ENDOMETRIOSIS-ASSOCIATED INFERTILITY: THE ROLE OF HORMONES AND ITS CORRECTION

In: International Journal of Medicine and Medical Research · 2021 · vol. 6(2) , pp. 5–10 · doi:10.11603/ijmmr.2413-6077.2020.2.12011 · W3176907288
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Sclerotherapy and a vitamin complex with inositol and vitamin D3 improved the endocrine profile of women with endometriosis-associated infertility.

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The study evaluated endocrine profiles in 70 women aged 21–40 with endometriosis-associated infertility, comparing them with a group of 30 women with tuboperitoneal infertility. Using ELISA, serum anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), progesterone, and estradiol were measured before and after a two-cycle intervention that combined pregravid preparation (FT 500 plus containing inositol and vitamin D3) with transvaginal sclerotherapy using 95% ethanol on cycle days 6–8. Women with endometriosis-associated infertility had lower AMH and progesterone and higher FSH, LH, and estradiol compared with the tuboperitoneal infertility group, and within the EAI group FSH, LH, and estradiol decreased significantly compared with baseline after treatment. The authors conclude that sclerotherapy plus inositol and vitamin D3 preparation had a positive effect on endocrine profiles; the paper does not specify additional limitations such as randomization or blinding. This paper is centrally about endometriosis-associated infertility — it analyzes hormone changes before and after ethanol sclerotherapy and inositol/vitamin D3 pregravid preparation in women with endometriosis-related infertility.

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Abstract

Background. Endometriosis-associated infertility (EAI) has a number of specific features, which are crucial in the choice of medical treatment. Objective. The aim of the study is to analyze endocrine profile in women with EAI before and after sclerotherapy and pregravid preparation (PP), which includes a vitamin complex FT 500 plus with inositol and vitamin D3. Methods. The study involved 70 women aged 21-40 years with endometriosis-associated infertility. The comparison group included 30 women with tuboperitoneal infertility. ELISA was used to determine concentrations of Anti-Mullerian hormone (AMH), follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone and estradiol in blood serum using a standard kit by Diagnostic Systems Laboratories, Inc (USA). During two menstrual cycles the FT 500 plus was prescribed once a day from the 2nd/3rd day of the cycle, vitamin D3 was prescribed at the dose of 2,000 IU for women without its deficiency and in therapeutic doses in case of hypovitaminosis. The sclerotherapy with 95% ethanol solution was performed on the 6th-8th day of menstrual cycle. Results. It was established that in women with EAI undergoing PP and sclerotherapy the level of AMH was lower (by 12.90%) as well as progesterone (by 9.84%), while FSH (by 14.47%), LH (by 21.14%) and estradiol (by 35.55%) was higher compare to the comparison group. At the same time, FSH (by 21.98%), LH (by 32.89%) and estradiol (by 32.23%) concentrations were significantly lower compare to their primary indices before sclerotherapy. Conclusions. Sclerotherapy and PP with a vitamin complex, inositol and vitamin D3 has a positive effect on endocrine profile in women with endometriosis-associated infertility
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ENDOMETRIOSIS-ASSOCIATED INFERTILITY: THE ROLE OF HORMONES AND ITS CORRECTION DOI: https://doi.org/10.11603/ijmmr.2413-6077.2020.2.12011Keywords: infertility, endometriosis, hormones, sclerotherapy, inositol, vitamin D3Abstract Background. Endometriosis-associated infertility (EAI) has a number of specific features, which are crucial in the choice of medical treatment. Objective. The aim of the study is to analyze endocrine profile in women with EAI before and after sclerotherapy and pregravid preparation (PP), which includes a vitamin complex FT 500 plus with inositol and vitamin D3. Methods. The study involved 70 women aged 21-40 years with endometriosis-associated infertility. The comparison group included 30 women with tuboperitoneal infertility. ELISA was used to determine concentrations of Anti-Mullerian hormone (AMH), follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone and estradiol in blood serum using a standard kit by Diagnostic Systems Laboratories, Inc (USA). During two menstrual cycles the FT 500 plus was prescribed once a day from the 2nd/3rd day of the cycle, vitamin D3 was prescribed at the dose of 2,000 IU for women without its deficiency and in therapeutic doses in case of hypovitaminosis. The sclerotherapy with 95% ethanol solution was performed on the 6th-8th day of menstrual cycle. Results. It was established that in women with EAI undergoing PP and sclerotherapy the level of AMH was lower (by 12.90%) as well as progesterone (by 9.84%), while FSH (by 14.47%), LH (by 21.14%) and estradiol (by 35.55%) was higher compare to the comparison group. At the same time, FSH (by 21.98%), LH (by 32.89%) and estradiol (by 32.23%) concentrations were significantly lower compare to their primary indices before sclerotherapy. Conclusions. Sclerotherapy and PP with a vitamin complex, inositol and vitamin D3 has a positive effect on endocrine profile in women with endometriosis-associated infertility References Abbas S, Ihle P, Koster I, Schubert I. Prevalence and incidence of diagnosed endometriosis and risk of endometriosis in patients with endometriosis-related symptoms: findings from a statutory health insurance-based cohort in Germany. Eur J Obstet Gynecol Reprod Biol 2012;160:79–83. Giudice LC. Clinical Practice: Endometriosis. N Engl J Med 2010; 362: 2389-98. DOI: https://doi.org/10.1056/NEJMcp1000274 Bulun SE. Endometriosis. N Engl J Med 2009;360(3): 268-79. DOI: https://doi.org/10.1056/NEJMra0804690 Shestakova IG, Ipastova ID. 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Gynecol Obstet Fertil Senol. 2018 Mar;46(3):278–89. Miquel L, Preaubert L, Gnisci A, Netter A, Courbiere B, Agostini. Transvaginal ethanol sclerotherapy for an endometrioma in 10 steps. Fertility and Sterility. 2020.Oct;115(1):259-64. DOI: https://doi.org/10.1016/j.fertnstert. 2020.08.1422 Gatta G, Parlato V, Di Grezia G, Porto A, Cappabianca S, Grassi R. Ultrasound-guided aspiration and ethanol sclerotherapy for treating endometrial cysts. Radiol Med.Torino. 2010 Dec;115(8): 1330–9. DOI: https://doi.org/10.1007/s11547-010-0586-0 Aflatoonian A, Rahmani E, Rahsepar M. Assessing the efficacy of aspiration and ethanol injection in recurrent endometrioma before IVF cycle: A randomized clinical trial. Iran J Reprod Med. 2013 Mar;11(3):179–84. Fisch JD, Sher G. Sclerotherapy with 5% tetracycline is a simple alternative to potentially complex surgical treatment of ovarian endometriomas before in vitro fertilization. Fertil Steril. 2004;82(2):437-41. DOI: https://doi.org/10.1016/j.fertnstert.2004. 01.031 Tsoumpou I, Kyrgiou M, Gelbaya TA, Nardo LG. The effect of surgical treatment for endometrioma on in vitro fertilization outcomes: a systematic review and meta-analysis. Fertil Steril. 2009;92(1):75-87. DOI: https://doi.org/10.1016/j.fertnstert.2008. 05.049 André GM, Vilarino FL, Christofolini DM, Bianco B, Barbosa CP. Aspiration and ethanol sclerotherapy to treat recurrent ovarian endometriomas prior to in vitro fertilization–a pilot study. Einstein (Sao Paulo). 2011 Dec;9(4):494-8. DOI: https://doi.org/10.1590/s1679-45082011ao2081 Wang XT, Meng B, Liu JF, Jin FX and Xu H. The influences of ultrasound guided radiofrequency ablation assisted by polyol on fibroid volume and endocrine function among patients with uterine fibroid. Modern Practical Medicine 2018; 30: 1425-28. https://doi.org/10.1093/rfs/hhx014 Alborzi S, Namavar Jahromi B, Ahmadbeigi M. Recovery Rate of Patients with Recurrent Ovarian Endometriomas Using Sclerotherapy with 95% Ethanol. Journal of Obstetrics, Gynecology and Cancer Research (JOGCR). 2018 Sep 10;3(3):105-10. DOI: https://doi.org/10.1002/epi4.12285 Khmil SV, Kulyk II, Mykula RP. [Antioxidant therapy in women with infertility caused by endometriosis]. Bulletin of social hygiene and health care organization. 2018; 4 (78):56-63 (In Ukrainian). DOI: https://doi.org/10.11603/1681-2786.2018. 4.10031 Tsysar Yv, Andriets OA. [The influence of pathology of thyroid gland on menstrual function in girls of pubertal age]. Bukovinian Medical Bulletin. 2011;15(2):130–4. (In Ukrainian). Downloads Published How to Cite Issue Section License Copyright (c) 2021 International Journal of Medicine and Medical Research This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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