PECULIARITIES OF HORMONAL BACKGROUND OF WOMEN WITH INFERTILITY ON THE BACKGROUND OF OVARIAN ENDOMETRIOSIS

Abstract

Introduction. One of the most important aspects of endometriosis is its impact on the hormonal balance of the female body. This disease causes significant changes in the production and metabolism of hormones, which has a major impact on the clinical picture and treatment approaches.

The aim of the study – to evaluate the hormonal profile of women with infertility in the setting of ovarian endometriosis who underwent controlled ovarian stimulation in the cycle of infertility treatment by in vitro fertilization.

Research Methods. A retrospective analysis and processing of clinical and anamnestic data, materials of in vitro fertilization protocols with comparison of the main laboratory parameters of 112 outpatient records of women undergoing infertility treatment with ART was performed.

Results and Discussion. Follicle Stimulating Hormone (FSH) levels revealed a tendency to obtain eggs of poor quality, as evidenced by high levels of this hormone in the main study groups, namely (11.98±2.25) IU/L in the first group and (10.45±1.81) IU/L in the second. Low levels of luteinizing hormone (LH) along with elevated basal FSH lead to a decrease in the ratio of LH to FSH in women with endometriosis (p<0.05). A significant difference was found relative to the control group in women with a history of endometriosis-associated surgical interventions, in which the AMH level was the lowest and amounted to (0.98±0.11) ng/ml. The level of prolactin was borderline close to the upper limit of normal both in the first group of women ((19.25±4.36) μg/l) and in the second ((18.29±3.25) μg/l), which was a significant difference from the control group ((11.17±2.25) μg/l) (p<0.05). Progesterone on day 2–3 of the cycle was (1.23±0.21) ng/ml in the first group and (1.18±0.19) ng/ml in the second group. In the group of women with endometriosis-associated ovarian surgery, estradiol levels also tend to be elevated ((55.8±26.4) pg/ml) at the beginning of the follicular phase of the cycle. The level of total testosterone was significantly reduced in the first and second groups of the study and amounted to (0.38±0.21) ng/ml and (0.51±0.18) ng/ml, respectively.

Conclusions. The peculiarities of the hormonal profile in women with endometriosis-associated infertility indicate profound disorders of the hypothalamic-pituitary-ovarian axis, marked changes in the functioning of the reproductive system and hormonal disorders.