Tolstanova H. Endometrial pathology at women with unrealized reproductive function: diagnostics and tactics of infertility treatment.

Dissertation work is devoted to increasing the efficiency of diagnostics and sterility treatment at women with pathological changes endometrium on the basis of improvement and introduction of algorithm of diagnostic and treatment-and-prophylactic actions. New aspects of pathogenesis of infertility in women with different variants of endometrial pathology which consist in changes in pinopodia formation depending on an expression of receptors to steroid hormones in endometrium during the predicted implantation window are presented. It is established that the expression of estrogens receptors both in an epithelium of glands, and in endometrial stroma exceeds expected for predicted implantations window indicators, and also essential differences in expression indicators of estrogens receptors in an epithelium of glands for different types of endometrial pathology. It is shown that in an epithelium of glands the progesterons expression differed between variants of endometrial pathology, in patients with endometrial polyps thus was less. The received results allowed to prove scientifically need of improvement of diagnostic algorithm and treatment-and-prophylactic actions in steril women with endometrial pathology. Comparative aspects of structure and factors of infertility development in women with various endometrial pathology are established. Frequency and structure of accompanying genital and extragenital pathology, and also the postponed surgical interventions in infertile women with different variants of endometrial pathology is presented. Tactics of medicamental preparation of endometrium is optimized for different variants of pathology on the basis of the differentiated approach to hormonal correction applying at the stage of preparation for assisted reproductive technologies.