Infertility and recurrent miscarriage occupy 10–20 % in the structure of reproductive disorders in the outpatient service. Endocrine infertility is 35–40 % among other forms of infertility. This is due to various factors: chronic inflammatory diseases of the pelvic organs, abortion or curettage, resulting in miscarriages or missed abortion to a subsequent breach of the endometrium, including chronic endometritis and changes in hormonal ovarian status. The peculiarities of the modern prevalence of genital infections are mixed infections with a significant increase in the number of pathogens in microbial associations. It is caused by disease duration, the method of treatment, as immunity and so on. One of the underrated factor infertility are worms that fall from the gastrointestinal tract or through sexual transmission in the vagina. According to the results of previous studies, roundworm and pinworm eggs were found in 40 % of patients with inflammatory diseases of the pelvic organs and recurrent vaginitis.

Taking into account complications that can caused by worms persistence, their impact on a woman’s body can be divided into two groups: local and general.

Chronic pelvic pain syndrome, intestinal dysbiosis and vaginal secondary dysbiosis, vitamin deficiencies, anemia, chronic intoxication syndrome are general factors that may indirectly lead to women reproductive function disorders. Endocervicitis, endometritis, tubovarian abscesses, chronic salpingitis, urgent surgery with postoperative adhesive processes are local parasites affect. All of these conditions can cause problems on the reproductive health of women and possible development of infertility. In the available literature was found data on changes in hormonal balance in patients with primary infertility with parasitic lesions.

The objective of the study was to investigate the hormonal status in women with primary infertility depending on presence of parasite invasions. Were examined 82 patients aged 23 to 40 years with primary infertility (1–20 years). The results of investigations revealed that parasitic infestations in 58 % of women with primary infertility. However, ascariasis was observed in 48 % of patients, indicating that its aggressive effect on reproductive health of women. The combination of ascariasis with toxocariasis was noted in 29,7 % of patients with primary infertility and parasitic lesions, 5 % of ascariasis were also detected with enterobiasis and giardiasis. The combination of both toxocariasis with ascariasis was observed in 78 % of patients. In in 45 % patients with parasitic invasions and infertility testified dysfunction of the gastrointestinal tract. There were no changes depending on the presence or absence of worms on the menstrual cycle, hypermenorrhea, algomenorrhea in patients with primary infertility. In patients with primary infertility and parasitic lesions lutein phase defect observed 15 % more compared with women without worms (10 % vs 25 %). Increased cortisol levels was detected in 23 % of patients with primary infertility and parasitic lesions that were significantly higher than cortisol in patients with primary infertility without identifying parasites (5 %).

In patients with primary infertility and parasitic lesions FSH, LH, prolactin, TSH, free and total testosterone in women of reproductive age is almost no different. The content of estradiol in the blood of the women with parasitic invasion was 122,3 ± 4,4 pg/ml, in comparison 84,25 ± 3,6 pg/ml in patients without worms. The trend to increased estradiol levels threatening uterine bleeding, endometriosis, menstrual disorders, risk of uterine fibroids, endometrial hyperplasia and polyps, the development of cancer pathologies of female genitals and breasts. All these changes are factors infertility and confirm toxic effects of parasites on the ovaries. In addition, ascariasis affects the duration of bleeding and endometrial status of women in the postpartum period, causing secondary infertility and habitual miscarriage. Increasing levels of estradiol, ATPO and ATTH in 16 % of patients with parasitic invasions requires further research in this direction.

Keywords: primary infertility, ascariasis, toxocariasis, hormonal status, Cortisol, ATPO, ATTH

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1. 1. Deminа T, Alipova N. Autoimmune thyroiditis and reproductive function of women. Obstetrics, gynecology, reproduction. 2009;275:47-49.
2. 2. Zhylka N, Irkin T, Steshenko V. Reproductive health in Ukraine (medical and demographic overview). Kyiv: Ministry of Health of Ukraine, National Academy of Sciences, Institute of Economics; 2001. 68.
3. 3. Krasnopolskiy V, Logutova L, Serov O et al. Insufficiency of luteal phases: definition, diagnosis and differential treatment. Information letter. Moscow: 2004.
4. 4. Logishinets I. Morphological and functional aspects of homeostasis pituitary-thyroid system in experimental ascariasis. Bulletin of the Vitebsk State Medical University. 2010;9(4):134-141.
5. 5. Pirogova B, Veresnyuk N, Malachynska M. Modern approaches to differential diagnosis hyperprolactinemia in women of reproductive age. Practical medicine. 2010;16(3):3-13.
6. 6. Romashchenko O, Rudenko A, Biloholovska V et al. Diagnosis and treatment of inflammatory diseases of the urinary tract and genitals in women of reproductive age. PAG. 2003;4:95-99.
7. 7. Sadovnikow A, Panchenko K, Denisov N. Severe complications nematosis. Bulletin of Surgery. I. Grekov. 2010;169(6):87-89.
8. 8. Sklyarova V. Ascariasis: is impact factor of infertility? Can ascariasis cause postpartum endometritis? Taurian Medical and Biology Bulletin. 2012;15(2):247- 248.
9. 9. Sklyarova V, Tretyakova M. Clinical case not the usual pregnancy and secondary sterility caused by ascariasis (case from practice). Taurian Medical and Biology Bulletin. 2011;14(I): 280-283.
10. 10. Tatarchuk T, Hunkov S, Efimenko O. Modern approaches for diagnosis and Treatment hyperprolactinemia. Reproductive Endocrinology. 2012;1:26-44.
11. 11. Błaszkowska J. Preliminary evaluation of maternotoxic effect of Ascaris extract in mice. Wiad Parazytol. 2003;49(2):187-194.
12. 12. Mali B, Hazari K, Meherji P. Ascaris lumbricoides eggs in vaginal wet smear. Diagn. Cytopathol. 2006;34(5):387-388. doi.org/10.1002/dc.20425
13. 13. Ng Y, Ng S, Low J. Enterobius vermicularis infestation of the endometrium - a cause of menstrual irregularity and review of literature. Ann. Acad. Med. Singapore. 2011;40(11):514-515.
14. 14. Sklyarova V. Helminthiasis as impact factor of gynecological disordersIndian. J. Sex Transm. Dis. 2010;31:58-60.
15. 15. Vázquez Piloto A, Cruz Robaina J, Nú-ez Fernández F, Sánchez Díaz J. Bilateral tubo-ovarian abscess caused by Enterobius vermicularis. Presentation of a case. Rev. Cubana Med. Trop. 1994;46(1):65-67.
16. 16. Wang H. Six cases of pinworm ectopic infection in endomentriumZhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi. 2003;21(4):202.