Synenko V. Physical and mental development and peculiarities of the bioenergetic metabolism in children born after assisted reproductive technology

The thesis for the degree of a candidate of medical sciences (doctor of philosophy) by specialty 14.01.10 – pediatrics. – The Odesa National Medical University of the Ministry of Health of Ukraine, Odesa, 2021. Taking into account the rapid development of in vitro fertilization (IVF) technologies with the successful overcoming of subfertility problem, the thesis presents the solution of modern pediatrics problem – improvement of medical and psychological observation of children born after assisted reproductive technologies (ART). The paper covers the results of the longitudinal observation of 136 children born after ART within the period between birth and 7 years old, with integrated analysis of preconception factors and ART strategies, peculiarities of the ante- and perinatal periods, characteristics of psycho-physical development and adaptive resources of the child in different age periods. Based on the comparative analysis of the ART methods, it is presented that the application of the “Cryo-embrio-transfer” strategy with the minimum number of the embryos reduces the risk of prematurity, neonatal period pathology, congenital malformations. The age-related peculiarities of the mental and physical development of children of various age groups born after ART have been analyzed. The contribution of the genetic polymorphism SOD2 (T58C), CAT (C-262T), HIF1A (Pro582Ser) has been detected in the formation of pathological conditions in ART children. Cytochemical analysis of enzyme activity (SDH, GFDG, LDH, NAD) showed the role of secondary mitochondrial dysfunction in pathology of the respiratory, digestive, cardiovascular systems and allergic diseases in children born after ART. It is shown that the polymorphism of energy metabolism disorders involving several functional links causes the development of polysystemic pathology.