Changes in hemostasis in patients with ovaries endometrioid cystes with SARS-CoV‑2 infection in anamnesis

Kalimatova Donna Magomedovna, Dobrokhotova Yulia Eduardovna

Aim: To improve the outcomes of treatment of infertility associated with endometrial ovarian cyst, based on the study of hemostasis system in patients who have undergone COVID-19 infection. Materials and methods. Clinical and laboratory examination and treatment of 135 patients with infertility (lasting from 1 to 12 years) and ovarian endometriomas, who underwent laparoscopic endometrioma removal, were carried out. The patients included in the study were divided into 2 groups: group 1 consisted of 78 women who had no clinical and laboratory signs of SARS-CoV-2 infection in the anamnesis; Group 2 included 57 patients who underwent laboratory-confirmed SARS-CoV-2 infection within 6 months prior to endometrioma treatment. The levels of follicle-stimulating hormone, anti-Müllerian hormone (AMH) were determined. The assessment of the volume and number of follicles in the ovaries was carried out using ultrasound. The level of D-dimer was assessed before treatment, 3-5 days after surgery, and 2 months after surgery. The results of the above parameters were compared in the examined patients. Results. It was found that in women with ECL who had a history of COVID-19 infection, there are signs of a decrease in ovarian reserve, as evidenced by a decrease in the concentration of anti-Müllerian hormone, which persists over time after surgical treatment of cysts. The revealed violations occur against the background of a decrease in FSH concentration, and are also combined with changes in the coagulation system of hemostasis in these women, which is confirmed by a statistically significant increase in the level of D-dimer. Conclusion. The data obtained indicate the possibility of the impact of the transferred COVID-19 infection on the ovarian reserve, as well as disorders in the coagulation system of women with endometrial cysts and infertility, which should be taken into account when developing treatment tactics for these patients.

Keywords:endometriosis, infertility, endometrial ovarian cyst, hemostasis system, SARS-CoV-2 virus, follicle-stimulating hormone, anti-Müllerian hormone, D-dimer