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تقييم حالة الحديد، فيتامين ج والهرمونات في انخفاض الخصوبة لدى النساء == Assessment of Iron Status, Vitamin C And Hormones In Subfertile Women
Author name:
ميسم محمد حسين الكعبي
Supervisor name:
سامي رحيم الكاتب
General topic:
Medicine
Specific topic:
Physiology
Degree:
Doctorate
University:
University of Kufa - Faculty Of Medicine - Department Of Physiology And Medical Physics
Language:
English
University location:
Najaf
First pages:
19T1111 - p.pdf
Abstract:
انخفاض الخصوبة مشكلة شائعة ولكن علاجها في بعض الاحيان غير كافي لعدم تشخيص الاسباب بالكامل. الحديد عنصر ناقل للاوكسجين ولذلك فهو محفز لحيوية كل الخلايا والانسجة في الجسم. نقص الحديد من اكثر مشاكل نقص الغذاء الشائعة في العالم. لذلك ربط الحديد مع الخصوبة يح | Subfertility is a common problem, but the treatment is sometimes inadequate because the causes are not fully diagnosed. Iron is essential for oxygen transport and therefore promotes health of all cells and tissues. Iron deficiency is the most common nutritional deficiency in the world. Therefore, the connection between iron and fertility need more explanation. Some researchers have suggested that iron may be important for ovulation as the egg has an increased demand for iron while it matures and women who do not get sufficient amounts of iron may suffer anovulation and possibly poor egg health, which can inhibit pregnancy at a rate 60% higher than those with sufficient iron stores in their blood. However women planning to become pregnant should test for serum ferritin level and accordingly if low they can use iron supplements because they may help them to prevent iron deficiency and also improve fertility. Vitamin C is essential for the uptake and absorption of iron. The objective of this study was to assess the iron status, vitamin C and some hormone levels in subfertile women. The sample of study consists of 106 women subdivided into two groups : first consist of 76 subfertile women were taken from the outpatient to fertility center in the gynecological and obstetrical teaching hospital in Kerbala city and from multiple gynecology/obstetrics privet clinics. Second consist of 30 fertile women (control and comparative) who obtained from outpatients and some relatives. The subfertile women subdivided into two subgroups according to the cause of subfertility in presented study : first group : ovarian dysfunction (OD) either due to polycystic ovary syndrom (PCOS) or due to other cause (OC) like anovulation, hyperprolactenemia, premature ovarian failure. Second group : unexplained (idiopathic). Also the subfertile women subdivided into two subgroups according to the type of subfertility : primary and secondary. All of them were at reproductive age (16 - 45) years and there BMI ranged between (20 - 45 kg/m2). The study was achieved throughout a period which extends from July 2012 - October 2013. The protocol of study summarized as following : At day 3±1of menstrual cycle (menstrual phase), all women underwent the measurement of concentrations for multiple hormones in the blood like luteinizing hormone, follicle stimulating hormone, estradiole, prolactine and Testosterone. In addition to iron status (serum iron, serum ferrtin and total iron binding capacity) and vitamin C also assessed. And at day 13 of menstrual cycle (near time of ovulation), all women underwent two investigations : first : the measurement of concentrations of luteinizing hormone, serum Leptin and antioxidants as vitamin C and glutathione. In addition to Iron status (serum iron, serum ferrtin and total iron binding capacity) and hemoglobin concentration also estimated. Second : estimation the size and the number of dominant follicles in both ovaries by ultrasonograghy. While at day 23±1 of menstrual cycle (secretary phase), all women underwent two investigations : first : estimation the concentration of serum progesterone to detect ovulation. Second : estimation the endometrial thickness by ultrasonograghy. The results of study shows : • A significant increase (P<0.05) in number of subfertile women with age group (16 - 25) years and there were highly significant decreases (P<0.001) in number of women with age 36 - 45 years for both primary and secondary subfertility. While no significant difference (p>0.05) in age group (26 - 35) years.• A significant increases (P<0.05) in body mass index for subfertile women due to polycystic ovary syndrome. Also a significant increase (P<0.05) in serum leptin for women with overweight and obese as compared with normal weight.• A significant increase (P<0.05) in serum ferritin level for polycystic ovary syndrome at day 13 of menstrual cycle. Also, a significant decreases (P<0.05) in number of polycystic ovary syndrome in those having serum ferritin lower than normal at day 13 of menstrual cycle.• A significant increase (P<0.05) in the number of subfertile women due to ovarian dysfunction other than polycystic ovary syndrome who having a lower serum level of vitamin C at day 3 of menstrual cycle. • A significant increase (P<0.05) in serum testosterone level in polycystic ovary syndrome group at day 3 of menstrual cycle. • A significant increase (P<0.05) in serum prolactine level in group of ovarian dysfunction due to other cause at day 3 of menstrual cycle. when serum ferritin level lower than or within normal value. • A significant decrease (P<0.05) in serum level of luteinizing hormone for group of ovarian dysfunction due to other cause at day 13 of menstrual cycle when serum ferritin less than normal but no significant differences (P>0.05) in serum luteinizing hormone when serum ferritin within normal value. • A significant decrease (P<0.05) in serum luteinizing hormone for group of ovarian dysfunction due to O.C when vitamin C within normal value at day 13 of menstrual cycle.• A highly significant decrease (p<0.001) in endometrial thickness for all subfertile group at day 23 of menstrual cycle.• No significant difference (P>0.05) in serum levels of follicle stimulating hormone, estradiole and glutathione as compared with other parameters in fertile and subfertile women.It was concluded that the decrease in serum ferritin and vitamin C levels in the blood may be associated directly or indirectly with subfertility caused by ovarian dysfunction.
