THE PECULIARITIES OF HORMONAL HOMEOSTASIS IN WOMEN WITH INFERTILITY AND INTRAHEPATIC CHOLESTASIS
DOI:
https://doi.org/10.11603/1811-2471.2020.v.i1.11074Keywords:
pregnancy, infertility, intrahepatic cholestasis, hormonal homeostasisAbstract
The aim of the study – to examine the peculiarities of hormonal homeostasis in women with infertility treated with assisted reproductive technologies and with concomitant intrahepatic cholestasis.
Material and Methods. We analyzed the hormone profiles of 30 female patients with infertility and intrahepatic cholestasis (Group 1), 30 women with infertility but without intrahepatic cholestasis (Group 2) and 20 women from the reference group.
The levels of hormones in blood serum were measured with the use of standard kits for immunoradiometric assay.
Results and Discussion. Important to the assessment of the reproductive function are not only the absolute values of the follicle-stimulating hormone (FSH) and the luteinizing hormone (LH) but also their balance. The comparative analysis of the LH/FSH ratios in women with infertility and women from the reference group in the course of the menstrual cycle has significantly shown an increase of the said ratio in women from the basic groups in the follicular phase of the menstrual cycle (1.91±0.08) IU/l in patients with the hepatobiliary disorder vs. (1.47±0.06) and (1.19±0.08) IU/l in women from Group 2 and from the reference group respectively, р<0.05). The prolactin level, according to our findings, is significantly increased in patients from Group 1 in comparison with women from the reference group (9.11±0.18) vs. (8.43±0.22) ng/ml, р<0.05).
The average value of the estradiol level in blood serum on the fifth day of the menstrual cycle was significantly higher in women with infertility in comparison with the reference group (р<0.05). The average progesterone level on the 21st day of the menstrual cycle was significantly lower in women from Group 1 and 2 in comparison with the reference group (р<0.05), and still lower in women with intrahepatic cholestasis if compared with women with infertility but without such biliary disorders (р<0.05). The testosterone level in women with infertility from both basic groups is considerably higher than that measured in women from the reference group (р<0.05).
Women with infertility treated with assisted reproductive technologies and with concomitant intrahepatic cholestasis present more apparent signs of threat of abortion, in view of imbalance in progesterone and estrogen levels in favor of hyperestrogenism, which had been proved by the results of examination of the hormone levels in blood (reduction of the progesterone/estradiol ratio to (3.1±0.21) vs. (6.74±0.87) in pregnant women with infertility treated with ART but without hepatic pathologies, р<0.05).
Conclusions. The research of the hormonal status in women with infertility and concomitant hepatobiliary diseases found an imbalance in gonadotropic and sex hormones, which manifests itself in progesterone insufficiency, signs of hyperestrogenism, hyperandrogenism and hyperprolactinemia as well as more apparent signs of threat of abortion.
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