20-30% of uterine myomas grow during pregnancy, and this growth is most common in the first 10 weeks. In most women with fibroids, there is no change in the size of the fibroid after becoming pregnant until delivery. In the second and third trimesters of pregnancy, the growth of fibroids can be seen, there is vascular insufficiency, and as a result, some degenerative changes can occur. Clinically, this often causes pain and local tenderness and may lead to preterm labor.During childbirth, uterine myomas can cause laziness of the uterus, fetal position disorders, and obstruction of the birth canal. Large cervical or isthmic fibroids may require caesarean section. Fibroids can cause uterine contraction disorder and lead to bleeding after delivery.If the location and size of the uterine myomas are suitable, it can be removed during caesarean section. However, the removal of some uterine myomas can cause bleeding during pregnancy due to increased blood flow to the uterus. Therefore, myomectomy is not always applied during cesarean section.
PCOS has a leading place in women's infertility. Based on the data of recent researches, Anti-Mullerian hormone (AMH) has been considered as one of the diagnostic criteria for PCOS. The aim of study was to determine the interrelation of Anti-Mullerian hormone with hormonal and ovarian morphological characteristics in patients with PCOS, with and without insulin resistance. 110 women with diagnosis of PCOS were involved in the study. Patients were divided into two groups: PCOS patients with insulin resistance (60 women) and PCOS patients without insulin resistance (50 women).All patients underwent hormonal investigation (AMH, FSH, LH, T, FT, HOMA-IR, FAI and SHBG). The volume of ovaries and the number of antral follicles (AFC) were determined by ultrasound imaging. Сorrelation between AMH and the ovarian hormonal and morphological characteristics has been shown. In particular, a significant positive interrelation between AMH and the volume of the ovaries in both groups was demonstrated. In the group of patients with PCOS and insulin resistance a positive interrelation between AMH and the volume of ovary, AFC was shown, as well as a negative interrelation between AMH and SHBG. In the same group a tendency of the positive interrelation between AMH and TT, HOMA-IR and IRI was seen. In the group of patients with PCOS without insulin resistence a positive interrelation between AMH and the volume of ovary was observed, as well as the tendency of positive interrelation between AMH and AFC, TT, HOMAIR, IRI. Additionally, a negative interrelation between AMH and SHBG was seen in the later patient group. Increased levels of AMH in all PCOS patients in our study, in comparison with the accepted norm, indicates on possibility of using this data in the diagnosis of PCOS. AMH levels in PCOS patients with and without insulin resistance do not differ significantly. The interrelation between AMH and the morphological characteristics of ovaries has been established.
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