THE PRESERVATION OF REPRODUCTIVE FUNCTION IN WOMEN WITH A HISTORY OF PRIMARY OLIGOMENORRHOEA

The purpose of the research is to study the effectiveness of treatment of primary oligomenorrhoea in girls-teenagers to preserve the reproductive function. We examined 45 women aged 20.96±0.63 years with a history of primary oligomenorrhoea (main group): 30 received treatment and rehabilitation in adolescence (1^st subgroup), 15 have not received (2^nd subgroup). The control group consisted of 30 women of similar age with normal menstrual cycles. The level of Anti-Mullerian hormone (AMH), the basal level of follicle-stimulating hormone (FSH), luteinizing hormone, thyroid-stimulating hormone, prolactin, cortisol, dehydroepiandrosterone sulfate (DHEA-S), total testosterone, estradiol on 3-5^th day and progesterone on 22-24^th day of the menstrual cycle were studied in the blood serum with immune-enzyme method. The transvaginal ultrasound investigation was performed to determine ovarian volume and the number of antral follicles. In women of the main group the level of AMH was higher (p<0.01), but the level of FSH, estradiol and progesterone was lower if compared with the control group (p<0.01), which indicates the role of the normogonadotropic function of the pituitary and ovarian hypofunction. According to clinical data, the level of total testosterone and DHEA-S, hyperandrogenism was not revealed. AMH in 1 subgroup had no statistically significant differences with the control group, in the 2^nd subgroup it was higher - 8.04±1.77 ng/ml (p<0.01). AMH negatively correlated with FSH (r=-0.773; p<0.05), which does not exclude the role of AMH in reducing ovarian stimulation. Ovarian volume in 1^st subgroup was 13.91±2.96 ml, in 2^nd subgroup it was 20.42±4.48 (p<0.001) due to the number of antral follicles of 2-5 mm in diameter. They had a direct correlation with AMH (r=0.733; p<0.05). In 1^st subgroup 74.6% of women had ovulatory menstrual cycles; among those planning pregnancy 73.6% became pregnant. In 2^nd subgroup in 60% of women multifollicular ovaries structure and anovulatory menstrual cycles were visualized, which is a predictor of functional ovarian reserve decline and the risk of polycystic ovaries development.

подростковый возраст, гипофизарно-яичниковые гормоны, олигоменорея, репродуктивная функция, овариальный резерв, adolescence, pituitary-ovarian hormones, oligomenorrhoea, reproductive function, ovarian reserve

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