Gök Soner, Alataş Erkan
Obstetrics and Gynecology, Pamukkale University, Denizli, TUR.
Cureus. 2022 Nov 21;14(11):e31721. doi: 10.7759/cureus.31721. eCollection 2022 Nov.
Objective This study aimed to investigate the effects of levonorgestrel-releasing intrauterine device (LNG-IUD) treatment on ovarian reserve in women of reproductive age diagnosed with menorrhagia. Methods This was a prospective controlled trial involving 50 women with menorrhagia and a control group comprising age-matched 50 healthy women. Women who satisfied the LNG group criteria underwent an endometrial pipelle biopsy and LNG-IUD insertion. Ovarian reserve tests were performed prior to and six months after LNG-IUD insertion in the LNG group cases. Results Follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), anti-Müllerian hormone (AMH), endometrial thickness (ET), total antral follicle count (AFC), and mean ovarian volume values before LNG-IUD insertion did not differ between the LNG and control groups. When the final measurements were compared, FSH, AMH, total AFC, and average ovarian volume increased (p=0.05, 0.046, 0.022, and 0.022, respectively), E2 and ET decreased (p=0.034 and 0.001, respectively) in the LNG group, while LH did not differ significantly between the groups (p=0.71). Conclusion We observed that LNG-IUD use effectively improves fertility capacity. In this study, LNG-IUD use in reproductive-age women diagnosed with menorrhagia decreased E2 levels, did not change LH levels, and increased FSH, AFC, and AMH levels.
目的 本研究旨在探讨左炔诺孕酮宫内节育器(LNG-IUD)治疗对诊断为月经过多的育龄期女性卵巢储备功能的影响。方法 这是一项前瞻性对照试验,纳入50例月经过多的女性,对照组为50例年龄匹配的健康女性。符合LNG组标准的女性接受子宫内膜活检及LNG-IUD置入。LNG组患者在LNG-IUD置入前及置入后6个月进行卵巢储备功能检测。结果 LNG组与对照组在LNG-IUD置入前的促卵泡生成素(FSH)、促黄体生成素(LH)、雌二醇(E2)、抗苗勒管激素(AMH)、子宫内膜厚度(ET)、窦卵泡总数(AFC)及平均卵巢体积值无差异。比较最终测量结果时,LNG组的FSH、AMH、总AFC及平均卵巢体积增加(p分别为0.05、0.046、0.022和0.022),E2和ET降低(p分别为0.034和0.001),而两组间LH无显著差异(p = 0.71)。结论 我们观察到使用LNG-IUD可有效提高生育能力。在本研究中,诊断为月经过多的育龄期女性使用LNG-IUD可降低E2水平,不改变LH水平,并提高FSH、AFC及AMH水平。