Возможности коррекции гормонального статуса, репродуктивной функции и нейровегетативных расстройств у пациенток с преждевременной недостаточностью яичников

Abstract

Background: nowadays reproductive health condition tends to worsen. One of the problems is a decrease in the ovarian reserve, manifested in the form of premature ovarian insufficiency (POI), which initiates the infertility problem on the one hand, and the issue of premature menopause with all its accompanying socio-psychological aspects on the other Aim: to study the therapeutic possibilities of the bovine epiphyseal cartilage polypeptide in POI and anovulation in female patients aged 30–45 years old. Patients and Methods: the study included 40 female patients aged 30–45 years with a BMI of 18.5–29.9 kg/m2 and POI signs, determined by the following indicators: follicle-stimulating hormone (FSH) concentration ≥12 IU/L; anti-müllerian hormone (AMH) 0.2–1.2 ng/mL; antral follicle count (AFC) ≤5 during ultrasound on the 7th±2 day of the menstrual cycle; decreased serum estradiol concentration and anovulation lasting 1 to 5 years or with failed IVF. The female cohort was randomized into 2 groups of 20 persons: for two menstrual cycles, the main group received a drug for menopausal hormone therapy (MHT) containing 2 mg of estradiol and 10 mg of didrogesterone (per os 1 tablet daily in a cyclic regimen from day 1 to day 28) and the bovine epiphyseal cartilage polypeptide (lyophilizate for the preparation of a solution for intramuscular administration, 10 mg intramuscularly daily for 10 days from the 5th to the 14th day of the cycle). The control group received only MHT in the same regimen for two menstrual cycles. During the study, the changes of endometrial thickness and follicle growth, ovulation markers (corpus luteum), FSH, estradiol and AMH concentrations, the number of female patients with a normalized menstrual cycle and spontaneous conception were evaluated in both groups Results: in the main group there was a statistically significant (p<0.05) decrease in FSH and luteinizing hormone (LH) levels relative to the baseline, an increase in estradiol concentration, an increase in the AFC and endometrial thickness, whereas the similar indicator changes were statistically insignificant in the control group. Besides, complete relief of neurovegetative symptoms was noted in the main group, and restoration of the ovulatory cycle was observed in 6 (30%) cases. There were no adverse events or complications during the drug regimen. Conclusion: the results obtained indicated the efficacy of the bovine epiphyseal cartilage polypeptide in the treatment of female patients with POI and anovulation and allowed to recommend the developed treatment regimen for practical use. KEYWORDS: premature ovarian insufficiency, follicle-stimulating hormone, anti-müllerian hormone, infertility, anovulation, menopausal disorders FOR CITATION: Khardikov A.V., Netyaga O.A. Correction of hormonal status, reproductive function and neurovegetative disorders in female patients with primary ovarian insufficiency. Russian Journal of Woman and Child Health. 2024;7(2):116–122 (in Russ.). DOI: 10.32364/2618- 8430-2024-7-2-5.