Abstract

The clinical confirmation of the relationship between uterine leiomyoma and female infertility is of interest to scholars. The aim of our research was to study obstetric history and the level of sex hormones in women of reproductive age with leiomyoma. Materials and methods. The main group consisted of 90 women of reproductive age with uterine leiomyoma, the control group - 45 healthy women. Gynaecological and obstetric history, hormone content in peripheral blood and pelvic vessels (estradiol, progesterone) were analysed. Statistical processing of clinical material was performed using Microsoft Excel, Statistica 7.0, and Statistica 8.0 for Windows. Results. The frequency of infertility in the surveyed women with LM was 18.9 %. One in three patients in the main group (33.3 %) did not give birth, which was statistically different from the healthy women group. In this case, 25.6 % of women in the main group did not use any methods of contraception. It was found that 51.11 % of patients with LM had threatened miscarriage in their history, 37.5 % – complicated delivery. Pathological changes in the concentrations of estradiol and progesterone in the preferential blood and blood vessels of women with fibroids have been identified. We have found that the content of sex hormones in the local bloodstream has a reliable relationship with the location of the myomatous node. Conclusion. The obtained results may indicate that leiomyoma contributes to the reduction of fertility. This is evidenced by the fact that women with LM are more likely to have the risk of miscarriage, complicated delivery and delivery by caesarean section, including complicated one. The findings have made a significant contribution to the further development of effective strategies for the prevention and treatment of infertility in women with fibrotic uterine lesions.

Highlights

  • Uterine leiomyoma is a tumour of smooth muscle cells, which is the most common gynaecologic oncologic benign disease among women of reproductive age [1, 2]

  • 25.6 % of women in the main group did not use any methods of contraception

  • The obtained results may indicate that leiomyoma contributes to the reduction of fertility

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Summary

Introduction

Uterine leiomyoma (fibroids, fibroma) is a tumour of smooth muscle cells, which is the most common gynaecologic oncologic benign disease among women of reproductive age [1, 2]. This pathology is often identified in the diagnostic search in infertile couples [3, 4]. Fibroids are hormone-dependent tumours and it has been proven that estrogens contribute to their growth: local estrogen concentrations at myomatic nodes are higher than in surrounding myometrium, possibly due to a higher aromatase concentration [5, 6]. Fibroids can cause infertility through obstruction of the fallopian tubes, impaired migration of sperm and gamete transport, implantation of blastocysts through venous ectasia and endometrial atrophy near myoma, as well as increased expression of angiogenetic factors [4, 5]

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