ENDOMETRIOSIS-ASSOCIATED INFERTILITY: THE ROLE OF HORMONES AND ITS CORRECTION
Keywords:infertility, endometriosis, hormones, sclerotherapy, inositol, vitamin D3
Background. Endometriosis-associated infertility (EAI) has a number of specific features, which are crucial in the choice of medical treatment.
Objective. The aim of the study is to analyze endocrine profile in women with EAI before and after sclerotherapy and pregravid preparation (PP), which includes a vitamin complex FT 500 plus with inositol and vitamin D3.
Methods. The study involved 70 women aged 21-40 years with endometriosis-associated infertility. The comparison group included 30 women with tuboperitoneal infertility. ELISA was used to determine concentrations of Anti-Mullerian hormone (AMH), follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone and estradiol in blood serum using a standard kit by Diagnostic Systems Laboratories, Inc (USA). During two menstrual cycles the FT 500 plus was prescribed once a day from the 2nd/3rd day of the cycle, vitamin D3 was prescribed at the dose of 2,000 IU for women without its deficiency and in therapeutic doses in case of hypovitaminosis. The sclerotherapy with 95% ethanol solution was performed on the 6th-8th day of menstrual cycle.
Results. It was established that in women with EAI undergoing PP and sclerotherapy the level of AMH was lower (by 12.90%) as well as progesterone (by 9.84%), while FSH (by 14.47%), LH (by 21.14%) and estradiol (by 35.55%) was higher compare to the comparison group. At the same time, FSH (by 21.98%), LH (by 32.89%) and estradiol (by 32.23%) concentrations were significantly lower compare to their primary indices before sclerotherapy.
Conclusions. Sclerotherapy and PP with a vitamin complex, inositol and vitamin D3 has a positive effect on endocrine profile in women with endometriosis-associated infertility
Abbas S, Ihle P, Koster I, Schubert I. Prevalence and incidence of diagnosed endometriosis and risk of endometriosis in patients with endometriosis-related symptoms: findings from a statutory health insurance-based cohort in Germany. Eur J Obstet Gynecol Reprod Biol 2012;160:79–83.
Giudice LC. Clinical Practice: Endometriosis. N Engl J Med 2010; 362: 2389-98.
Bulun SE. Endometriosis. N Engl J Med 2009;360(3): 268-79.
Shestakova IG, Ipastova ID. [Endometriosis: a new consensus — new solutions: Global consensus on the management of patients with endometriosis as a first step towards the creation of industry standards: News bulletin]. Moscow: Status Praesens, 2014; 16 p. (In Russian).
Shcherbyna NA, Demidenko DI, Demidenko AD. [Melatonin’s tocolytic activity in threatening preterm birth]. Emergency Medicine. 2014;5:100-102. (In Russian).
Borham MM. Comparison between omentoplasty and partial cystectomy and drainage (PCD) techenques in surgical management of hydatid cysts liver in endemic area (Yemen). J. Egypt. Soc. Parasitol. (JESP) 2014; 44(1):145-50.
Shakiba K, Bena JF, M McGill K. Surgical treatment of endometriosis: a 7-year follow-up on the requirement for further surgery. Obstetrics and Gynecology. 2008;111(6):1285-92.
Khamoshina MB, Vakhabova MI, Kalinina EA. [Pharmacotherapy of endometriosis: opportunities and perspectives]. Meditsnskyi Sovet. 2013;8: 23-7. (In Russian).
Matsuzaki S, Houlle C, Darcha C. Analysis of risk factors for the removal of normal ovarian tissue during laparoscopic cystectomy for ovarian endometriosis. Human Reproduction. 2009; 24(6):1402-06.
Singh AK, Chattopadhyay R, Chakravarty B, Chaudhury K. Markers of oxidative stress in follicular fluid of women with endometriosis and tubal infertility undergoing IVF. Reprod Toxicol. 2013; 42:116-24.
DOI: https://doi.org/10.1016/j.reprotox.2013. 08.005
Augoulea A, Mastorakos G, Lambrinoudaki I, Christodoulakos G, Creatsas G. The role of the oxidative-stress in the endometriosis-related infertility. Gynecol Endocrinol.2009; 25: 75-81.
DOI: https://doi.org/10.3917/eres.strei.2009. 01.0075
Rubod C, Jean Dit Gautier E, Yazbeck C. Surgical management of endometrioma: Different alternatives in term of pain, fertility and recurrence. CNGOF-HAS Endometriosis Guidelines. Gynecol Obstet Fertil Senol. 2018 Mar;46(3):278–89.
Miquel L, Preaubert L, Gnisci A, Netter A, Courbiere B, Agostini. Transvaginal ethanol sclerotherapy for an endometrioma in 10 steps. Fertility and Sterility. 2020.Oct;115(1):259-64.
DOI: https://doi.org/10.1016/j.fertnstert. 2020.08.1422
Gatta G, Parlato V, Di Grezia G, Porto A, Cappabianca S, Grassi R. Ultrasound-guided aspiration and ethanol sclerotherapy for treating endometrial cysts. Radiol Med.Torino. 2010 Dec;115(8): 1330–9.
Aflatoonian A, Rahmani E, Rahsepar M. Assessing the efficacy of aspiration and ethanol injection in recurrent endometrioma before IVF cycle: A randomized clinical trial. Iran J Reprod Med. 2013 Mar;11(3):179–84.
Fisch JD, Sher G. Sclerotherapy with 5% tetracycline is a simple alternative to potentially complex surgical treatment of ovarian endometriomas before in vitro fertilization. Fertil Steril. 2004;82(2):437-41.
DOI: https://doi.org/10.1016/j.fertnstert.2004. 01.031
Tsoumpou I, Kyrgiou M, Gelbaya TA, Nardo LG. The effect of surgical treatment for endometrioma on in vitro fertilization outcomes: a systematic review and meta-analysis. Fertil Steril. 2009;92(1):75-87.
DOI: https://doi.org/10.1016/j.fertnstert.2008. 05.049
André GM, Vilarino FL, Christofolini DM, Bianco B, Barbosa CP. Aspiration and ethanol sclerotherapy to treat recurrent ovarian endometriomas prior to in vitro fertilization–a pilot study. Einstein (Sao Paulo). 2011 Dec;9(4):494-8.
Wang XT, Meng B, Liu JF, Jin FX and Xu H. The influences of ultrasound guided radiofrequency ablation assisted by polyol on fibroid volume and endocrine function among patients with uterine fibroid. Modern Practical Medicine 2018; 30: 1425-28.
Alborzi S, Namavar Jahromi B, Ahmadbeigi M. Recovery Rate of Patients with Recurrent Ovarian Endometriomas Using Sclerotherapy with 95% Ethanol. Journal of Obstetrics, Gynecology and Cancer Research (JOGCR). 2018 Sep 10;3(3):105-10.
Khmil SV, Kulyk II, Mykula RP. [Antioxidant therapy in women with infertility caused by endometriosis]. Bulletin of social hygiene and health care organization. 2018; 4 (78):56-63 (In Ukrainian).
DOI: https://doi.org/10.11603/1681-2786.2018. 4.10031
Tsysar Yv, Andriets OA. [The influence of pathology of thyroid gland on menstrual function in girls of pubertal age]. Bukovinian Medical Bulletin. 2011;15(2):130–4. (In Ukrainian).
How to Cite
Copyright (c) 2021 International Journal of Medicine and Medical Research
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who sent their manuscript to International Journal of Medicine and Medical Research agree to the following terms:
1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License CC-BY-NC that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
2. Authors able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).