Determination of the proliferative activity of the endometrium during the period of the implantation window in veteran women of reproductive age with a history of contusion

Abstract

Today, more than 50.000 women serve in the Armed Forces of Ukraine. The number of people with post-traumatic stress disorder is 27.7 % among military personnel who took part in active combat operations. Post-traumatic syndrome is a frequent predictor of various states of proliferative activity of the endometrium in veteran women of reproductive age with changes in the hormonal background, morphofunctional changes of the endometrium, which in turn negatively affects the reproductive health of women. The purpose of the work: to determine the proliferative activity of the endometrium in patients of reproductive age who took part in hostilities and suffered a concussion. The selection criteria of the women included in the study were: the presence of contusion in the anamnesis, normospermia in the husband, the absence of pregnancy within a year after putting the main disease into remission, and unfulfilled reproductive plans. The age of the examined women ranged from 20 to 40 years. 457 women who took part in combat operations and suffered concussions were examined. The criterion for inclusion in the main group (O) was post-concussive syndrome as a consequence of a concussion sustained during hostilities. The number of examinees was 211 women. The criterion for inclusion in the comparison group (P) (n=246 women) was a concussion during combat operations, but the absence of post-concussion syndrome. The control group (K) included 30 civilian women without episodes of any trauma in the anamnesis. Clinical, instrumental and morphological research methods were used during the research. The most significant differences in the number of immunopositive endometrial cells in the state of proliferation and apoptosis were noted between groups P and O in chronic endometritis and simple atypical hyperplasia of the endometrium. Thus, in the structure of the endometrium of women with reproductive plans who participated in hostilities with episode of contusion in anamnesis, an increase in the proliferation processes in the glands and stroma of the endometrium against the background of intensification of the processes of apoptosis in the stroma and a decrease in the processes of apoptosis in the glands, which may interfere with the normal course of adhesion, was characteristic blastocysts and trophoblast invasions during implantation.