Clinical features of the state of reproductive health of patients with submucous uterine fibroids after COVID-19

The issue of effectively achieving the desired pregnancy still remains debatable due to the increase in infertile patients with comorbid conditions. Aim - to determine the impact of COVID-19 on the nature of hormonal changes in patients with submucosal uterine fibroids (SUF) before and after hysteroscopic myomectomy. Materials and methods. 112 women of reproductive age were examined, who were divided into three groups: I - 57 women with SUF who had COVID-19; II - 35 patients with SUF who did not have COVID-19; III - 20 practically healthy women. Hormonal status disorders were studied by determining the serum concentration of gonadotropic and steroid hormones by enzyme-linked immunosorbent assay after surgery in dynamics. To determine the probability of the difference in values, the Student's t-test was used. Differences were considered to be significantly significant at a level of significance of p<0.05. Results. After the surgical intervention in the scope of hysteroscopic myectomy, according to the results of the hormonal balance studies of women in the groups I and II, it was determined that the differences between the indicators remained, which indicates pathological mechanisms of hormonal imbalance independent of uterine fibroids. Conclusions. Patients represent a complex contingent from the point of view of the implementation of reproductive function, since hormonal changes detected before surgery, in particular a decrease in steroid hormones, high concentrations of gonadotropic hormones against the background of hyperandrogenism, contribute to the development of desynchronization of the perception of neurohumoral signals by the receptor apparatus of myositis, which leads to the development of fibroids nodes with a submucosal location. Transferred COVID-19 in patients with SUF is the main risk factor for failure to restore fertility after surgery. The study was performed in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee. Informed consent of women was obtained for the study. No conflict of interests was declared by the authors.