Clinical Characteristics of the Examined Patients with Infertility and Perioded Prenatal Stress

Abstract

The purpose of the study was to go thoroughly into a question about the clinical features of the history and reproductive status in women with psychoemotional disorders associated with prenatal stress in comparison with the clinical features of the history and reproductive status of somatically healthy women with tubo-peritoneal factor infertility. Materials and methods. The study involved 120 patients, 80 of whom experienced prenatal stress: the main group, which was divided respectively into group 1 – women who underwent in vitro fertilization and group 2 – women who did not undergo in vitro fertilization. For comparison, a control group of 40 women without prenatal stress was formed. The age of the patients ranged from 22 to 45 years. Complaints, medical and life history, gynecological history, educational level were studied in all patients, and the causes of infertility were assessed. Results and discussion. Among the causes of primary infertility, hypothalamic-pituitary-ovarian insufficiency and associated ovulatory changes, which are manifested by menstrual irregularities, are dominant. Persistent anovulation, lack of correction of menstrual irregularities lead to the development of endocrine-dependent gynecological diseases, one of the manifestations of which is primary infertility. The frequency of infertility with a regular menstrual cycle is 30-70%. In these patients, combined forms of infertility are more common. The study found that in terms of place of residence, social status, the presence of bad habits, gynecological history data, infertile patients in vitro fertilization programs do not differ from healthy women with tubo-peritoneal factor of infertility. A significant difference was revealed between the indicators of the nature of the menstrual cycle in the comparison groups. It was found that a menstrual cycle lasting less than 23 days is a predictor of decreased functional activity of the hypothalamic-pituitary-ovarian axis in women. Analysis of the hormonal regulation of the reproductive function of the examined groups of women established the prevalence of follicle-stimulating hormone indices in the main group over the control group (9.6 ± 0.2 versus 6.2 ± 0.1 mMod / ml, respectively, p <0.05), and the thyroid-stimulating hormone level had no differences between comparison groups. We proposed to distinguish 3 states of ovarian reserve – normal, low and extremely low for women with infertility and a history of prenatal stress. Conclusion. Timely comprehensive assessment of the state of the endocrine system, the state of the ovaries in relation to the state of the regulatory mechanisms of psychoemotional adaptation of women with infertility associated with prenatal stress, which we studied, requires a partial revision of approaches to this group of patients and the timely use of in vitro fertilization to improve the effectiveness of infertility treatment