prolapse, dyspareunia, and impaired quality of life. Contemporary obstetrics increasingly focuses on preserving pelvic floor integrity as an essential component of safe vaginal birth. Objective. To evaluate current evidence regarding the adaptive capacity of the birth canal and evidence-based strategies for the prevention and rehabilitation of OASI. 2026-01-01T00:00:00Z