Polyakova E. Optimization of diagnosis and management of the anovulatory infertility amongst the females with different variants of the polymorphic alleles of detoxication enzymes genes

The purpose of the present study was to increase the effectiveness of diagnosis and management of the anovulatory infertility amongst the females with polycystic ovary syndrome (PCOS) and different variants of the polymorphic alleles of detoxication enzymes, metabolism, steroidogenesis and receptory apparatus genes. It is shown that for the patients with polycystic ovary syndrome (PCOS) the essential increase of the ratio luteinizing hormone / follicle stimulating hormone up to 2.0±0.1 and hypoprogesteronemy - (8.9±0.8) nmol/I at the background of the moderate hypoestrogenemia - (45.4±0.1) pg/ml and significant increase of the serum level of anti-mullerian hormone - up to (6.0±0.2) pg/ml, as well as insulin resistance index - up to 2.4±0.1 are inherent. It is proved that the risk of PCOS occurrence amongst the females with GSTM1 0/0 genotype is 3.7 times increased (OR=3.7; CI 95% 2.8; 4.9), and in conjunction of the deletions by GSTMI and GSTT1 genes - 34.5 times (OR=34.5; CI 95% 20.1; 59.4). It is evidenced that the homozygotic genotype GG by rsl 801282 three times increases the risk of PCOS (OR=3.2; CI 95% 1.8; 5.6) and cause the development of clomifen-resistancc. Thus, availability of the functional polymorphism rsl2907866 by CYP19 gene was correlated with the level of hyper-androgenism (r=-0.63; p<0.05). There is investigated the clinical effectiveness and safety of letrozole aromatase inhibitor dependently on the genotype of the females suffering from anovulatory infertility and differentiated therapy administration criteria were determined.