Contemporary Perspectives On The Impact Of Enzymatic Dysfunction In The Pathogenesis Of Female Infertility And Innovative Approaches To Its Treatment (Literature Review)

Abstract

Aim. To conduct a comprehensive analysis of modern aspects of enzymatic dysfunction in female infertility and to explore innovative methods for its correction. Materials. A review of publications in electronic databases, including PubMed, Google Scholar, and eLibrary, was conducted. Selection of publications was carried out in accordance with PRISMA guidelines. All relevant articles published up to January 2024 were included in the analysis. The search yielded 110 publications from PubMed, 80 from eLibrary, and 25 from Google Scholar. Duplicates and articles without full text were excluded from consideration. Results. Pharmacological methods, such as the use of aromatase inhibitors (e.g., letrozole), demonstrated significant effectiveness in restoring ovulation and increasing pregnancy rates in women with anovulatory infertility. Studies also showed that metalloproteinase inhibitors, such as doxycycline, improve implantation conditions and reduce the risk of early miscarriage. Biotechnological approaches, such as gene therapy and exosome therapy, have shown promising results in correcting enzymatic dysfunctions, particularly in cases involving genetic mutations and chronic implantation failures. Regenerative methods, including PRP therapy, have proven effective in improving endometrial condition and stimulating ovulation, leading to increased fertility rates. Conclusion. Enzymatic dysfunction is a significant factor in the pathogenesis of female infertility. The development of personalized therapeutic strategies aimed at correcting enzymatic activity through both traditional and innovative methods offers promising prospects for improving reproductive outcomes. However, further comprehensive research is needed to optimize these approaches and enhance their effectiveness in treating infertility.