The Role Ovarian Index in Formation of Oligomenorrhea in Women with Autoimmunity

Menstrual irregularities of the oligomenorrhea type may depend on the presence or absence of hormonal or metabolic disorders. Antiovarian antibodies to the ovaries (AOA) can be one of the causes of hormonal disorders and related menstrual disorders. The aim of the study was to assess the functional state of the ovaries in women with oligomenorrhea and to compare the presence of antiovarian antibodies (AOA) with a group of healthy fertile women. Material and Methods: 105 patients of reproductive age with oligomenorrhea were examined. Control - 50 women of childbearing age with an undisturbed rhythm of menstruation. Body mass index was calculated, ultrasound was performed, LH, FSH, estradiol, total testosterone by immunochemiluminescent method, anti-Müllerian hormone (AMH) by ELISA, AOA by ELISA method were determined. Statistica software (Stat Soft, USA) was used for statistical analysis. Results: The average age of patients with oligomenorrhea and the control group was 31.39 ± 6.05 and 30.52 ± 5.92 years. Body mass index averaged 25.59 ± 2.74 and 24.12 ± 2.77 kg / m2 , respectively, in the main and control groups. The volume of the ovaries in the main group was 13.22 ± 3.01, in the control group - 6.0 ± 1.26 (p = 0.028), the width of the stroma in the main group was 16.46 ± 3.25 mm, in the control group - 8.97 ± 1.16 mm (p = 0.031). The average LH level in women with oligomenorrhea was 51.75% higher than the control level (p = 0.048), the LH / FSH ratio was higher by 44.28% (p = 0.007), and the AMH value was higher by 33.86% (p = 0.048). The AOA level in the main group averaged 6.36 ± 1.14 ng / ml, in the control group - 3.06 ± 1.16 ng / ml (p = 0.044). In patients with oligomenorrhea, AOA correlated with all studied hormones by a statistically significant relationship, and a significant relationship was determined with the level of LH, AMH and estradiol. In contrast to the main group, in women with a normal menstrual cycle, AOA was correlated with a significant significant association with FSH, total testosterone, and a weak insignificant association with LH. Conclusion: In women of reproductive age with oligomenorrhea, high levels of LH, AMH, LH / FSH and antiovarian antibodies are determined. Antiovarian antibodies to the ovaries in oligomenorrhea correlate with a direct, noticeable relationship with gonadotropic and steroid hormones. To identify the autoimmune process in patients with oligomenorrhea, it is necessary to determine antiovarian antibodies.

Gender characteristics of autoimmune hypogonadism

Autoimmune gonadal lesions represent a highly heterogenous conditions affecting men and women of reproductive age and resulting in loss of endocrine function and, eventually, infertility. Well-known and well-documented risk factors exist, and the presence or suspicion of autoimmune disorder should be regarded as an important one. For the purpose of the present study, ELISA kits according to the proprietary technology for detection of antitesticular and antiovarian antibodies were developed. Among men with autoimmune orchitis an increased level of antibodies to steroid-producing testicular cells, decreased serum total and free testosterone and altered semen parameters were found. Combined autoimmune diseases were present (autoimmune thyroiditis, vitiligo, type 1 diabetes) in 13.5 % of cases. In women with autoimmune oophoritis the main finding was anovulation with preserved serum FSH and LH levels (91.6 %) and luteal insufficiency (8.4 %). In total, 19.4 % of patients had other autoimmune diseases (autoimmune thyroiditis, vitiligo, chronic autoimmune hepatitis, rheumatoid arthritis, systemic lupus erythematosus).

The level of antiovarian antibodies in normal and in pathology

Autoimmune salpingoophoritis – is an actual problem of reproductive system. The work is dedicated to studying of autoimmune antibodies. The studying involved 10 healthy persons and 10 patients with infertile of tubal origin.