Сhaika O. Tactics of conduction of induced pregnancy with pathology of the thyroid gland.

The thesis is devoted to the problem of increasing the effectiveness of restoration of reproductive function in women with infertility in anamnesis against the background of thyroid pathology by way of studying clinical and laboratory, ultrasound changes, peculiarities of the thyroid status, development and introduction of scientifically substantiated complex of diagnostic and therapeutic and prophylactic measures at induced pregnancy. The scientific analysis of the results allowed to expand the data that is about the relationship of reproductive function disorders and dysfunction of the thyroid system. A comprehensive study of somatic and obstetric-gynecological anamnesis in pregnant women with this pathology has been conducted, which allowed to scientifically substantiate the need for the development of correction of thyroid disturbances at the conception stage in women with infertility in anamnesis. For the first time, the prevalence and structure of the thyroid gland pathology in women with infertility has been studied, and the condition of ovarian reserve in them has been estimated. For the first time, the functional state of the pituitary-thyroid system during induced pregnancy was studied in women with thyroid pathology. For the first time, it has been proven that placental dysfunction is manifested by violations of the hormonal function of the placenta from the early stages of pregnancy, with induced pregnancy against the background of thyroid gland pathology. The role of the thyroid gland pathology in women with infertility in history, the effect of correction of thyroid function on the conception stage, during induction of pregnancy, as well as further perinatal consequences are presented. The necessity of improving the algorithm for the prevention of obstetric and perinatal complications in women with thyroid gland pathology during pregnancy is scientifically substantiated. As a result of this study, an algorithm for the restoration of reproductive function in patients with infertility and thyroid abnormalities considering the ovarian reserve was developed and proposed for use in clinical practice. The complex tactics of conducting induced pregnancy are developed considering the initial functional state of the thyroid gland (hypothyroidism subclinical, hypothyroidism medically compensated, euthyroid goiter: nodular and diffuse) and the revealed features of the pregnancy in women with thyroid pathology. The algorithm of conception preparation and tactics of conducting induced pregnancy with the consideration of the functional state of the thyroid gland is improved and implemented.