Kuzmuk L. Internal endometriosis: differential diagnosis and pathogenetic therapy including the preservation of reproductive function

The work is devoted to the question of restoring reproductive function in women with endometriosis by establishing an internal algorithm choice of hormonal drugs, which includes features of hysteroscopic pictures and receptor saturation of hyperplastic endometrium . Hysteroscopy is a minimally invasive modern effective method for diagnosing endometriosis internal, which allows you to reliably determine its pathognomonic signs and spend diagnostic and therapeutic manipulations under visual control. Using immunohystochemical determination of expression levels of receptors for estrogen and progesterone in the sighting received biopsies defines a receptor expressed mosaic and can justify the differential approach to choice of therapeutic tactics, which provides an advantage over empirical choice of drug. The proposed method of selecting the hormonal treatment provided almost the same high efficiency of the used regimens. The effect of hormone replacement therapy was determined to normalize the secretion of gonadotropins and sex hormones, thereby eliminating the formation and relative hyperestrogenemia and two phases menstrual cycle. The differential approach to diagnosis and treatment of internal endometriosis allowed to save and restore reproductive function in 38 % of women.