DOI: https://doi.org/10.30841/2307-5112.1-2.2020.204760

Clinical and Paraclinical Aspects of Uterine Fibroids Complicated by Infertility

М. А. Флаксемберг

Abstract


The relevance of preventing the development of uterine leiomyoma is important in connection with an increase in the frequency and decrease in the onset disease age, as well as a social tendency to postpone the implementation of reproductive function to a later age. On the one hand, the uterine fibroids presence can lead to a reproductive dysfunction, in particular infertility. On the other hand, there is a complicated course of pregnancy, a high risk of reproductive losses, anomalies of labor and postpartum complications.

The objective: to determine the relationship between uterine leiomyoma and infertility in reproductive age women based on the course of the disease and data from instrumental research methods.

Materials and methods. An analysis of complaints, medical history, clinical data and results of an ultrasound study of 336 reproductive age patients with uterine leiomyoma was carried out. The clinical features, the frequency of concomitant pathology, the dependence of infertility and miscarriage on the localization and size of nodes, the onset disease age and anamnesis were studied.

Results. It was found that among patients with uterine leiomyoma, infertility occurred in 34 % of cases. These patients were significantly younger compared with other groups and their disease developed much earlier, on average, at 29 years old. Among the concomitant pathologies, the combination of uterine fibroids and infertility is characterized by a high frequency of concomitant inflammatory diseases of the genital organs (73 %) and genital adhesions (39.1 %). Women with miscarriage are characterized by the presence of multiple uterine fibroids (66.7 %) with large nodes (62.5 %) that distort the uterine cavity (41.7 %). In patients who realized reproductive function, uterine leiomyoma developed 5 years later than in the group with infertility.

Conclusions. The etiology of infertility in uterine leiomyoma is multifactorial. The concomitant inflammatory process of the genitals is one of the factors in the early manifestation of uterine leiomyoma, which should be taken into account when examining patients and determining measures for preventing the development of the disease and rapid growth of nodes. For miscarriage, the presence of multiple nodes, distorting the uterine cavity, larger than 30 mm, is critical.

Keywords


uterine leiomyoma; infertility; miscarriage; reproductive age; risk factors

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ISSN 2412-8708 (Online), ISSN 2307-5112 (Print)

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ISSN (print): 2307-5112.