Вплив блокатора мінералокортикоідних рецепторів еплеренону на динаміку структурно-функціонального стану міокарда в пацієнтів із не Q-інфарктом міокарда через 3 та 6 місяців лікування

Context: It is well known that oral isotretinoin treatment causes numerous ocular side-effects.Objective: To investigate the effect of systemic isotretinoin treatment on central corneal thickness (CCT) values due to meibomian gland disease (MGD).Participants: In this prospective study, 47 patients (27 men, 20 women) with nodulocystic acne vulgaris treated with oral isotretinoin (0.8 mg/kg daily) were included.Methods: All patients were analyzed with the Pentacam Scheimpflug topography at baseline, on the 3rd and 6th month of treatment. Main outcome measures were MGD scores and CCT.Results: The mean age of patients was 25.1 ± 4.4 years. The mean MGD scores were significantly higher at 3rd month (1.3 ± 0.9) and 6th month (1.5 ± 1.0) of treatment compared with baseline (1.1 ± 0.9) (p < 0.001). The mean CCT value at baseline was 540.5 ± 22.1 µm; 536.9 ± 20.5 µm at 3rd month and 531.4 ± 22.2 µm at 6th month. The differences between baseline and 6th month CCT measurements were statistically significant (p < 0.001). There was negative correlation between mean MGD scores and CCT values at the 6th month of treatment which was statistically significant (p = 0.038, r = −0.221).Conclusion: Isotretinoin treatment causes higher MGD scores. A statistically significant decrease in CCT due to MGD was detected at 6th month of treatment.

To evaluate the change of corneal epithelial thickness (ET) in subjects using isotretinoin with spectral-domain optical coherence tomography and further to explore reflection of changes on corneal topography. Forty eyes of 40 subjects with acne vulgaris scheduled for oral isotretinoin were included in this prospective study. Subjects were examined with RTVue-XR and Pentacam at baseline, 1th, 3rd, and 6th months of treatment, and 3rd month of isotretinoin cessation. A statistically significant increase was detected in each sector of ET map except inferonasal 7 to 9 mm between baseline and following visits (P<0.05, for all visits). The increase in superior (2-7 mm), inferior (2-7 mm), and maximum values in epithelium statistics and the decrease in superior (2-7 mm), inferior (2-7 mm), minimum, and maximum values in stroma statistics at follow-up visits were significant (P<0.05, for all visits). Central corneal thickness, maximum Ambrosio-relational thickness, average pachymetric-progression index at 1th, 3rd, and 6th months, and thinnest pachymetry, index of surface variance (ISV) at 3rd, and 6th months differed significantly (P<0.05, for specified visits). The regression in parameters was observed at 3rd month of isotretinoin cessation. Isotretinoin treatment induces epithelial thickening and stromal thinning. Remodeling of corneal layers causes statistical differences in ISV and pachymetry-related parameters of Pentacam. The pachymetry changes in cornea return to baseline at the 3rd month of discontinuation of treatment.

Short- and long-term effects on prolactin of risperidone and olanzapine treatments in children and adolescents

Ischaemia-reperfusion injury (IRI) is a factor leading to the damages of the transplanted kidney, what affects mainly the proximal tubules. Early monitoring of tubule damage can be an efficient tool to predict the allograft dysfunction. Present in proximal tubules, N-acetyl-beta-glucosaminidase (NAG) is a lysosomal enzyme whose excretion rises as a result of IRI or acute rejection. The aim of this study was to monitor the NAG urine activity to evaluate the early proximal tubule damage, and to try to predict the long-term function of the transplanted kidney. The study enrolled 87 Caucasian renal transplant recipients (61.7% males, 38.3% females, mean age 45.56±14.34 years). Urine samples were collected for NAG and creatinine analysis on the 1st day after transplantation, and then in the 3rd and 12th month. Protocol biopsies were performed in the 3rd and 12th month. A significant positive correlation between NAG urine activity in the 3rd month after transplantation and creatinine concentration on the 14th (p=0.004) and 30th day (p=0.05), in the 3rd month (p=0.009) and after the 1st (p=0.005) and 2nd year (p=0.003) was observed. A statistically significantly higher urinary NAG activity in samples collected in the first 3 days and in the 3rd month after transplantation among patients with DGF (p=0.006 and p=0.03 respectively) was found. There was a significant positive correlation between NAG urine activity in the 3rd month and the grade of tubular atrophy in specimens collected in the 3rd (p=0.03) and 12th (p=0.04) month. Monitoring of NAG urine activity is useful in the evaluation of early proximal tubule damage and predicting the long-term function of the transplanted kidneys.

Objective Aim of this study is to compare the thiol/disulfide variables before treatment, at the 3rd and 6th months of biologic treatment in patients with axSpA. Materials & Methods Consecutive patients with axial spondyloarthritis to whom biologic treatment was initiated in our clinic were enrolled upon consent. Demographics, clinical characteristics, laboratory parameters and treatment agents were collected. Disease activity scores and thiol-disulfide balance parameters were recorded at baseline and 3rd, 6th months of treatment. Statistical analyses were performed in all patients and in subgroups of ankylosing spondylitis and non-radiographic axial spondyloarthritis patients. Results In all patients, total thiol levels were significantly increased at 6th month in comparison to baseline values (470.5 ± 74.7 vs 491.9 ± 69.6, p = 0.047). Native thiol levels were increased at 6th month close to significance (438.9 ± 70.4 vs 458.8 ± 63.7, p = 0.060). Moderately strong negative correlations were observed between native thiol levels and disease activity parameters (BASDAI: p = 0,019; ASDAS-CRP: p = 0,035; ASDAS-ESR: p = 0,030), and between total thiol levels and disease activity parameters (BASDAI: p = 0,031; ASDAS-CRP: p = 0,020; ASDAS-ESR: p = 0,026) at 6th month evaluation Discussion & Conclusions Our results demonstrated oxidative stress reducing effect of biologics in axSpA patients parallel to suppression of disease activity at 6th month of the treatment.

Aim: To evaluate the efficacy of early duloxetine therapy in stress urinary incontinence occurring after radical prostatectomy (RP). Material and Method: Patients that had RP were randomly divided into 2 groups following the removal of the urinary catheter. Group A patients (n = 28) had pelvic floor exercise and duloxetine therapy. Group B patients (n = 30) had only pelvic floor exercise. The incontinence status of the patients and number of pads were recorded and 1-hour pad test and Turkish validation of International Consultation on Incontinence Questionnaire-Short Form test were applied to the patients at the follow-up. Results: When the dry state of the patients was evaluated, 5, 17, 3, and 2 of 28 Group A patients stated that they were completely dry in the 3rd, 6th, 9th and 12th month respectively and pad use was stopped. There was no continence in 30 Group B in the first 3 months. Twelve, 6, and 8 patients stated that they were completely dry in the 6th, 9th and 12th month, respectively. But 3 of 4 patients in whom dryness could not be provided were using a mean of 7.6 pads in the first day and a mean of 1.3 pads after 1 year. When pad use of the patients was evaluated, the mean monthly number of pad use was determined to be 6.2 (4-8) in the initial evaluation, 2.7 (0-5) in the in 3rd month, 2 (0-3) in the 6th month and 1.6 (0-2) pad/d in the 9th month in the group taking medicine. The mean monthly number of pads used was determined to be 5.8 (4-8) in the initial evaluation, 4.3 (3-8) in the 3rd month, 3 (0-6) in the 6th month and 1.6 (0-6) pad/d in the 9th month in the group not taking medicine. Conclusion: According to the results, early duloxetine therapy in stress urinary incontinence that occurred after RP provided early continence.

Normalization of serum aminotransferase levels is achieved in approximately 50% of chronic hepatitis C patients treated with interferon (IFN); however, in about one-half of these patients the hepatitis relapses after therapy. In this study we investigated the efficacy of serum hepatitis C virus (HCV) RNA monitoring during IFN therapy to predict the outcome of a biochemical end-of-treatment (ETR) response. Eighty patients with chronic hepatitis C received leucocyte (natural) IFN-alpha (13 patients) or recombinant IFN-alpha2a (67 patients). Antiviral therapy was given for 12 months to 43 (53.7%) responders and this group was analysed further. During follow-up, 15 relapsed and 28 showed a sustained response (median follow-up 50 months, range 39-67 months). Viraemia was monitored at baseline, and at months 1, 3, 6, 9 and 12 of treatment, by nested polymerase chain reaction (PCR) (sensitivity 10-100 copies ml-1). A combination of positive nested PCR and HCV RNA values at the 3rd and 6th months of treatment was 100% predictive of relapse (sensitivity, 66.6%; specificity, 100%). A combination of negative nested PCR and HCV RNA values at the 1st and 3rd months of treatment was 100% predictive of sustained response (sensitivity, 39.3%; specificity, 100%). In conclusion, serum HCV RNA monitoring is an appropriate and reliable tool for predicting early outcome of the biochemical ETR response after IFN discontinuation. This could be useful in the modulation of therapeutic management of chronic hepatitis C.

Bladder cancer is the 7th most commonly diagnosed cancer in males worldwide and the 11th when both genders are considered. Seventy five per cent of bladder cancer cases are non-muscle invasive bladder cancer (NMIBC). Bacillus Calmette–Gu rin (BCG) immunotherapy remains the standard intravesical agent for NMIBC. The exact mechanism by which BCG prevents recurrence is unknown. The aim of this study was to evaluate NLR4 gene expression and IL-1β as possible prognostic indicators for NMIBC recurrence and BCG treatment failure, and to detect the difference in their levels among muscle invasive bladder cancer (MIBC) and NMIBC that may aid in primary differentiation between cases. This study was conducted in 30 patients who had NMIBC and 17 patients who had MIBC. Urine samples were obtained in sterile cups before operation. From NMIBC cases, four more samples were obtained as mentioned below. Evaluation of NLR4 gene expression was performed in pre-surgical sample for MIBC and in 4 samples for NMIBC: pre-surgical sample, sample collected 4 hours after the 3rd dose of BCG instillation, and samples collected during follow up (3 and 6 months post-surgically). There was statistical significant increase in NLRP4 expression levels in NMIBC (CT=0.87±1.48) compared to MIBC (CT=2.82±2.07). As far as we searched, no published results were found regarding comparative gene expression levels between NMIBC and MIBC cases. Gene expression in recurrent cases was higher in pre-surgical urine samples than in non-recurrent cases. The expression level further increased up to 21 fold than the pre-surgical level in the sample taken after injection of the 3rd dose of BCG. This level decreased distinctly to become 1-fold increase over pre-surgical level at the 3rd month follow up then to only 0.9-fold at the 6th month. In non- recurrent cases, gene expression level started pre-surgically in much lower levels than those encountered in recurrent cases. There were 11-fold increase in expression level after 3rd dose of BCG instillation and then decreased to be 5.6 folds higher in the sample taken at 3rd month follow up than in presurgical samples. Gene expression further decreased to become 4.1 fold higher in samples taken at 6 month follow up than the pre-surgical levels. IL-1β levels were estimated for NMIBC and MIBC cases in urine samples pre-surgically and during BCG therapy in case of NMIBC before and 4 hours after the 3rd dose and during 3rd month follow-up of those cases for searching its possible use of for primary differentiation between NMIBC and MIBC, and also as a prognostic factor for possible recurrence in case of NMIBC cases. The level of IL-1β was generally higher in pre-surgical samples (0.62±0.12 pg/ml) when compared to its level before the 3rd dose of BCG induction therapy (0.53±0.13 pg/ml). Its level was distinctly higher four hours after administration of the 3rd dose BCG (1.96±0.62 pg/ml) than both previous levels. Levels decreased bellow pre-surgical level at 3rd month follow up (0.57±0.099 pg/ml). The levels of IL-1β estimated in samples collected four hours after the 3rd dose BCG was higher in cases that showed recurrence later on than non-recurrent cases. The levels decreased in both cases and became higher in non-recurrent cases (0.64±0.05 pg/ml) than in cases already developed recurrence at the 3rd month diagnosed during follow-up (0.45±0.05 pg/ml). To conclude, on following NLRP4 gene expression and IL-1β levels during BCG administration among recurrent and non-recurrent cases of thirty NMIBC cases, there was a significant statistical difference in both levels for the samples collected after the third dose BCG, being higher in patients who showed subsequent recurrence at the 3rd and 6th month of follow-up. If these preliminary reported findings will be confirmed in upcoming larger cohort’s studies, it could be promising in prognosis of such cases, with the possibility of early manipulation of individualized treatment schedule, keeping patients most probably prone to encounter recurrence safe from possible side effects of BCG therapy. The assessment of NLRP4 expression and IL-1β levels could help predict failure of BCG therapy, playing an appreciable role in early deciding radical surgery. When comparing NLRP4 expression and IL-1β levels between MIBC and NMIBC cases, increased values were noted among non-invasive ones. This finding may serve as a possible diagnostic tool, which represents a challenging issue. Hence, cut-off values for gene expression and cytokine level are to be specified.

When considering the quality of life of patients who undergo total laryngectomy, constipation problems are often overlooked. This study aims to determine whether surgical or concurrent chemoradiotherapy treatments matter in the development of functional constipation in patients with advanced-stage laryngeal cancer. Patients without presurgical constipation (according to Rome IV) who were treated with either surgery (n=30) or chemoradiation (n=25) were evaluated for constipation development. Interim evaluation and recommendations were made on the 3rd month. On the 3rd and 6th months, the frequency of constipation between groups was compared using the Rome IV criteria and European Organization for Research and Treatment of Cancer Quality of Life Scale-C30 constipation symptom score. On the 3rd month, the frequency of constipation was higher in the surgery group than in the chemoradiation group (76.7% vs. 28%, p<0.001). On the 6th month, although still higher, the frequency of constipation decreased following the recommendations in laryngectomized patients (56.7% vs. 36%, p=0.17). C30 Constipation "yes/no" inquiry failed to detect 11 (36.6%) and 8 (26.6%) laryngectomized patients with constipation on the 3rd and 6th months, respectively. Constipation is more frequent and develops in the early period of postlaryngectomy. Patients seem to benefit from additional special rehabilitation recommendations. Constipation-prone laryngectomized patients should be screened with the Rome IV criteria, which effectively detect constipation.

Understanding the postoperative dynamics of the nasal soft-tissue envelope (NSTE) is necessary to obtain the desired cosmetic results after rhinoplasty. This study was conducted to determine the changes of NSTE thickness and its effects on periorbital edema and ecchymosis following rhinoplasty. Thirty-five patients who underwent rhinoplasty were included in the study. Nasal skin and subcutaneous tissue thickness at the tip, supratip, rhinion, and nasion were measured using ultrasonography preoperatively and at the postoperative 3rd and 10th months. Periorbital edema and ecchymosis were evaluated at postoperative days 1, 3, and 7. The patients were categorized as the thick NSTE group (n = 17) and the thin NSTE group (n = 18) according to the preoperative median NSTE thickness. In the thin NSTE group, supratip skin, subcutaneous tissue, and total NSTE thickness were lowest on the preoperative day but no statistically significant difference was found for the thick NSTE group. In the thin NSTE group, total NSTE thickness of the rhinion was highest at the postoperative 3rd month, but in the thick NSTE group, there was no statistically significant difference between postoperative 3rd and 10th months. In both groups, total NSTE thickness of the nasion was highest at the postoperative 3rd month and lowest at the postoperative 10th month. Supratip fullness occurs more prominent in patients with thin NSTE. Postoperative edema in the rhinion is greater in patients with thin NSTE for the early postoperative period but it lasts longer in patients with thick NSTE. Soft-tissue envelope atrophy at the nasion occurs in both groups in the late postoperative period. Periorbital edema and ecchymosis severity are not affected by NSTE thickness.

BackgroundIron deficiency increases cardiovascular risk and all-cause mortality in hemodialysis patients. However, standard diagnostic tests, serum ferritin and transferrin saturation (TSAT), have limitations and are costly. Reticulocyte hemoglobin equivalent (RET-He) is a novel, less expensive marker for diagnosing iron deficiency. This study aimed to assess the non-inferiority of RET-He-guided intravenous (IV) iron supplementation compared with TSAT-guided supplementation in hemodialysis patients. MethodsA total of 138 hemodialysis patients were randomized into TSAT-guided (n = 68) and RET-He-guided (n = 70) groups. Both groups received intravenous iron according to a prespecified protocol. The primary outcome was the erythropoietin resistance index (ERI) at the 3rd and 6th months. RET-He was considered non-inferior if the upper bound of the 95% confidence interval (CI) for the between-group difference was ≤160 units/week/g/dL. Secondary outcomes included death, hospitalization, cardiovascular events, blood transfusion, and infection. ResultsBaseline characteristics were similar between the groups. At the 3rd and 6th months, RET-He-guided supplementation was non-inferior to TSAT-guided supplementation in reducing the erythropoietin resistance index (ERI): 814.37 ± 355.19 and 766.87 ± 368.60 units/week/g/dL in the TSAT group, and 834.59 ± 335.47 and 743.04 ± 390.86 units/week/g/dL in the RET-He group (p for non-inferiority = 0.0027 and 0.001); with mean differences of –35.92 (95% CI: –174.07 to 102.24) and –89.25 (95% CI: –246.76 to 68.25) at the 3rd and 6th months, respectively. Patients in the RET-He group received significantly less IV iron (498 ± 247 mg/3 month vs. 605 ± 278 mg/3 month; p = 0.01 at the 3rd month and 412 ± 248 mg/3 month vs. 507 ± 306 mg/3 month; p = 0.03 at the 6th month). Secondary outcomes, including death, hospitalization, cardiovascular events, blood transfusion, and infection, were not significantly different between the groups. ConclusionRET-He-guided IV iron supplementation demonstrated non-inferior efficacy in reducing ERI over six months compared with TSAT-guided supplementation and required significantly less iron. RET-He may offer a lower cost for iron management in hemodialysis patients by reducing both laboratory and treatment expenses.

To investigate the effect of topical cyclosporine (0.05%) on the ocular surface and corneal sub-basal nerve plexus in patients with chronic Ocular Graft-versus-Host Disease (oGVHD). This prospective study included 24 eyes from 24 patients with chronic oGVHD. All patients were treated twice daily with topical cyclosporine (0.05%). Ophthalmic examinations were performed at baseline and at the 1st, 3rd, and 6th months of treatment, including the evaluation of corneal fluorescein staining (CFS).The Ocular Surface Disease Index (OSDI) questionnaire was administered. Non-invasive tear break-up time (NIBUT) (Sirius, CSO, Italy), central corneal epithelial thickness (ET) (AS-OCT, Topcon 3D OCT-1 Maestro, Japan), upper eyelid non-contact meibography (Sirius, CSO, Italy), and in vivo confocal microscopy (ConfoScan4, Nidek, Japan) measurements were performed.A paired t-test was used for comparative analysis. Significant improvements were observed in CFS, NIBUT, and OSDI scores at the 1st, 3rd, and 6th months, as well as in upper eyelid meiboscores at the 3rd and 6th months compared to baseline (p < 0.05).However, no significant changes were found in ET, corneal sub-basal nerve fiber density, nerve fiber count, or fiber tortuosity throughout the study period (p > 0.05). While topical cyclosporine significantly improved the ocular surface and symptoms in patients with oGVHD, it did not alter the morphology of the corneal sub-basal nerve plexus. Its anti-inflammatory effects were evident at the epithelial level, but the treatment did not appear to affect the subepithelial region in the short term. Further research is needed to assess the long-term impact of topical cyclosporine on corneal innervation.

The work is devoted to the study of the reactivity of the biochemical composition of saliva in children with SCI, which was used for the treatment of non-removable and removable OA. There was a decrease in the activity of the α-amylase enzyme during orthodontic treatment in both experimental groups: in patients in the experimental group, which used non-removable equipment 3 months after starting treatment at 16.5% and 6 months after starting treatment it was 16%. There was a decrease in the activity of saliva α-amylase after 3 months at 11% and in samples of saliva taken after 6 months at 10% during treatment of patients of the experimental group with removable orthodontic equipment. The total calcium level after 3 months of observation was 15% lower compared to the start of treatment. The phosphorus level was 9% lower at this moment of observation. After 6 months of observation, the trace elements were different from the original ones: calcium was 27% lower, and the level of phosphorus was lower comparing to the baseline by 15%. Treatment of SCI with removable orthodontic equipment impaired the mineral balance: the calcium level after 3 months of observation was lower by 12%, and the level of phosphorus was lower by 6% compared to the beginning of the study. After 6 months of observation, the traced elements differed from the original ones: the level of calcium was 21% lower than the previous values, and the level of phosphorus was lower by 13% compared to the start of treatment. The evaluation of alkaline phosphatase activity in mixed unstimulated saliva using non-removable orthodontic equipment showed that the level of alkaline phosphatase after 3 months of treatment was 3% lower compared to the beginning of treatment, and after 6 months of observation activity of the investigated enzyme was less than the initial by 10%. Treatment of dental anomalies with removable equipment inhibited the enzyme activity: after 3 months of treatment, the activity of alkaline phosphatase was less than 7% compared to the beginning of the study, and after 6 months of observation activity of the investigated enzyme differed from the initial by 20%. The use of non-removable orthodontic equipment led to a significant increase in the activity of IL-1β. Three months after starting the study, IL-1β was 4-fold higher compared to the start of treatment, and after 6 months of treatment, it became 9-fold higher. Treatment of dental abnormalities with removable equipment showed that the activity of IL-1β after 3 months of treatment increased 4-fold, and after 6 months of observation the researched index was different from the initial 9-fold.&#x0D; At the 3rd month of observation in children using non-removable OA, the activity of lysozyme decreased by 21%; reduction of lysozyme activity during the 6th month of treatment constituted 23%. Patients in the experimental group treated with detachable OA observed an increase in lysozyme activity at the 3rd month of observation by 27%, and 6 months after the start of treatment, the activity of lysozyme was less than 29% compared to the data of the 3rd month of the use of non-removable orthodontic equipment it led to a significant increase in the level of anti-inflammatory cytokine: after 3 months of observation was 2.5 times more than at the beginning of treatment, and after 6 months of observation, they differed from the initial in 4 times. Treatment of dental anomalies with removable orthodontic equipment also contributed to an increase in anti-inflammatory cytokine: IL-4 levels were higher after 3 months of treatment compared to baseline data by 1,8, and after 6 months of follow-up, the study figure was in 4 times higher than the previous values.&#x0D; The obtained results of the study of the reactivity of biochemical changes in oral fluid using removable and non-removable OA in children can be used in planning of orthodontic treatment as diagnostic markers for the further selection of tactics and assessment of the oral cavity in children on the background of treatment of JFA by removable and non-removable OA.

The study aimed to investigate the effect of high dose radioactive iodine (RAI) on parathyroid function in patients with differentiated thyroid cancer. Nineteen patients (8 men/11 women, age 46.5 +/- 13.2 years) undergoing RAI for thyroid remnant ablation were enrolled in the study. The biochemical parameters related to parathyroid function [serum calcium (Ca), phosphate (P), creatinine (Cr), alkaline phosphatase (ALP), intact parathyroid hormone (iPTH), urinary Ca, cAMP concentrations and the maximum tubular capacity for phosphate per unit volume of glomerular filtrate (TmP/GFR)] were evaluated at baseline and at the 1st, 3rd, 6th and 12th months of RAI administration. SPSS 15.0 was used for statistical analysis. For all patients, thyroid-stimulating hormone levels were >30 U/ml at baseline and <0.1 U/ml at the following visits. Serum iPTH levels were decreased significantly at the 6th month and reached basal levels at the 12th month (baseline vs. 6th p = 0.027, 1st vs. 6th p = 0.011, 3rd vs. 6th p = 0.047, 3rd vs. 12th p = 0.014, 6th vs. 12th p = 0.001). At the 6th month, P and TmP/GFR levels were higher (p = 0.036, 0.017, respectively), and urinary cAMP measurements were lower (p = 0.020) compared to those of the 1st month. No difference was detected concerning the other parameters. Serum Ca levels decreased below 2.1 mmol/l in several patients (n = 5 at 1st month, n = 4 at 3rd month, n = 8 at 6th month and n = 3 at 12th month) without clinical symptoms. The study indicated a transient decline in PTH levels at the 6th month following RAI therapy. Although this decrease did not cause symptoms in any of the present cases, this pattern might be important especially in individuals with diminished parathyroid background.

The onset of pregnancy in the natural cycle is a task that requires the coordinated work of both central and peripheral levels of regulation of hypothalamic‑pituitary hormones. An analysis of the reproductive health of women with a menstrual cycle disorder against the background of hypoandrogenism indicates an unsatisfactory course of the early stages of the pregnancy process with the subsequent formation of infertility against the background of a reduced ovarian reserve. Hypolubrication is considered a clinical marker of hypoandrogenism in women of reproductive age.&#x0D; Objective — Optimization of pre‑pregnancy training in women with hypoandrogenism, menstrual cycle disorders and early pregnancy losses in the anamnesis.&#x0D; Materials and methods. A comprehensive clinical, laboratory and instrumental examination involved 90 women with menstrual cycle disorders and hypoandrogenism, from them 45 women received the proposed therapy (group Ia), and 45 patients traditional therapy (group IIa). The control group consisted of 30 healthy women at the stage of pre‑gravid examination. The age of women was 18 to 35 years. Hormonal reproductive background was determined on the 5 ‑ 7th day of the menstrual cycle in all examined women, as well as levels of thyroid‑stimulating hormone (TSH), thyroid peroxidase antibody, vitamin D, homocysteine. The proposed algorithm of pre‑gravid measures included: 1) optimization of thyroid gland function (after consultation with an endocrinologist); 2) restoration of pituitary‑ovarian relationships in case of functional central hypogonadism; 3) therapy aimed at optimizing the prolactin level (target value 12.5ng/ml); 4) reduction of homocysteine level (target level 5.6 mmol/l); 5) normalization of vitamin D level (norm is 75—125 nM/l, insufficiency defined as 50—75 nM/l, and deficiency &lt;50 nM/l). The target control parameters included restoration of lubrication, ovulatory menstrual cycle, onset and progression of pregnancy. IBM SPSS Statistics version 25.0 software was used for statistical processing of the obtained data. The control periods of therapy were 3, 6 and 9 months.&#x0D; Results. In women with proposed treatment algorithm, therapy resulted in the recovery of vitamin D levels, starting from the 6th month of therapy, and complete normalization was recorded at the 9th month of treatment. This indicates the need for long‑term supplementation of vitamin D in women with hypoandrogenism. A decrease in the homocysteine levels was also noted on the 6th month of treatment, and its normalization after 9 months of treatment. Elevated homocysteine levels and vitamin D insufficiency/deficiency were observed throughout the follow‑up period in the conventional therapy group. In women with the proposed therapy, the levels of follicle‑stimulating hormone (FSH), TSH, luteinizing hormone (LH) and prolactin tend to normalize already from the 3rd month of therapy, while the highest positive increase was noted in the LH indicator on the 3rd‑6th month of treatment. Ovarian steroidogenesis approached the indicators of the control group after 6—9 months of therapy. Proandrogenic steroidogenesis began to increase on the 3rd month of therapy, reaching maximum on the 9th month. Unsatisfactory indicators of changes in free testosterone and dehydroepiandrosterone sulfate (DHEA‑C) were noted in women from the group of the traditional pre‑pregnancy preparation even after 9 months.&#x0D; The specified features of steroid support of the hormonal background of women’s reproductive health demonstrated the following: signs of female sexual dysfunction in the group with the proposed therapy completely disappeared after the 9th month of treatment, and in the group of traditional therapy they continued to bother 91.1% of women. At the end of the observation period, the regular menstrual cycle was gained in 40.0% of women with the proposed therapy and in 6.7% with the traditional one. Progressive pregnancies in the group with the proposed algorithm were achieved in 37.5% of women (successfully overcame the luteoplacental barrier), and in 8.8% in the group of the traditional approach (ended by early termination of pregnancy).&#x0D; Conclusions. The period of formation of the luteal phase insufficiency is the specific feature of the restoration of menstrual cycle fullness in women with hypoandrogenism, which requires additional therapy to ensure the conditions for a full‑fledged secretory endometrium transformation. The pregnancy process takes place in unfavorable conditions, which can lead to early pregnancy losses. The period of pre‑pregnancy measures in this group of patients should last at least 6—9 months. Traditional pre‑pregnancy preparation does not contribute to the restoration of the central mechanisms of menstrual cycle regulation in women with hypoandrogenism, nor does it contribute to the restoration of full‑fledged ovarian steroidogenesis, it is accompanied by anovulation and insufficiency of the luteal phase, early pregnancy losses. Symptoms of female sexual dysfunction do not disappear under the influence of traditional treatment.