Vol 13, No 1 (2026)

Despite similarities in healthcare system organization, the incidence of congenital syphilis remains stable in Russia, whereas a marked decline has been achieved in China. The question remains which systemic factors constitute key barriers in Russia. This study seeks to identify and quantitatively assess specific gaps in screening, monitoring, and treatment of syphilis among pregnant women in Russia that hinder effective adoption of successful Chinese practices. The work aimed to perform a comparative analysis of syphilis incidence among pregnant women in Russia and China. A retrospective analysis was conducted using data from the Russian Federal State Statistics Service, the Chinese Center for Disease Control and Prevention, and scientific publications (2013–2023).

In China, a decline in syphilis incidence among pregnant women has been observed due to mandatory trimester-based screening (coverage > 99%) and a comprehensive program for the prevention of mother-to-child transmission. The incidence of congenital syphilis decreased from 91.6 to 18.4 cases per 100,000 live births (between 2011 and 2018). In Russia, the incidence remains consistently high (13.1–17.6 per 100,000 population in 2020–2023), with more than 30% of women entering antenatal care in the second or third trimester. Data on treatment coverage are lacking. Reducing the burden of congenital syphilis in Russia may be facilitated by standardization of screening protocols and implementation of monitoring systems ensuring early antenatal registration. The success of the Chinese model is driven by comprehensive screening and integration of services within the national healthcare system, which is comparable to that of the Russian Federation.

According to the World Health Organization, infertility affects 17.5% of the adult population worldwide and remains a serious medical and social challenge. Despite significant progress in assisted reproductive technologies, the treatment of infertility associated with endometrial disorder and ovarian dysfunction remains relevant and requires the search for new therapeutic approaches.

This review analyzes current data from Russian and international sources published over the past 5 years on the use of autologous platelet-rich plasma (PRP) as a promising therapeutic modality in assisted reproductive technology programs. The search for published data was conducted in PubMed, eLibrary, and Google Scholar databases. Analysis of the publications demonstrated that PRP therapy is clinically effective in treating thin endometrium, recurrent implantation failure, and premature ovarian insufficiency and may also improve the clinical pregnancy rate. However, the available studies are limited by small sample sizes and nonrandomized designs, precluding definitive conclusions regarding the efficacy and safety of PRP therapy. Additionally, different routes of administration, injected plasma volumes, and platelet concentrations are currently in use. However, their efficacy has not been compared against one another but only against control groups receiving conservative therapy. This technology requires further investigation in randomized clinical trials to develop standardized protocols and evaluate long-term outcomes.

BACKGROUND: Endometrial receptivity disorders are the primary focus in patients with repeated implantation failure. However, the cellular and receptor characteristics of endometrial mesenchymal stromal cells in this population remain poorly understood, especially in terms of proliferative activity and estrogen receptor expression. This work examined the proliferative activity and expression of estrogen receptors in endometrial mesenchymal stromal cells in these patients to identify a new pathogenetic link of infertility and potential therapeutic targets.

AIM: The work aimed to assess the functional characteristics of endometrial mesenchymal stromal cells, including their proliferative activity and estrogen receptor expression, in patients with repeated failure of euploid embryo implantation.

METHODS: This pilot study included five patients aged 25–40 years. The main group included four patients with repeated implantation failure. An endometrial sample from a surrogate mother with a history of six term births served as a positive control. Mesenchymal stromal cells were isolated from endometrial aspiration biopsy samples collected during the first phase of the menstrual cycle. ESR1 expression was assessed by real-time polymerase chain reaction, and estrogen receptor alpha (ERα) levels were measured by fluorescent immunocytochemistry. The proliferative activity of mesenchymal stromal cells was assessed in the IncuCyte live-cell analysis system in a control medium and with 0.1 nM 17β-estradiol.

RESULTS: ESR1 mRNA levels in cultured endometrial mesenchymal stromal cells were approximately 10 times higher than in adipose tissue mesenchymal stromal cells. Immunocytochemistry revealed specific expression of nuclear ERα in all samples. Patients with unexplained infertility had fewer receptors than the control group, with the lowest ERα expression reported in patients with tubal-peritoneal infertility. Endometrial mesenchymal stromal cells from patients with repeated implantation failure had a significantly lower proliferation rate than mesenchymal stromal cells from a surrogate mother. Patients with unexplained infertility had the lowest proliferative capacity of endometrial mesenchymal stromal cells. Adding 17β-estradiol significantly increased endometrial mesenchymal stromal cell proliferation in both the surrogate mother and patients with unexplained infertility. In patients with tubal-peritoneal infertility, 0.1 nM estradiol did not improve endometrial mesenchymal stromal cells proliferation.

CONCLUSION: This work is the first to demonstrate decreased proliferative activity and expression of estrogen receptors (ERα) in endometrial mesenchymal stromal cells in patients with repeated implantation failure. The findings indicate that mesenchymal stromal cells from patients with unexplained infertility remain sensitive to estrogen despite the reduced number of receptors. These data add to a better understanding of the functional characteristics of endometrial mesenchymal stromal cells in repeated implantation failure.

BACKGROUND: Medical students, as future doctors, have a prominent role in shaping medical culture and public opinion. Creating educational programs, events, and campaigns to support families with children, as well as instilling a positive attitude towards multi-child parenting in medical students, can help to increase birth rates in the near future.

AIM: The work aimed to analyze the reproductive potential of medical students, identify factors influencing birth rates, and assess the commitment to traditional family values among young people.

METHODS: An anonymous online survey among Sechenov University students was conducted. Primary endpoint: to obtain the results of the online survey (completed online questionnaires). Secondary endpoints: to analyze the findings and perform a comparative analysis of the answers based on the year of study and sex.

RESULTS: The survey was conducted between August and December 2024. A total of 1785 students responded, including 1441 (80.7%) females and 344 (19.3%) males. The majority of respondents do not plan to have children while attending the University, citing financial constraints, housing issues, and concerns about the impact on their careers and childbirth. One of the main reasons for delaying motherhood is the desire for self-fulfillment and a successful career. Many female respondents claim that they delay having children in order to pursue a career and provide for themselves financially. A college degree leads to a desire for a higher social status, and women who pursue college education have more options for effective self-fulfillment outside of motherhood.

CONCLUSION: Sustainable population growth necessitates long-term efforts to improve welfare and strengthen families. One potential strategy is to encourage medical students to promote family values and support multi-child parenting. The majority of medical students surveyed prioritize a successful career over family planning, without considering the age-related decline in fertility.

A uterine scar is a connective tissue area in the myometrium that results from surgical intervention, injury, or inflammation. It is characterized by the replacement of smooth muscle fibers with fibrous tissue, as well as abnormalities in myometrial vascularization, innervation, and architecture. These abnormal changes impair the function of the uterus and increase the risk of obstetric and gynecological complications. The rising global cesarean section rates continue to be a major concern. In Russia, they were 30.1% in 2022, which is comparable to North America (32.3%), lower than in Latin America (40.5%) and Turkey (57.2%), but considerably higher than the WHO-recommended threshold of 10%–15%. As cesarean section rates increase, so does the number of patients with postoperative uterine scars and specific complications. These complications include isthmocele with myometrial thinning at the scar site (residual myometrial thickness at the scar site < 3–2.5 mm on ultrasound). Preconception monitoring is used to minimize risks, with surgical treatment (metroplasty) as indicated. Metroplasty, however, carries the risk of complications such as genital fistulas, which are uncommon but clinically significant. This article presents a clinical case of a uterocervicovaginal fistula after vaginal metroplasty. According to the medical history, a patient with uterine isthmocele in the lower segment had a spontaneous singleton pregnancy after surgical treatment. The pregnancy ended in abortion with expulsion of the gestational sac through the fistulous opening. The patient underwent repeat surgery at the Department of Operative Gynecology and Gynecologic Oncology with Day Hospital, V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology. The procedure aimed to restore the anatomic integrity of the reproductive organs and to provide preconception care for a future pregnancy. This is the first published report of this complication, highlighting its clinical and scientific significance.