Clinical characteristics of women with infertility and ovaricovaricocele
Despite numerous studies devoted to the etiological factors and pathogenetic aspects of infertility, the lack of a comprehensive analysis of the causes of ovarian dysfunction and the exact diagnosis leads to the polypharmacy of hormonal drugs and their low effectiveness. One of the less well known and poorly studied factors is pelvic venous complications, including varicose veins of the ovaries. Violation of venous circulation in the pelvic organs plays a significant role in the structure of gynecological pathology, particularly in the development of ovarian dysfunction. The purpose of our study was to analyze the clinical characteristics of women with functional infertility and ovaricovaricocele, namely the features of anamnesis of life, gynecological and somatic anamnesis, the study of which allows to assess and determine the risk factors, possible causes of ovarian dysfunction and the formation of varicose veins. To solve the goals and objectives, were prospectively examined and divided into 2 groups for the comparative analysis 117 pregnant women of reproductive age (21–44 years old) with functional infertility: the main group was 62 women with infertility and varicose veins in the ovaries; comparison group has 55 women with infertility without varicose veins. Patients were examined by a specially designed questionnaire, which included the results of gynecological and somatic anamnesis, anamnesis of life. In the main group of women there is an increased proportion of women with intellectual differentiation of labor and psycho-emotional and physical activity, which may be the basis for the formation of maladaptation syndrome with the subsequent occurrence of functional disorders of the reproductive system. In addition, conditions of work with considerable physical activity can indirectly have a negative effect on venous hemodynamics in the small pelvis. Women with functional infertility and ovaricovaricocele had a high incidence of infectious diseases in childhood — 83.9%. It is precisely at the stage of formation of reproductive function that the action of an infectious factor can be significant in the occurrence of violations of complete oogenesis in the subsequent reproductive life of patients. Attention is drawn to the large number of inflammatory diseases of the internal organs in women as the main group and the comparison group in the study of the somatic anamnesis: from the otolaryngologic organs — 48.3%, respiratory organs – 54.7%, genitourinary system — 43.5% and in the structure of gynecological diseases: inflammation of ovaries — 43.5%, vagina and cervix — 25.8%, suggesting that factors of violations of folliculogenesis in active reproductive age may be inflammatory diseases of the genitals. There is a significant percentage of dyshormonal abnormalities in the form of abnormal uterine bleeding in the structure of gynecological pathology in women with functional infertility and ovaricovaricocele (30.6%) against patients with infertility without structural changes in ovarian veins. Patients with infertility are more likely to point out dysgharmony of sexual life (58.1%), which in patients with varicose veins in the pelvic organs was accompanied by dyspareunia (32.2%), suggesting the role of chronic stress as a risk factor for ovarian dysfunction, which is also exacerbated by the presence pain of syndrome in the lower abdomen in women of the main group (77,4%). The more significant percentage of gynecological pathology of endocrine genesis in women with functional infertility and ovaricovaricocele and the presence of certain extragenital pathology, which affects the formation of pelvic pelvic flooring in comparison with patients with infertility without structural changes in ovarian veins, is established during the analysis of the clinical characteristics of the significant percentage of venous hemodynamics in the functional properties of the ovary and induces further investigation of the role of varicose veins of the pelvic reservoirs, in particular ovariсovariсocele, in the pathogenesis of ovarian dysfunction in order to further develop the methods of therapeutic correction.
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