The features of reproductive function in women with rheumatoid arthritis

DOI: https://doi.org/10.29296/25877305-2020-05-04
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Issue: 
5
Year: 
2020

B. Turmukhambetova, Candidate of Medical Sciences; Professor L. Kozlova, MD; A. Dzhulamanova; E. Nikonova, Candidate of Medical Sciences Orenburg State Medical University

Objective: to evaluate the reproductive system of women with rheumatoid arthritis (RA). Subjects and methods. Examinations were made in 27 women aged 37.65±8.76 years with RA and its duration of 7.01±4.23 years. A control group consisted of 21 apparently healthy women aged 36.8±8.3 years. Enzyme immunoassay was used in all to measure the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), prolactin (PRL), total testosterone, cortisol, free thyroxine, thyroid stimulating hormone (TSH) and anti-thyroid peroxidase antibodies. Pelvic ultrasonography and ovarian artery blood flow Doppler sonography were performed. Results. Menstrual irregularities were present in 14 (51.85%) women with RA. Hypomenstrual syndrome was most frequently diagnosed. The average age of menopause onset was 36.54±1.09 years in patients with RA. The endocrine factor (66.66%) prevailed in the structure of the causes of infertility. The level of LH, FSH, E2, PRL, and TSH was statistically significantly higher in women with RA than in controls. Pelvic ultrasonography and ovarian artery blood flow Doppler sonography revealed a significant decline in the number of antral follicles and an increase in the resistance index and systolic/diastolic ratio in the patients with RA compared with the controls. RA disease activity parameters were directly correlated with the level of E2, PRL, and TSH, whereas the clinical stage was with the level of FSH. There was an inverse correlation of the volume of the ovaries and the number of antral follicles with the clinical stage of RA. Thus, the parameters of reproductive function in the women with RA differ from those in the healthy population. This confirms the concept of the impact of the hormonal background on the course of autoimmune processes, while it is not inconceivable that RA makes a considerable contribution to the development of endocrine disorders, inter alia, by affecting the indicators of reproductive function.

Keywords: 
rheumatology
gynecology
rheumatoid arthritis
menstrual irregularities
reproductive function



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