Characteristics of factors contributing to disorders of reproductive function in patients with adenomyosis

Z.S. Guseinova
In: Russian Bulletin of Obstetrician-Gynecologist · 2025 · vol. 25(2) , pp. 68 · doi:10.17116/rosakush20252502168 · W4409887143
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Abstract

Objective. Timely diagnosis of adenomyosis, identification of distinctive and similar signs in comparison with other benign diseases of the uterus, as well as the study of the features of reproductive disorders in this disease. Material and methods. 4 groups of patients were examined: the control group consisted of 50 practically healthy women; the 1st group consisted of 165 patients without adenomyosis, with impaired reproductive function and with other benign uterine diseases; the 2nd group consisted of 19 patients with adenomyosis and impaired reproductive function; the 3rd group consisted of 16 patients with impaired reproductive function — functions in which adenomyosis was combined with one of the benign diseases of the uterus (uterine fibroids, endometrial hyperplasia, endometrial polyps). Results. With adenomyosis, the frequency of reproductive function disorders increased with increasing age of the patients. Menstrual cycle disorders most often appeared in the form of menometrorrhagia and dysmenorrhea. In group 2, secondary infertility was more common than in the other groups. In the group with isolated adenomyosis, the levels of estradiol, luteinizing hormone, were higher, and the level of progesterone in the blood was lower than in the other groups. Blood prolactin levels were higher in the groups with adenomyosis (groups 2 and 3) compared with those in the control and 1st groups. Changes in uterine artery hemodynamics were observed between the groups. In the 2nd group with adenomyosis, the systolic ratio, resistance index, and relaxation index were higher than in the other groups. Conclusion. Timely assessment and diagnosis of clinical signs of adenomyosis, as well as identification of differences in laboratory and instrumental examination parameters from those in other benign uterine diseases, form a pathogenetically based approach to the realization of reproductive function in patients with adenomyosis.

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adenomyosisdysmenorrheainfertility

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