Эндометриоз: влияние на фертильность и исходы беременности
Эндометриоз: влияние на фертильность и исходы беременности
Габидуллина Р.И., Кошельникова Е.А., Шигабутдинова Т.Н. и др. Эндометриоз: влияние на фертильность и исходы беременности. Гинекология. 2021; 23 (1): 12–17. DOI: 10.26442/20795696.2021.1.200477
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Gabidullina R.I., Koshelnikova E.A., Shigabutdinova T.N., et al. Endometriosis: impact on fertility and pregnancy outcomes. Gynecology. 2021; 23 (1): 12–17. DOI: 10.26442/20795696.2021.1.200477
Эндометриоз: влияние на фертильность и исходы беременности
Габидуллина Р.И., Кошельникова Е.А., Шигабутдинова Т.Н. и др. Эндометриоз: влияние на фертильность и исходы беременности. Гинекология. 2021; 23 (1): 12–17. DOI: 10.26442/20795696.2021.1.200477
________________________________________________
Gabidullina R.I., Koshelnikova E.A., Shigabutdinova T.N., et al. Endometriosis: impact on fertility and pregnancy outcomes. Gynecology. 2021; 23 (1): 12–17. DOI: 10.26442/20795696.2021.1.200477
Цель. Изучить современное состояние проблемы бесплодия и акушерских осложнений при эндометриозе, основные аспекты тактики ведения женщин с эндометриозом при планировании беременности. Материалы и методы. В статье представлен обзор литературы по результатам поиска исследований в электронных ресурсах MEDLINE, PubMed, EMBASE, Cochrane Library и eLibrary. Результаты. Эндометриоз является одной из самых распространенных причин бесплодия. Целый каскад неблагоприятных реакций, вызванных эндометриозом, препятствует успешному наступлению беременности. В настоящее время доказано, что пациентки с эндометриозом имеют высокий риск ряда акушерских осложнений, таких как самопроизвольный выкидыш, преждевременные роды, преэклампсия, низкая масса тела новорожденных и гестационный сахарный диабет. Гестагены относят к 1-й линии терапии эндометриоза, а дидрогестерон является препаратом, отвечающим всем необходимым требованиям при эндометриозассоциированном бесплодии. Применение дидрогестерона способствует уменьшению негативной симптоматики эндометриоза, улучшению качества жизни и повышению фертильности. Дидрогестерон является единственным гестагеном, имеющим две эффективные схемы приема при эндометриозе, что позволяет назначить терапию как женщинам, планирующим беременность, так и тем, кто уже реализовал свои репродуктивные планы. Более того, в отношении препарата высказаны предположения о повышении шансов на наступление беременности при эндометриозе. Дидрогестерон доказал свою эффективность в поддержке лютеиновой фазы в программах вспомогательных репродуктивных технологий, лечении угрожающего и привычного выкидыша. Заключение. Эндометриоз ассоциирован с бесплодием и высоким риском развития акушерских осложнений. Дидрогестерон обладает рядом преимуществ по сравнению с другими гестагенами.
Aim. To investigate the modern condition of the problem of infertility and obstetric complications in endometriosis and the main management aspects of women with endometriosis in pregnancy planning. Materials and methods. The article presents a systematic literature review on the results of search for studies in electronic databases MEDLINE, PubMed, EMBASE, Cochrane Library and eLibrary. Results. Endometriosis is one of the most common causes of infertility. A cascade of adverse reactions caused by endometriosis prevents a successful pregnancy. Currently, there is an evidence that patients with endometriosis have a high risk of several obstetric complications, such as spontaneous miscarriage, premature birth, preeclampsia, low birth weight and gestational diabetes. Progestogens belong to the first line of therapy of endometriosis, and dydrogesterone is a drug that meets all the necessary requirements. The use of dydrogesterone in the treatment of endometriosis helps to reduce the negative symptoms of endometriosis, improve the quality of life and increase fertility. Dydrogesterone is the only progestogen that has two effective regimens for endometriosis, which allows prescribing therapy for women who are planning pregnancy and for those who have already realized their reproductive plans. Dydrogesterone is the only progestogen that has been suggested to increase the chances of pregnancy in women with endometriosis. Dydrogesterone has been shown to be effective in supporting the luteal phase in ART programs, treating threatening and recurrent miscarriages. Conclusion. Endometriosis is associated with infertility and a high risk of obstetric complications. Dydrogesterone has a number of advantages compared to other progestogens.
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DOI: 10.1016/j.bpobgyn.2018.06.002
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20. Lalani S, Choudhry AJ, Firth B, et al. Endometriosis and adverse maternal, fetal and neonatal outcomes, a systematic review and meta-analysis. Hum Reprod 2018; 33: 1854–65.
21. Leone Roberti Maggiore U, Ferrero S, Mangili G, et al. A systematic review on endometriosis during pregnancy: diagnosis, misdiagnosis, complications and outcomes. Human Reprod Update 2015; 22 (1): 70–103. DOI: 10.1093/humupd/dmv045
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DOI: 10.1007/s40265-018-0928-0
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1. Hodgson RM, Lee HL, Wang R, et al. Interventions for endometriosis-related infertility: a systematic review and network meta-analysis. Fertil Steril 2020; 113: 374–82.
2. Fuldeore MJ, Soliman AM. Prevalence and symptomatic burden of diagnosed endometriosis in the United States: national estimates fr om a cross-sectional survey of 59,411 women. Gynecol Obstet Invest 2016. DOI: 10.1159/000452660
3. Tanbo T, Fedorcsak P. Endometriosis-associated infertility: aspects of pathophysiological mechanisms and treatment options. Acta Obste Gynecol Scand 2017; 96 (6): 659–67. DOI: 10.1111/aogs.13082
4. Giudice LC. Clinical practice. Endometriosis. N Engl J Med 2010; 362: 2389–98.
5. Tomassetti C, D’Hooghe T. Endometriosis and infertility: Insights into the causal link and management strategies. Best Pract Res Clin Obstet Gynaecol 2018.
DOI: 10.1016/j.bpobgyn.2018.06.002
6. Akande VA, Hunt LP, Cahill DJ, Jenkins JM. Differences in time to natural conception between women with unexplained infertility and infertile women with minor endometriosis. Hum Reprod 2004; 19 (1): 96–103.
7. Santulli Р, Tran С, Gayet V, et al. Oligo-anovulation is not a rarer feature in women with documented endometriosis. Fertil Steril 2018; 110 (5): 941–8.
8. D'Hooghe TM, Debrock S, Hill JA, Meuleman C. Endometriosis and subfertility: is the relationship resolved? Semin Reprod Med 2003; 21 (2): 243–54.
9. Meuleman C, Vandenabeele B, Fieuws S, et al. High prevalence of endometriosis in infertile women with normal ovulation an normospermic partners. Fertil Steril 2009; 92 (1): 68–74.
10. Aliani F, Ashrafi M, Arabipoor A, et al. Comparison of the symptoms and localisation of endometriosis involvement according to fertility status of endometriosis patients. J Obstet Gynaecol 2018; 38 (4): 536–42. DOI: 10.1080/01443615.2017.1374933
11. Hosseini E, Nikmard F, Aflatoonian B, et al. Controlled ovarian stimulation in endometriosis patients can be individualized by anti-mullerian hormone levels. Acta Endocrinol (Buchar) 2017; 13 (2): 195–202.
12. Matasariu RD, Mihaila A, Iacob M, et al. Psycho-social aspects of quality of life in women with endometriosis. Acta Endocrinol (Buchar) 2017; 13 (3):334–9.
13. Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet 2008; 371: 75–84.
14. Wolf M, Sauk J, Shah A, et al. Inflammation and glucose intolerance: a prospective study of gestational diabetes mellitus. Diabetes Care 2004; 27: 21–7.
15. Bodnar LM, Ness RB, Harger GF, Roberts JM. Inflammation and triglycerides partially mediate the effect of prepregnancy body mass index on the risk of preeclampsia. Am J Epidemiol 2005; 162: 1198–206.
16. Farland LV, Prescott J, Sasamoto N, et al. Endometriosis and Risk of Adverse Pregnancy Outcomes. Obstet Gynecol 2019; 134 (3): 527–36.
DOI: 10.1097/aog.0000000000003410
17. Hjordt Hansen MV, Dalsgaard T, Hartwell D, et al. Reproductive prognosis in endometriosis. A national cohort study. Acta Obstet Gynecol Scand 2014; 93: 483–9.
18. Stephansson O, Kieler H, Granath F, Falconer H. Endometriosis, assisted reproduction technology, and risk of adversepregnancy outcome. Hum Reprod 2009; 24: 2341–7.
19. Glavind MT, Forman A, Arendt LH, et al. Endometriosis and pregnancy complications: a Danish cohort study. Fertil Steril 2017; 107: 160–6.
20. Lalani S, Choudhry AJ, Firth B, et al. Endometriosis and adverse maternal, fetal and neonatal outcomes, a systematic review and meta-analysis. Hum Reprod 2018; 33: 1854–65.
21. Leone Roberti Maggiore U, Ferrero S, Mangili G, et al. A systematic review on endometriosis during pregnancy: diagnosis, misdiagnosis, complications and outcomes. Human Reprod Update 2015; 22 (1): 70–103. DOI: 10.1093/humupd/dmv045
22. As-Sanie S, Black R, Giudice LC, et al. Assessing Research Gaps and Unmet Needs in Endometriosis. Am J Obstet Gynecol 2019. DOI: 10.1016/j.ajog.2019.02.033
23. Koninckx PR, Zupi E, Martin DC. Endometriosis and pregnancy outcome. Fertil Steril 2018; 110 (3): 406–7. DOI: 10.1016/j.fertnstert.2018.06.029
24. Barra F, Scala C, Mais V, et al. Investigational drugs for the treatment of endometriosis, an update on recent developments. Exp Opin Investig Drugs 2018; 27 (5): 445–58. DOI: 10.1080/13543784.2018.1471135
25. Ferrero S, Barra F, Leone Roberti Maggiore U. Current and Emerging Therapeutics for the Management of Endometriosis. Drugs 2018; 78 (10): 995–1012.
DOI: 10.1007/s40265-018-0928-0
26. Gheorghisan-Galateanu AA, Gheorghiu ML. Hormonal Therapy in Women of Reproductive Age with Endometriosis: an Update. Acta Endo (Buc) 2019; 15 (2): 276–81. DOI: 10.4183/aeb.2019.276
27. Orazov M.R., Radzinskij V.E., Hamoshina M.B., et al. Besplodie, associirovannoe c endometriozom: ot legendy k surovoj real'nosti. Trudnyj pacient. 2019; 17 (1–2): 6–12 (in Russian)
28. Barra F, Laganà AS, Casarin J, et al. Molecular targets for endometriosis therapy: where we are and wh ere we are going? Int J Fertil Steril 2019; 13 (2): 89–92.
DOI: 10.22074/ijfs.2019.5736
29. Vercellini P, Buggio L, Berlanda N, et al. Estrogen-progestins and progestins for the management of endometriosis. Fertil Steril 2016; 106 (7): 15520–71.
30. Duffy JM, Arambage K, Correa FJ, et al. Laparoscopic surgery for endometriosis. Cochrane Database Syst Rev 2014.
31. Dunselman GA, Vermeulen N, Becker C, et al. ESHRE guideline: management of women with endometriosis. Hum Reprod 2014; 29: 400–12.
32. Adamyan L.V. Clinical guidelines for the management of patients. Endometriosis: diagnosis, treatment and rehabilitation. 2016 (in Russian)
33. Brown J, Farquhar C. Endometriosis: an overview of Cochrane reviews. Cochrane Database Syst Rev 2014; CD009590.
34. Hughes E, Brown J, Collins JJ, et al. Ovulation suppression for endometriosis. Cochrane Database Syst Rev 2007; CD000155.
35. Georgiou EX, Melo P, Baker PE, et al. Long-term GnRH agonist therapy before in vitro fertilisation (IVF) for improving fertility outcomes in women with endometriosis. Cochrane Database Syst Rev 2019; 2019 (11).
36. Abdul Karim AK, Shafiee MN, Abd Aziz NH, et al. Reviewing the role of progesterone therapy in endometriosis. Gynecol Endocrinol 2019; 35 (1): 10–6.
37. Regidor PA. The clinical relevance of progestogens in hormonal contraception: Present status and future developments. Oncotarget 2018;
9 (77): 34628–38.
38. Dubrovina S.O., Berlim Yu.D. Drug treatment for endometriosis-related pain. Akusherstvo i ginekologiya. 2019; 2: 34–40 (in Russian)
39. Schindler AE. Progestational effects of dydrogesterone in vitro, in vivo and on the human endometrium. Maturitas 2009; 65: S3–S11.
40. Trivedi P, Selvaraj K, Mahapatra PD, et al. Effective post-laparoscopic treatment of endometriosis with dydrogesterone. Gynecol Endocrinol 2007; 23 (1): 73–6.
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1 ФГБОУ ВО «Казанский государственный медицинский университет» Минздрава России, Казань, Россия;
2 ГАУЗ «Городская клиническая больница №7», Казань, Россия
*ru.gabidullina@yandex.ru
________________________________________________
Rushania I. Gabidullina*1, Ekaterina A. Koshelnikova2, Tatiana N. Shigabutdinova2, Evgenii A. Melnikov2, Gulfiria N. Kalimullina2, Angelina I. Kuptsova2
1 Kazan State Medical University, Kazan, Russia;
2 City Clinical Hospital №7, Kazan, Russia
*ru.gabidullina@yandex.ru