ANALYSIS OF FACTORS OF REPRODUCTIVE FUNCTION DISORDERS IN WOMEN WITH INFERTILITY AND UTERINE LEIOMYOMA IN ASSISTED REPRODUCTIVE TECHNOLOGY PROGRAMS
DOI:
https://doi.org/10.11603/1681-2786.2020.4.11916Keywords:
infertility, uterine leiomyoma, steroid hormones, innate nonspecific immunity, specific immunity, assisted reproductive technologiesAbstract
Purpose: to study the factors of reproductive dysfunction in infertile women with uterine leiomyoma by analyzing hormonal and immunological homeostasis and further optimization of the treatment and prevention complex.
Materials and Methods. A randomized prospective clinical study was conducted among 175 (29.0 %) women of reproductive age who were diagnosed with uterine leiomyoma (UL) and a control group (CG) of 32 somatically healthy women with normal menstrual and reproductive functions, who were divided into the following groups: Main Group (MG) A – 137 women with UL receiving the proposed treatment; Comparison Group (CG) B – 38 women with UL receiving conventional treatment.
Results. An analysis of the reproductive hormonal panel in the examined women of the main group on day 2–3 of the menstrual cycle revealed a decrease in estradiol concentration with unchanged progesterone levels (p>0.05) and a significant decrease in progesterone in women of the main group and the comparison group on day 21 of the cycle. In women of the main group and the comparison group, a statistically significant decrease in the level of estradiol in the blood was observed (60.27±0.004) and (66.69±0.003) nmol/l. A decrease in the ratio of LH to FSH was detected in the range of 1.18–1.2, whereas the required physiological balance is 1.5–2.0, which indicates an impairment of the hormone-producing function of the ovaries.
Conclussions. Changes in specific and nonspecific immunity observed in women with infertility and uterine leiomyoma in assisted reproductive technology programs are subcompensated by reducing the potential bactericidal activity of phagocytic cells, reducing the activity of phagocytic cells by 52.4 %, an increase in immunological coefficient and relative number of 0-lymphocytes, a 48.2 % decrease in the relative number of T-lymphocytes, leuko-T-cell index, and immunoregulatory index and a concurrent increase in the relative number of CD8 + cytolytic lymphocytes by 50.3 %.
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