Today we will consider the deficiency of magnesium and zinc: the problem of conception in married couples varies widely and has no tendency to decrease in all countries of the world and is 8-18%. Infertility in a married couple can be caused by several reasons, and therefore the diagnosis and treatment of infertility is a difficult and lengthy process. Special attention among the causes leading to infertility, both congenital and acquired, is paid to the connective tissue, which makes up the stroma of all organs and occupies about 50% of the body weight.
Connective tissue dysplasia (CTD) is a poorly studied condition, it has two types that affect the reproductive function. The first group includes diseases with hereditary collagen diseases-collagenopathies. The second group consists of undifferentiated CTD — this is a genetically heterogeneous pathology caused by changes in the genome due to multifactorial influences, which, in turn, can lead to various chronic diseases. The development of both hereditary connective tissue disorders (syndromic forms) and non-syndromic forms is based on mutations of genes responsible for the synthesis/catabolism of structural connective tissue proteins or enzymes involved in these processes, quantitative changes in the formation of full-fledged extracellular matrix components, fibrillogenesis disorders. CTD is a multi-level process, since it can manifest itself at the gene level, at the level of an imbalance of enzymatic and protein metabolism, as well as at the level of a violation of the homeostasis of individual macro – and microelements.
Magnesium and zinc are necessary for the full formation of collagen at all levels. Zinc is a basic element in the synthesis of collagen. The entire connective tissue system is built on it. With a lack of zinc, the synthesis of collagen in the body is disrupted, since zinc takes part in more than 80% of enzymatic processes, plays a major role in the production of DNA and cell division, contributes to the stabilization of the structure of RNA, DNA, ribosomes. Magnesium, in addition to its alkalizing properties, is an integral part of the enzymes involved in the formation of collagen. The effects of magnesium on connective tissue are not limited to collagen and collagenases.
Microfibrils and elastin are the main components of flexible fibers. The degradation of elastin fibers can significantly increase (by 2-3 times) in the presence of magnesium. Its deficiency corresponds to a lower activity of elastases and a higher concentration of flexible fibers. It is proved that the most common effect of magnesium on connective tissue is that the ions are necessary for the stabilization of non-coding RNAs. Magnesium deficiency leads to an increase in the number of dysfunctional transport RNA molecules, reducing and slowing down the overall rate of protein synthesis. Thus, its role is extremely important for the structure of connective tissue, which is one of the main bioelements that ensure the physiological metabolism of connective tissue. Despite the fact that magnesium is widely distributed in nature, its deficiency in the human population occurs in 16-42%.
The aim of the study was to evaluate the quality of the obtained embryos in patients with CTD when correcting the concentration of magnesium and zinc in the blood serum.
Magnesium and zinc deficiency
Materials and methods of research
The clinical study included in the observation group 75 patients with infertility on the background of CTD of varying severity, who were divided before the in vitro fertilization (IVF) program into two observation subgroups: subgroup I (n = 40) did not receive treatment, while patients of subgroup II (n = 5) underwent nutrition correction taking into account macro – and microelements: magnesium at a dose of 1500 mg/day and zinc 20 mg/day for 30 days before the IVF program, in the IVF program and up to 20 weeks of pregnancy. The main indications for IVF were tubal infertility, infertility associated with stage 1, 2 and 3 endometriosis, endocrine infertility associated with the absence of ovulation, and male infertility with mild sperm pathology. The comparison group is represented by 25 practically healthy women who have no problems with conception.
The patients of the observation and comparison group were comparable in age and social status. The average age of the patients was 33 years with fluctuations from 25 to 45, in the comparison group 27 years. When analyzing morphoanthropometric data, it was revealed that the average height of patients with infertility was 162.5 cm, did not differ from the average height of pregnant women in the comparison group. The body weight of the patients in the observation group was 63 kg, did not differ from the comparison group.
Results and their discussion
From the anamnesis, it was found that every third woman – 21 (28%) had secondary and 54 (72%) – primary infertility. The duration of infertility in a married couple ranged from 2 years to 12 years, on average-6.1 years. 48 (64%) patients were diagnosed with tubal-peritoneal factor of infertility, 30 (40%) – reduced ovarian reserve, 21 (28%) – endometriosis, 3 (4%) – polycystic ovary syndrome. It should be noted that every third patient has a combination of 2 to 3 factors of female infertility.
All patients with CTD who have a female factor of infertility in the IVF program should study the concentration of magnesium and zinc (magnesium and zinc deficiency) in the blood serum and follicular fluid, with a decrease in the concentration of magnesium and zinc in the follicular fluid, treat using magnesium and zinc preparations for 30 days before the IVF program, in the IVF program and up to 20 weeks of pregnancy.