Specific features of the etiological pattern of endocrine infertility in women living in the north of Russia

Objective. To reveal the regional features of the etiological pattern of infertility in women from a northern region (in case of the town of Syktyvkar) versus a central one (in case of Belgorod and its region). Subject and methods. An open-label randomized controlled trial recruited 201 reproductive-aged women living in Syktyvkar and 109 women in Belgorod and its region. The women were divided into two groups: a control group of 40 healthy Syktyvkar women with a normal menstrual cycle, regular ovulation, and succeeding-year pregnancy. A comparison group was divided into two subgroups: 1) 85 Syktyvkar women and 45 Belgorod women who had anovulatory infertility and 2) 76 Syktyvkar women and 64 Belgorod women who had tubal or male factor infertility without anovulation. All the women underwent gynecological, clinical, anamnestic, hormonal, ultrasound, instrumental, radiological examinations, as well as studies of the endometrial biopsy specimens and spermogram of their sexual partner (husband). Results. The higher rate of infertility caused by endocrine disorders was noted in Syktyvkar. The levels of prolactin, testosterone, 17-hydroxyprogesterone and cortisol were considerably higher in the infertile women of Syktyvkar than in those of Belgorod without these differences being found in cortisol and testosterone levels between the women without anovulation. Hyperprolactinemia observed in the northern women was found to result from the higher rate of hypothyroidism or pituitary tumor processes. Conclusion. Hypercorticism in the infertile Syktyvkar women may be associated with the frequent exposure to cold stress while hyperandrogenism is likely to be due to the impact of seasons with long and short daylight hours. The reasons for the increased rate of hyperprolactinemia in the women of the northern region versus those from Belgorod remain unclear at this moment and require further investigation. It is apparent that the increased likeliness of anovulation due to hyperprolactinemia, hyperandrogenism, and hypercorticism should be borne in mind when elaborating prevention recommendations and when diagnosing and treating infertility in Syktyvkar women.

endocrine infertility, northern region, hyperandrogenism, hyperprolactinemia, hypercorticism