Frequency and structure of thyroid disfunction is at gynaecological diseases

Abstract

The objective. Women have a study of frequency and structure of thyroid violations with gynaecological diseases. Materials and methods. The screening estimation of pathology of thyroid is conducted was mine-out in 298 women with infertility (basic group) and in 50 fertility of women which appealed to the clinic for the selection of method of contraception (control group). The selection of patients was carried out by the opened cohort method as far as handling of patients infertility in the separation of maintainance and proceeding in a reproductive function. A questionnaire is conducted in 205 women with infertility. The inspection of patients with infertility was conducted in accordance with the generally accepted diagnostic algorithm, including endoscopic methods, and treatment – depending on found out reasons of infertility. Results. Prevalence of thyroid pathology women with infertility had at 3,8 time higher as compared to fertility women (48,0% and 12,5% respectively, p<0,05). In the structure of thyroid pathology at infertility prevailed the transmitter of antibodies to thyroperoxidase in combination with the signs of echo of autoimmune thyroiditis (24,0%); hypothyroidism as a result of autoimmune thyroiditis (9,4%), including manifest (0,8%) and subclinical (8,6%) women and euthyroid goitre (7,8%), while part of patients with infertility and thyrotoxicosis was low (0,6%). The estimation of the state of the reproductive system for women with infertility depending on found out pathology of thyroid rotined that a leading place in the structure of reasons of infertility for women external genital endometriosis occupied with autoimmuny thyroiditis - 34,4%, for women with found out a hypothyroidism is an endocrine factor of infertility (polycystic ovary syndrome) – 29,8%, for patients with the compensated hypothyroidism is external genital endometriosis (26,6%), for women with a euthyroid goitre and for patients without pathology of thyroid - pipe peritoneal factor (33,3% and 39,8%, respectively). Conclusion. The results of questionnaire, conducted for women with infertility, showed the low diagnostic value of clinical symptoms of hypothyroidism as compared to laboratory diagnostics in verification of this diagnosis. A sensitiveness of symptoms was low and hesitated from 16,1% to 27,8%, while specificity of symptoms was considerable and varied from 85,1% to 94,5%. A leading place in the structure of reasons of infertility for women with autoimmuny thyroiditis occupies external genital endometriosis (34,4%); for patients with a hypothyroidism is endocrine infertility (29,8%), for women with a euthyroid goitre and without pathology of thyroid - pipe peritoneal factor of infertility (33,3% and 39,8%). The got results must be taken into account at development of algorithm of diagnostic and treatment-and-prophylactic measures.