Ендокринна і гінекологічна захворюваність у жінок із непліддям та посттравматичним стресовим розладом

Abstract

Post-traumatic stress disorder is a complex of mental symptoms of an anxious, obsessive and avoidant nature that persist for more than 6 months after the impact of the traumatic factor. Purpose - to study the reproductive history of patients with infertility and post-traumatic stress disorder to improve preparation to additional reproductive technologies use. Materials and methods. The study analyzed the reproductive anamnesis, gynecological and endocrine morbidity of 67 patients with infertility, who were divided into 2 groups: the Group I - 36 women with impaired fertility before the action of a traumatic factor, the Group II - 31 women with infertility due to stress disorder The Comparison group consisted of 45 women with infertility without symptoms of post-traumatic stress disorder, the Control group - 30 healthy women. Results. The patients of the Group I had mostly primary infertility (80.5%), in the Group II, the vast majority of women had pregnancies and deliveries. 44.4% of women in the first group had a duration of infertility of 5 years or more, in the Group II 64.1% - up to 3 years. In the Group I, patients were characterized by late menarche (22.2%, in the Group II - 6.5%), uterine bleeding during adolescence (33.3%) and reproductive (27.8%) periods (in the Group II - 9.7% and 12,9%, respectively). Patients of the Group I more often had accompanying diabetes (33.3%; in the Group II - 16.2%), obesity (38.9%; in the Group II - 29.0%), hyperandrogenemia (27.8%; in the Group II - 16.2%). Every third patient with infertility and post-traumatic stress disorder had an increased concentration of prolactin. Conclusions. Post-traumatic stress disorder is a powerful factor of impaired fertility, because in the group of women with infertility registered after a traumatic factor, the previous history was uncomplicated (the vast majority of them had given birth - 77.5%), the frequency of endocrine disorders corresponds to the indicator of healthy women (carbohydrate metabolism disorders - 16.2% and 20.2%, respectively), obesity (29.0% and 23.3%, respectively), hyperandrogenemia (16.2% and 13.3%, respectively). Patients with post-traumatic stress disorder, who had infertility before the impact of the traumatic factor, mostly had the primary form of fertility disorder (80.5%), late menarche (22.2%; in the Control group - 6.6%), juvenile (33.3%; in the Control group - 6.6%) and abnormal uterine bleeding in the reproductive period (27.8%; in the Control group - 10%). Endocrine disorders were also more common in this group - carbohydrate metabolism disorders (33.3%), obesity (38.9%), hyperandrogenemia (27.8%). The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.