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MON-322 The Characteristic of Reproductive Disorders in Women with ACTH-Dependent Cushing Syndrome in the Republic of Uzbekistan (RUz) and Republic of Karakalpakstan (RKK)
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Abstract
The aim- to study the characteristic of the reproductive function in patients with ACTH-dependent Cushing Syndrome in (CS) in all regions of the RUz and RKK.
Material and methods. Under our supervision in the all regions of RUz and Tashkent-city there are 120 women of fertile age with ACTH-dependent Cushing Syndrome were observed in the framework of project. Middle age of patients was 27,6 ± 3, 4 years.
The complex of researches, including clinical, biochemical hormonal (ACTH, LH, FSH, cortizol, prolactin), ultrasound investigations, pituitary and adrenals CT/MRI was executed all patients.
Results. The patients were divided into 2 groups: 1 group - patients with conservative treatment - 47 cases (39,1%), 2 group -patients with pituitary surgery - 65 cases.(54,1%), 3 group - combined therapy - 8 patients (6,6%).
The reproductive disorders had 63 women from 120 (52,5%): amenorrhoea -35%), oligomenorrhoea (30%), polimenorrhoea (7,5%). It was found that with ACTH - dependent Cushing’s syndrome, primary infertility was 17,6%, secondary 23.5%,
We found hyperandrogenemiya and hypercortizolemiya in patients of all groups before treatment. Estradiol levels were significantly inversely correlated with cortisol levels. One year after surgery we established normal range of LH, FSH, ACTH, cortizol, prolactin in all women of 2 group, but in 1 and 3 group we didn’t achieve compensation yet.
After 1 year only 1 (2,1)% women from 1 group can pregnant. After 1 year 30 women from 65 patients of second group after pituitary surgery (46,1%) achieved pregnancy without stimulation therapy. There are 2 (25%) women of 3 group achieved pregnancy.
The restoration of reproductive function in women with CS was observed in 3,5% of cases in patients treated with medical therapy, 33,3% in patients with adrenalectomy and combination therapy, and 50% after transsphenoidal adenomectomy of pituitary tumor.
Conclusions. The fertility function in women with ACTH-dependent CS can improve after pituitary surgery without stimulation therapy. In 46,1% of cases, in patients with combined therapy -in 25%and in women after conservative therapy - in 2,1%.