CLINIC CHARACTERISTICS OF PATIENTS WITH ENDOMETRIOSIS-ASSOCIATED INFERTILITY
About the author:
Khmil S. V., Kulyk I. I.
Heading:
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
Scentific article
Annotation:
Despite the fact that a lot of time has passed since the first mention of endometriosis as a disease, the pathogenesis of this disease has not been fully studied, as well as there is no clear definition of why endometriosis provokes infertility. Therefore, the aim of our study was to analyze the clinical characteristics of patients with endometriosis-associated infertility (EAI) depending on the treatment of endometrioid cysts. The study analyzed the data of medical records of 114 women aged 21 to 40 years with endometriosis-associated infertility, who were treated at the medical center “Clinic of Professor S. Khmil”. The control group included 30 women with tubal – peritoneal factor infertility. Analysis of the results of the study shows no differences in age distribution among patients of different groups. During the analysis of data on the distribution of women with EAI by duration of infertility depending on its type, it was found that most often in the first 5 years of diagnosed infertility non-operated women with monolateral endometrioid cysts came to the reproductive clinic, while for 10 years almost all women sought medical help. A burdensome reproductive history occurred in all women with EAI. Among the clinical manifestations of pain in women with EAI, algomenorrhea and dyspareunia in women with monoor bilateral cysts on the previously operated ovary predominated. Urogenital infection was dominated in the structure of extragenital diseases in all experimental groups. Chronic salpingoophoritis prevailed in the structure of gynecological diseases in patients with EAI. When distributing patients with EAI depending on the number of cysts in the affected ovary, it was found that the largest number of women has one cyst. Thus, risk factors for endometriosis-associated infertility include hormonal dysbalance, inflammatory diseases of the female genital organs, the presence of a history of surgery, abortion, abnormal childbirth. The use of assisted reproductive technologies to treat endometriosis-associated infertility is equally needed in non-operated women and those with a history of surgical treatment of endometrioid cysts.
Tags:
endometriosis, infertility, clinical characteristics.
Bibliography:
- Zaharenko OS, Yuzko OM, Zaharenko LV. Genitalnuy endometrioz yak pruchuna zhinochogo bezplidya. Neonatologiya, hiryrgiya ta perenatalna diagnostuka. 2013;3.1(7):76-9. [in Ukrainian].
- Yyzko OM. Dopomizhni reprodyktuvni texnologiyi Ukrayinu – 25 rokiv yspihy. Zbirnuk naykovux prats Asociaciyi akusher-ginekologiv Ukrayinu. 2016;2(38):393-5. [in Ukrainian].
- Giudice LC, Swiersz LM, Burney RO. Endometriosis. 6th ed. Elsevier New York; 2010.
- Bulun SE. Endometriosis. N Engl J Med. 2009;360(3):268-79.
- Giudice LC. Clinical Practice: Endometriosis. N Engl J Med. 2010;362:2389-98.
- Prescott J, Farland LV, Tobias DK, Gaskins AJ, Spiegelman D, Chavarro JE, et al. A prospective cohort study of endometriosis and subsequent risk of infertility. Hum Reprod. 2016;31:1475-82.
- Kycherina NS. Optumizaciya laparoscopichnogo likyvannya khvorykh z apopleksiyeyu yayechnuka [avtoreferat]. Kharkiv; 2009. 21 s. [in Ukrainian].
- Parasar P, Ozcan P, Terry KL. Endometriosis: epidemiology, diagnosis and clinical management. Curr. Obstet. Gynecol. Rep. 2017;6:34-41.
- Taylor RN, Lebovic DI. Endometriosis and infertility. New York: Elsevier; 2009. р. 577-95.
- McLeod BS, Retzolff MG. Epidemiology of endometriosis: an assessment of risk factors. Clin Obstet Gynecol. 2010 Jun;53(2):389-96. DOI: 10.1097/ GRF.0b013e3181db7bde
- Adamyan LV, Aznaurova YaB. Molekulyarnyye aspekty patogeneza endometrioza. Problemy reproduktsii. 2015;21(2):66-77. DOI: 10.17116/ repro201521266-77 [in Russiаn].
- Ferraro S, Esposito F, Abbamonte LH, Anserini P, Remorgida V, Ragni N. Quality of sex life in women with endometriosis and deep dyspareunia. Fertil Steril. 2005;83:573-9.
- Fauconnier A, Chapron C, Dubisson J-B, Vieira M, Bousset B, Bréart G. Relation between pain symptoms and the anatomic location of deep infiltrating endometriosis. Fertil Steril. 2002;78:719-26.
- Vercellini P. Endometriosis: what a pain it is. Semin Reprod Endocrinol. 1997;13:251-61.
- Jarząbek-Bielecka G, Radomski D, Mizgier M, Wilczak M, Durda M, Kaczmarek M, et al. Dyspareunia and algomenorrhea in women with endometriosis – clinical aspects of dienogest therapy. Curr. Gynecol. Oncol. 2014;12(4):271-7.
- Harada T. Dysmenorrhea and endometriosis in young women. Yonago Acta Med. 2013;56(4):81-4.
- Bulletti C, De Ziegler D, Polli V, Del ferro E, Palini S, Flamigni C. Characteristics of uterine contractility during menses in women with mild to moderate endometriosis. Fertile Steril. 2002;77:1156-61.
- Dzorayeva SK, Goncharenko VV, Ynychko SV, Bilyayev GM, Sobol NV, Schogolyeva OV, Babyta AR. Kliniko-epidemiologichni aspektu khronichnykh urogenitalnykh zakhvoryuvan pry protozoyniy invaziyi Trichomonas vaginalis. Dermatologiya ta venerologiya. 2017;1(75):34-9. [in Ukrainian].
- Goyal MK, Teach SJ, Badolato GM, Trent M, Chamberlain JM. Universal Screening for Sexually Transmitted Infections among Asymptomatic Adolescents in an Urban Emergency Department: High Acceptance but Low Prevalence of Infection. J Pediatr. 2016 Apr;171:128-32. DOI: 10.1016/j.jpeds.2016.01.019
- Leyland N, Casper R, Laberge P, Singh SS, SOGC. Endometriosis: diagnosis and management. J Obstet Gynaecol Can. 2010;32(7.2):1-32.
- Uncu G, Kasapoglu I, Ozerkan K, Seyhan A, Oral Yilmaztepe A, Ata B. Prospective assessment of the impact of endometrium as and their removal on ovarian reserve and determinants of the rate of decline in ovarian reserve. Hum Reprod. 2013;28(8):2140-5.
- Nowak-Psiorz I, Ciećwież S, Brodowska A, Starczewski A. Treatment of ovarian endometrial cysts in the context of recurrence and fertility [published online as ahead of print on January 15, 2019]. Adv Clin Exp Med. 2019;28(3):407-13. DOI: 10.17219/acem/90767
- Ofer A, Shulman LP, Singh SS. Improving the Treatment and Management of Endometriosis: Improving the treatment and management of endometriosis: An overview of current and novel approaches. Am J Obstet Gynecol. 2015;19:2540-3.
Publication of the article:
«Bulletin of problems biology and medicine» Issue 4 (158), 2020 year, 214-218 pages, index UDK 618.15-007.62+618.177