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 %.
References
Onyshchuk, O.D. (2015). Optymizatsiia pidhotovky zhinok z bezpliddiam do zaplidnennia in vitro pislia nevdalykh poperednikh sprob [Optimization of training of women with infertility to in vitro fertilization after unsuccessful previous attempts]. Zdorovye zhenshchyny – Women᾽s Health, 10 (106), 112-117 [in Ukrainian].
Avramenko, N.V., Barkovskyi. D.Ye., Kabachenko, O.V., & Letsyn, D.V. (2017). Suchasni pohliady reproduktoloha na etiopatohenez i likuvannia leiomiomy matky [Modern views of the reproductive specialist on the etiopathogenesis and treatment of uterine leiomyoma]. Zaporizkyi medychnyi zhurnal – Zaporozhye Medical Journal, 19, 3 (102), 381-386 [in Ukrainian].
Moon, J.-W., Kim, C.-H., Kim, J.-B., Chae, H.-D., & Kang, B.-M. (2015). Alterations in uterine hemodynamics caused by uterine broids and their impact on in vitro fertilization outcomes. Clin. Exp. Reprod. Med., 42 (4), 163-168. DOI: 10.5653/cerm.2015.42.4.163.
Deligdish, L., & Loewenthal, M. (2014). Endometrial changes associated with myomata of uterus. J. CHn Pathol., 23, 676-680. DOI: 10.1136/jcp.23.8.676.
Samejima, T., Koga, K., Nakae, H., Wada-Hiraike, O., Fujimoto, A., Fujii, T., & Osuga, Y. (2015). Identifying patients who can improve fertility with myomectomy. Eur. J. Obstet. Gynecol. Reprod. Biol., 185, 28-32. DOI: 10.1016/j.ejogrb.2014.11.033.
Doroha, O., Iarotska, I., Vitiuk, A., & Strelko, H. (2019). Optimization of metods diagnostics and treatment of submucosal leiomyomas in woman of reproductive age. Georgian medical news, 12 (297), 35-41.
Fischer K., McDannold, N.J., & Tempany, C.M. (2015). Potential of minimally invasive procedures in the treatment of uterine broids: a focus on magnetic resonance- guidet focused ultrasound therapy. Int. J. Womens Health., 7, 901-912. DOI: 10.2147/IJWH.S55564.
Zepiridis, L.I., Grimbizis, G.F., & Tarlatzis, B.C. (2016). Infertility and uterine fibroids. Best Pract. Res. Clin. Obstet. Gynaecol., 34, 66-73. DOI: 10.1016/j.bpobgyn.2015.12.001.
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