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THE STUDY OF CLINICAL AND ANAMNESTIC FEATURES IN
WOMEN WITH ADENOMYOSIS AND INFERTILITY.
Mukhammadjonova M.M.
Gafurova F.A.
Center for the Development of Professional Qualifications of Medical Workers,
Department of Obstetrics, Gynecology and Perinatal Medicine, Tashkent
https://doi.org/10.5281/zenodo.16024785
Key words:
endometriosis, infertility, endometriosis-associated infertility,
tubo-peritoneal infertility.
Introduction.
Endometriosis, which affects up to 10% of women of reproductive age, is
the presence of endometrial tissue outside the uterine cavity. It is more common
in women with pelvic pain or infertility. Some women have asymptomatic
endometriosis, while others show symptoms such as debilitating pelvic pain,
dysmenorrhea, dyspareunia, and lack of pregnancy. The data on epidemiology,
risk factors, clinical picture, diagnosis formulation and modern methods of
diagnosis and treatment of endometriosis in the domestic and foreign literature
were studied. Patients with endometriosis are more likely to have risk factors
such as early menarche, late menopause, shortening of the menstrual cycle,
absence of childbirth, and a short period of breastfeeding. The clinical picture of
endometriosis is variable and ranges from debilitating pelvic pain and infertility
to an asymptomatic course.
The purpose of the study
– to conduct a comparative assessment of the
clinical and anamnestic characteristics of women with endometriosis-associated
and tubo-peritoneal infertility.
Materials and methods.
This case-control retrospective study examined the clinical and anamnestic
characteristics of 67 women, comparing women with endometriosis-related
infertility (n=47) and women with tubo-peritoneal infertility (n=20). The study
showed that women with infertility associated with endometriosis were older
and more likely to experience pelvic pain, dysmenorrhea, dyspareunia, and
abnormal uterine bleeding. Diagnosis of endometriosis was often delayed for
about 3 years after the onset of symptoms. The authors conclude that women
with infertility associated with endometriosis have distinct clinical features
compared to women with tubo-peritoneal infertility, and suggest that surgical
treatment may be effective for these patients, which requires further research
on the need and timing of laparoscopy.
Results.
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Patients with endometriosis-associated infertility were older than women
with tubo-peritoneal infertility (31 and 29 years old, p = 0.002), they were more
likely to experience pelvic pain (41.3%), dysmenorrhea (29.3%), dyspareunia
(31.3%), abnormal uterine bleeding (12.7%) were only in participants with
Endometriosis is associated with infertility (in all cases, p = 0.001). The foci of
endometriosis in these patients were localized mainly on the pelvic peritoneum,
ligamentous apparatus of the uterus and ovaries. Stages I—II of endometriosis
were registered in 57% of patients with endometriosis-associated infertility,
stages III and IV — in 43%, while the relationship between the stages of the
disease and its clinical manifestations has not been established. The minimum
preserved function in patients with endometriosis-associated infertility
averaged 12.8 ± 5.6 points, EFI — 6.7 ± 2.6 points. Diagnosis of endometriosis
with verification of the diagnosis was delayed, on average 3 years after the onset
of symptoms of the disease.
Conclusion.
Women with infertility associated with endometriosis have distinct clinical
features compared to women with tubo-peritoneal infertility. Despite the fact
that the diagnosis of endometriosis with verification of the diagnosis was carried
out on average 3 years after the onset of symptoms of the disease, based on EFI,
it can be assumed that the effectiveness of surgical treatment of infertility in
these patients will be quite high. Further studies are required to assess the need
and timing of laparoscopy in this category of patients.
References:
1. Sarria-Santamera A., Orazumbekova B., Terzic M. et al. Systematic review and
meta-analysis of incidence and prevalence of endometriosis. Healthcare (Basel).
2020; 9(1): 29. DOI: 10.3390/ healthcare9010029
2. Bougie O., Yap M.I., Sikora L. et al. Influence of race/ethnicity on prevalence
and presentation of endometriosis: a systematic review and meta-analysis. BJOG.
2019; 126(9): 1104-15. DOI: 10.1111/1471-0528.15692
3. Khine Y.M., Taniguchi F., Harada T. Clinical management of endometriosis-
associated infertility. Reprod. Med. Biol. 2016; 15(4): 217-25. DOI:
10.1007/s12522-016-0237-9
4. Pantou A., Simopoulou M., Sfakianoudis K. et al. The role of laparoscopic
investigation in enabling natural conception and avoiding in vitro fertilization
overuse for infertile patients of unidentified aetiology and recurrent
SCIENCE AND INNOVATION IN THE
EDUCATION SYSTEM
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implantation failure following in vitro fertilization. J. Clin. Med. 2019; 8(4): 548.
DOI: 10.3390/ jcm8040548
5. Hwang H., Chung Y.-J., Lee S.R. et al. Clinical evaluation and management of
endometriosis: guideline for Korean patients from Korean Society of
Endometriosis. Obstet. Gynecol. Sci. 2018; 61(5): 553-64. DOI:
10.5468/ogs.2018.61.5.553
6. Artymuk N.V., Bezhenar V.F., Berlim Yu.D. et al.; Dubrovina S.O., Bezhenar V.F.,
eds. Endometriosis. Pathogenesis, diagnosis and management. M.: GEOTAR-
Media; 2020. 352 p. (in Russian).
7. Mettler L., Alkatout I., Keckstein J. et al., eds. Endometriosis: a concise practical
guide to current diagnosis and treatment. Endo Press GmbH; 2018. 480 p.
8. Hodgson R.M., Lee H.L., Wang R. et al. Interventions for endometriosis-related
infertility: a systematic review and network meta-analysis. Fertil. Steril. 2020;
113(2): 374-82.e2. DOI: 10.1016/j.fertnstert.2019.09.031
9. Collinet P., Fritel X., Revel-Delhom C. et al. Management of endometriosis:
CNGOF/HAS clinical practice guidelines — short version. J. Gynecol. Obstet.
Hum. Reprod. 2018; 47(7): 265-74. DOI: 10.1016/j.jogoh.2018.06.003
