Peculiarities of gynecological history and reproductive status of women with psycho-emotional disorders related to prenatal stress
Abstract
Persistent anovulation, menstrual disorders lead to the development of endocrine-dependent gynecological diseases, one of the manifestations of which is primary infertility. The aim of the study: to assess the clinical features of history and reproductive status in women with psycho-emotional disorders associated with prenatal stress. The study involved 120 patients, 80 of whom suffered prenatal stress: 1 – the main group, which is divided into 1A subgroup – women who underwent in vitro fertilization, and 1B subgroup – women who did not undergo in vitro fertilization. For comparison, a 2 – control group of 40 women without prenatal stress with exclusively tubal factor of infertility, in which the parameters of the functional state of the reproductive system corresponded to the normal ovarian reserve. The age of patients ranged from 22 to 45 years. Complaints, anamnesis of disease and life, gynecological anamnesis, level of education were studied in all patients, the causes of infertility were assessed. The results of the study were processed using the statistical package of the licensed program “STATISTICA® for Windows 13.0”. The normality of the distribution of indicators was established by the Shapiro-Wilk criterion. Descriptive statistics are presented as the arithmetic mean and standard deviation of M±SD or the median and quartile interval Me (Q1-Q2) depending on the distribution of the trait. It was found that in place of residence, social status, the presence of bad habits, gynecological history of infertile patients in in vitro fertilization programs do not differ from healthy women with tubal-peritoneal factor infertility. There was a significant difference between the indicators of the nature of the menstrual cycle in the comparison groups. It has been found that a menstrual cycle of less than 23 days is a predictor of reduced functional activity of the hypothalamic-pituitary-ovarian axis in women. Analysis of hormonal regulation of reproductive function of the examined groups of women found the prevalence of FSH in the main group over the control (9,611±0,212 vs. 6,221±0,113 mMod/ml, respectively, (p<0.05), and the level of TSH was not differences between comparison groups. We proposed to identify 3 states of ovarian reserve - normal, low and extremely low for women with a history of infertility and prenatal stress. Conclusion: timely comprehensive assessment of the endocrine system, ovarian status in relation to the state of 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 timely use of in vitro extracorporeal the effectiveness of infertility treatment.
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