How the therapy for endometriosis affects the hormonal status in female infertility

Pedachenko N. Yu., Shemelko T. L., Tukhtarian R. A. How the therapy for endometriosis affects the hormonal status in female infertility. Journal of Education, Health and Sport. 2020;10(8):505-517. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.08.062 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.08.062 https://zenodo.org/record/4064093 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2020; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 04.08.2020. Revised: 14.08.2020. Accepted: 31.08.2020. How the therapy for endometriosis affects the hormonal status in female infertility N. Yu. Pedachenko1, T. L. Shemelko2, R. A. Tukhtarian1 1Shupyk NMAPE 2State Institution “Ciscarpathian Centre for Human Reproduction”, Health Ministry of Ukraine Pedachenko Natalia, MD, Dr Sci., Professor, Professor of Obstetrics, Gynecology and Perinatology Department of the Shupik National Medical Academy of Postgraduate Education; 9 Dorogozhitska Str Kyiv 02000 Ukraine; Clinical facility - Kyiv City Maternity Hospital No1, 5 Arsenalnaya Str,. Tel. +380 (44) 2850424, email: clinicnv@gmail.com ORCID 0000-0002-0821-2943 Shemelko Taras, obstetrian-gynecologist, Ciscarpathian Centre for Human Reproduction, Health Ministry of Ukraine ORCID 0000-0002-6333-0328 Tukhtarian Roksana, intern-doctor, Department of the Shupik National Medical Academy of Postgraduate Education ORCID 0000-0003-1452-8677 Abstract Aim. To determine changes in the values of pituitary and ovarian hormones in women with endometriosis-associated infertility, as well as to evaluate the impact of endometriosis therapy on hormonal parameters Materials and Methods. Sixty-nine women with small-sized endometriomas with adenomyosis (target group) and 50 women with tubal infertility (controls) were examined. The values of pituitary (luteinizing and follicle-stimulating hormones, prolactin) and ovarian (estradiol, tubular antimullerian hormone) hormones were studied. The comparison of quantitative indicators between the studied groups of women was carried out using the Mann-Whitney U-test, the statistical significance of the results was assessed at a level of not less than 95% (risk of error not more than 5% - p Results Infertile women with endometrioma and adenomyosis have lower AMH levels than infertile women with tubal factor. Among patients with endometriosis, there is an increase in serum FSH, LH, prolactin and estradiol compared with women without endometriosis. Dienogest moderately inhibits the secretion of FSH and LH; it has almost no effect on blood AMH and estradiol values. The use of dienogest can moderately increase the level of prolactin, It is noteworthy that these indicators are within the reference range. The use of diferelin for the treatment of endometriosis has a more active effect on the hormonal status of patients, given the decrease in such indicators as FSH and LH, AMH, estradiol and prolactin Conclusions. Women with infertility against the background of endometriosis have minor changes in the hypothalamic-pituitary-ovarian system, which indicates the need to develop medical measures in order to correct them. The use of dienogest compared to diferelin affects the hormonal status of patients with endometriosis to a lesser extent, given the pronounced anti-proliferative effect. Key words: endometriosis; pituitary hormones; ovarian hormones; hypothalamic-pituitary-ovarian system; infertility; dienogest; a-GnRH; diferelin.