Optimization of tactics of auxiliary genesial technologies at married couples with the burdened genetic anamnesis

The objective: rising of efficiency of treatment of sterility at married couples with the burdened genetic anamnesis on the basis of scientific justification and introduction of advanced algorithm of prognostic and treatment-and-prophylactic actions. Materials and methods. For the purpose of detection of risk factors of development of sterility and carrying out the correlation analysis were allocated the main group – 100 married couples with sterility in the anamnesis and control group of patients who had labors (n=100) in the anamnesis. The complex of the conducted researches included clinical, laboratory, tool and statistical methods of research. Results. Rising of efficiency of treatment of sterility at married couples with the burdened genetic anamnesis requires carrying out medicogenetic consultation with simultaneous planned preimplantation genetic research in programs of auxiliary genesial technologies. At a choice of this or that method of auxiliary genesial technologies at women with the burdened genetic anamnesis it is necessary to use a technique at which one spermatozoon is entered into an oocyte cytoplasma by means of equipment of a micromanipulation. In the program of training of doctors the obstetrician-gynecologists and urologists of an out-patient link it is necessary to loop thematic improvement concerning sterility treatment at married couples with use of auxiliary genesial technologies. Conclusion. Results of the conducted researches testify to need of rising of efficiency of auxiliary genesial technologies at married couples with the burdened genetic anamnesis. Use by our algorithm of prognostic and treatment-and-prophylactic actions allows to increase efficiency of auxiliary genesial technologies at married couples with the burdened genetic anamnesis for 26.7%. Key words: sterility at married couples, the auxiliary genesial technologies, the burdened genetic anamnesis.

Adenomyosis: diagnostics, tactics of treatment and rehabilitation of genesial function

The objective: depression frequencies disturbances genesial function and gestational complications at| women with various forms of an adenomyosis on the basis of studying of new aspects of pathogenesis nodal and diffuse forms, and also development of algorithm of diagnostic, treatment-and-prophylactic and rehabilitational actions depending on an adenomyosis form. Materials and methods. Researches were conducted in three stages. At 1 stage 200 women of genesial age with an adenomyosis who addressed for surgical treatment in unit of operational gynecology were surveyed. At the 2nd stage of researches 100 women of genesial age who were operative concerning the sterility caused by existence of nodal or diffuse forms of an adenomyosis І and ІІ to degree were surveyed. To all patients sterility treatment with use of auxiliary genesial technologies – an extracorporal fertilization or ICSI was carried out. At the 3rd stage we studied features of a course of pregnancy and labors at 33 of 100 women (the 2nd stage) who had various programs of auxiliary genesial technologies. The complex of the conducted researches included clinical, ekhografical, dopplerometrical, endocrinologic, immunohistochemical, morphological, psychological and static methods. Results. Results of the conducted researches testify that the problem of conservation of genesial health at women with various forms of an adenomyosis is rather actual and conforms to all modern requirements. The algorithm of maintaining women developed by us with various forms of an adenomyosis, since well-timed diagnostics, expeditious treatment, rehabilitation of genesial function and finishing the course of pregnancy and labors allows to reduce the frequency of disturbances of genesial health at women of genesial age with an adenomyosis. Conclusion. The received results allow to recommend them for wide use in practical health care. Key words: adenomyosis, various forms, sterility, diagnostics, treatment, pregnancy, labors.

Pathology an endometrium at women with unrealized genesial function: diagnostics and tactics of treatment of sterility

The objective: rising of efficiency of diagnostics and sterility treatment at women with pathological changes an endometrium on the basis of improvement and introduction of algorithm of diagnostic and treatment-and-prophylactic actions. Materials and methods. Сomplex clinical-tool, laboratory and morphological examination of 120 patients with unrealized genesial function and various pathology an endometrium which were divided into four groups was conducted. Results. Use of the advanced differentiated approach to tactics of maintaining women with unrealized genesial function against various options of pathology the endometriya allows to increase for 10.0% efficiency of treatment of sterility (33.3% in comparison with 23.3%). Conclusion. The algorithm improved by us allows to increase efficiency of auxiliary genesial technologies at these women for 10.0% that grants to us the right to recommend it for wide use in practical health care. Key words: pathology endometrium, sterility, diagnostics, treatment.

Рrophylaxis of unsuccessful attempts of auxiliary genesial technologies

The objective: depression of frequency of unsuccessful attempts of auxiliary genesial technologies on the basis of studying of new aspects of pathogenesis of female sterility, and also improvement and introduction of algorithm of prognostic and treatment-and-prophylactic actions. Patients and methods. Аt 1 stage (forecasting of results of ART) 97 married couples (1 group) which passed sterility treatment were surveyed. At the 2nd stage (prophylaxis of unsuccessful attempts of ART) 108 patients of genesial age who had in the anamnesis of 2 and more attempts of ART were surveyed. Results. Unsuccessful attempts ART arise at various reasons of sterility: a tubal and peritoneal factor – 48.5%; endocrine disturbances – 44.3%; a man’s factor – 29.9%; an external genital endometriosis of the I–II st – 21,7%, and also a combination of above-mentioned reasons of sterility – 60.8%. At female factors of sterility depression of an ovarialny reserve and unavailability of functional state an endometrium which take place are the main reasons of unsuccessful attempts of auxiliary genesial technologies as is independent, and in a combination. Conclusion. For rising of efficiency of ART it is necessary to use, first of all, effective forecasting taking into account functional, laboratory and morphological methods of researches. Further, it is necessary to develop the individual program of specific preparation taking into account all preliminary results. Key words: auxiliary genesial technologies, unsuccessful attempts, prophylaxis.

Forecasting of unsuccessful attempts of auxiliary genesial technologies

The objective: development of algorithm of forecasting of unsuccessful attempts of auxiliary genesial technologies on the basis of the mathematical analysis of the main reasons and risk factors. Patients and methods. 97 married couples which passed sterility treatment on the basis of clinic of auxiliary genesial technologies were surveyed. The complex of the conducted researches included clinical, endocrinologic, immunohistochemical, ehografical and statistical methods. Results. For forecasting of unsuccessful attempts of auxiliary genesial technologies it is necessary to use the constructed mathematical model which includes 4 most significant changes (as significance value depression): optical density of an expression of LIF in superficial and glandular epithelium the endometrium, received in the period of assumed «implantation windows» in cycle before carrying out an extracorporal fertilization, the maintenance of VEGF in cervical slime in day of transvaginal puncture, S/D and IR of spiral arteries in day of introduction of triger of an ovulation. Conclusion. Use of offered algorithm allows to increase forecasting effectiveness of unsuccessful attempts of auxiliary genesial technologies. Key words: auxiliary genesial technologies, unsuccessful attempts, forecasting.

Optimization of treatment of sterility at women with benign pathology of mammary glands

The objective: rising of efficiency of treatment of sterility at women with pathology of mammary glands on the basis of studying the clinical-ehografical, endocrinologic and hemodynamic features and improvement of algorithm of auxiliary genesial technologies. Patients and methods. Were included in research of 90 women who were on sterility treatment by various techniques including auxiliary genesial technologies. The main methods of research were clinical, endocrinologic, ehografical and immunologic. Results.Сlinical efficiency of treatment of sterility at women with pathology of mammary glands when using the short protocol makes 33.3%, and long – 50.0%. The main complications of pregnancy is its spontaneous discontinuing in 1 trimester – 20.0% and 6.7%, and also premature births – 20.0% and 6.7% respectively. Conclusion. Use of the algorithm improved by us allows to increase efficiency of treatment of sterility, and такеж to provide low level of perinatal pathology. Practical introduction of the received results allows to improve sterility treatment without deterioration of pathology of mammary glands. Key words: pathology of mammary glands, sterility, treatment, auxiliary genesial tekhologies.

Tactics of auxiliary genesial technologies after expeditious treatment of women with endometriome of ovaries

The objective: rising of efficiency of restoration of genesial function at women with endometrioidal cysts of ovaries on the basis of studying at them clinical-functional and endocrinologic features, and also improvement and introduction of algorithm of diagnostic and treatment-and-prophylactic actions with use of an endoscopy and auxiliary genesial technologies. Patients and methods. Were surveyed 144 women of genesial age who were operated concerning the sterility caused by existence the endometrioidal of cysts of ovaries. To all patients sterility treatment with use of auxiliary genesial technologies was carried out. Results. Optimization of restoration of genesial function at patients with endometrioidal cysts of ovaries with use of expeditious treatment and programs of auxiliary genesial technologies allows to reach effective results not only in respect of pregnancy offensive, but also a favorable current. Conclusion. The received results can be recommended for wide use in practical health care. Key words: endometriome of ovaries, auxiliary genesial technologies.