Tofan B. Y.

PROGNOSIS OF PREGNANCY IN WOMEN WITH INFERTILITY DUE TO ENDOMETRIOSIS USING A MATHEMATICAL MODEL AND LAPAROSCOPIC SURGERY

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About the author:

Tofan B. Y.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

Annotation:

Endometriosis and infertility are great problems in Ukraine and the whole world. The objective of the research was to assess the possibility of the onset of spontaneous pregnancy in patients with endometriosis, to analyze endometriosis influence depending on its location, to evaluate the effect of Anti-Mullerian Hormone (AMH) and the number of antral follicles (NAF), and considering the above data to construct a mathematical model prognosticating the onset of spontaneous pregnancy. 80 women participated in the research who underwent laparoscopic surgery due to infertility. During surgery, Fallopian tube patency was diagnosed, and endometriosis was found which was excised later. Endometriosis was described according to ENZIAN classification. The women had previously AMH level measured, ultrasound examination was made, and NAF was calculated in the right and left ovaries. The data obtained from surgery, classification, AMH, USD were used for regression analysis. In the first analysis, 31 women out of 80 became pregnant. According to our prognostic model, pregnancy was prognosticated in 22 (67%) women out of 31 in the first variant. Pregnancy was not prognosticated in 9 (33%) women. In 16 (33%) of those who were predicted to be pregnant pregnancy occurred. Pregnancy did not occur in 33 (67%) of those who were not predicted to be pregnant. In the second variant, pregnancy occurred in 31 women. According to our prognostic model, in the first case pregnancy was predicted in 21 women out of 31. The rest 10 women were not predicted to be pregnant. 24 women were predicted to be pregnant, and pregnancy occurred. 25 women were not predicted to be pregnant, and pregnancy did not occur.

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Bibliography:

1.  Kriachkova LV, Dubossarska ZM, Hrek LP. Prohnozuvannia khronichnoho tazovoho boliu tiazhkoho stupenia pry hinekolohichnii patolohii. Visnyk problem biolohii i medytsyny. 2019;1(48):112-116. [in Ukrainian].
2. Tosti C, Biscione A, Morgante G, Bifulco G, Luisi S, Petraglia F. Hormonal therapy for endometriosis: from molecular research to bedside. Eur J Obstet Gynecol Reprod Biol. 2017;209:61-6.
3. Agarwal SK, Chapron C, Giudice LC, Laufer MR, Leyland N, Missmer SA, et al. Clinical diagnosis of endometriosis: a call to action. Am J Obstet Gynecol. 2019;220(4):354.e1-354.e12.
4. Becker CM, Bokor A, Heikinheimo O, Horne A, Jansen F, Kiesel L, et al. ESHRE guideline: endometriosis. Hum Reprod Open. 2022;2022(2):hoac009. DOI: 10.1093/hropen/hoac009.
5. Shi JL, Zheng ZM, Chen M, Shen HH, Li MQ, Shao J. IL-17: An important pathogenic factor in endometriosis. Int J Med Sci. 2022;19(4):769- 78. DOI: 10.7150/ijms.71972.
6. US Department of Health and Human Services. Spotlight: What to Know About Endometriosis. NICHD Archive; 2018. Available from: https://www.nichd.nih.gov/newsroom/resources/spotlight/031218-spotlight- endometriosis.
7. World Health Organization. Endometriosis. Geneva: WHO; 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/ endometriosis.
8. Solomko OB, Shurpiak SO. Aktualizatsiia dyferentsialnoi diahnostyky syndromu khronichnoho tazovoho boliu u zhinok reproduktyvnoho viku. Reproduktyvne zdorovia zhinky. 2024;7(62):62-8. DOI: 10.30841/2708-8731.7.2022.2724. [in Ukrainian].
9. Shemelko TL, Panchenko NIu. Bezplidnist ta endometrioz: retrospektyvnyi analiz. 2018;2(166):35-9. [in Ukrainian].
10. Dyndar OA, Dymarska OZ. Medicalsocial audit of reproductive age women with ovarian endometriomas. Clin Med. 2024;20(1):4-11. DOI: 10.32345/2664-4738.1.2024.01.
11. Lamvu G, Antunez-Flores O, Orady M, Schneider B. Path to diagnosis and women’s perspectives on the impact of endometriosis pain. J Endometr Pelvic Pain Disord. 2020;12(1):16-25.
12. Revised American Fertility Society Classification of endometriosi: 1985. Fertil Steril. 1985;43(3):351-2.
13. Revised American Society of Reproductive Medicine Classification of Endometriosis: 1996. Fertil Steril. 1997;67(5):817-21.
14. Tuttlies F, Keckstein J, Ulrich U, Possover M, Schweppe KW, Wustlich M, et al. ENZIAN-score, a classification of deep infiltrating endometriosis. Zentralbl Gynakol. 2005;127(5):275-81.
15. Adamson GD. Endometriosis Fertility Index: is it better than the present staging systems Curr Opin Obstet Gynecol. 2013;25(3):186-92.
16. Korol TM, Sorokoumov VP, Orlova DO. Endometrioz zhinochykh statevykh orhaniv: patomorfolohiia, diahnostyka, likuvannia ta profilaktyka. Visnyk Vinnytskoho natsionalnoho medychnoho universytetu. 2018;22(4):737-42. [in Ukrainian].
17. Aylamazyan E, Yarmolinskaya M, Molotkov A, Tsitskarava D. Classifications of endometriosis. J Obstet Women Diseas. 2017;66(2):77-92.
18. Johnson NP, Hummelshoj L, Adamson GD, Keckstein J, Taylor HS, Abrao MS, et al. World Endometriosis Society consensus on the classification of endometriosis. Hum Reprod. 2017;32(2):315-24.

Publication of the article:

«Bulletin of problems biology and medicine», 2025 Issue 1, 176, 305-314 pages, index UDC 618.2-037:[618.177-06:618.145-007.415]-072.1-08:519.87

DOI:

10.29254/2077-4214-2025-1-176-305-314