Features of the women hormonal background with endometriosis-associated infertility

Abstract

Introduction. According to experts, endometriosis affects 10-15% of women of reproductive age; the percentage of endometriosis-associated infertility in this category of women is 30-50%. Given that endometriosis affects women of young reproductive age, the question arises about conservative and surgical ways to restore reproductive function.

Objective of the research: to analyze retrospectively the level of serum hormones of patients with endometriosis-associated infertility, depending on the type of treatment of endometrioid cysts.

Materials and methods. The study included 114 women aged 21- 40 years with endometriosis-associated infertility, who were treated at the “ProfessorS.KhmilClinicMedicalCenter”. The comparison group included 30 women with tuboperitoneal infertility factor. Patients with endometriosis-associated infertility were divided into 2 groups. Group 1 consisted of 54 women of reproductive age with unoperated endometrioid cysts up to4 cm in diameter, group 2 - 60 women with a medical history of surgical treatment of endometrioid cysts. Each of the groups was divided into 2 subgroups. 1a - monolateral endometrioid cysts; 1b - bilateral endometrioid cysts; 2a - without recurrent cysts in the previously operated ovary; 2b - with mono- or bilateral cysts in the previously operated ovary.

Determination of the concentration of the reproductive system hormones was performed in an accredited laboratory of the “Professor S. Khmil Clinic Medical Center” with the help of  “Diagnostic Systems Laboratories, Inc.” test system (USA) using the analyzer “StatFax”.

Results and Discussion. It was found that the concentration of AMH was probably lower in the blood serum of women who underwent cystectomy, but did not differ statistically significantly between groups 2a and 2b. The concentration of FSH in the experimental groups was probably higher than in the comparison group, but its level in different experimental groups probably did not differ when analyzing the rank variations of Kruskal-Wallis. Changes in LH concentration had similar dynamics to FSH, in particular, the level of LH in the experimental groups was probably higher against the data of the comparison group. It should be noted that the concentration of LH in 2b group was probably higher in relation to 1a (by 26.25%), 1b (by 22.42%) and 2a (by 20.24%) groups. Progesterone level was statistically significantly lower in groups 1a, 1b and 2b relative to the comparison group. Analysis of prolactin level did not show statistical difference both in the analysis of rank variations of Kruskal-Wallis, and when compared with the data of the comparison group.

Conclusions. Women with endometriosis-associated infertility have hormonal disorders characterized by increased levels of follicle stimulating and luteinizing hormones, estradiol, decreased levels of progesterone and anti-müllerian hormone, with AMH probably lower in women after cystectomy, according to data of unoperated patients.