The role of endothelial dysfunction in reducing ovarian reserve in women with chronic salpingophoritis.

Abstract

Among inflammatory diseases of the pelvic organs, a special place is occupied by chronic salpingophoritis, which is one of the risk factors of lowering the ovarian reserve of the ovaries. It is known that chronic salpingophoritis is accompanied by a deterioration of blood supply in the uterus. Circulation in the peripheral bloodstream of pathological inflammatory factors and immune complexes in the blood contributes to the development of oxidant stress, which damages the endothelium vessels and leads to impairment of its functions. Against the background of long-term pathological reactions in the inflammation center forms a «vicious circle», in which endothelial dysfunction plays an important role in the development of sclerotic processes in the ovarian tissues and endocrine function of the organ. These persistent morphofunctional disorders contribute to the delay of follicle maturation, leading to a decrease in the ovarian reserve. In the result of the study, it was revealed that in women during the heyday of reproductive function, having chronic salpingophoritis and reduced ovarian reserve, blood flow in the ovarian arteries deteriorates. Pronounced changes in the dopplerometric blood flow parameters in the ovarian arteries are due to persistent damage to the vascular wall in the form of distortion of its tone, disorders in the production of vasoconstrictors and vasodilators (NO and ET-1). This is exacerbated by blood vessel endothelial thrombogenicity and leads to long-term endothelial dysfunction, which contributes to impaired hormonal function of the ovaries. It has been proven that a persistent disorder of vasodimotor and thrombogenic endothelial function leads to a decrease in recruitment of follicles in the ovaries and a reduction in the ovarian reserve in the selected patient population.