Prokopovich E. Optimization of diagnosis and treatment of infertility in women with leiomyoma of the uterus on the background of endometriosis.

The thesis presents a new solution to the actual problem of modern gynecology - increasing the effectiveness of organ-preserving treatment for external genital endometriosis and uterine leiomyoma in women with infertility. Based on the study of the effects of various types of combination therapy (ulipristal acetate and buserelin acetate) on angiogenesis factors (SEFR, рSEFR P1 and рSEFR P2 receptors) in the blood serum of women with uterine leiomyoma and external genital endometriosis, a new method was developed for predicting fertility recovery depending on options for disease activity and reducing the number of recurrences of diseases. Clinical efficacy of combination therapy (laparoscopy and medical treatment) in patients with external genital endometriosis, uterine leiomyoma and reproductive function impairment consisted of a significant decrease in pain syndrome in 97-100% of patients and the restoration of reproductive function in 38,5-42,3% of cases. Reducing the serum levels of SEFR-A in the bloodstream as a result of combined treatment is a marker of a favorable prognosis for the restoration of fertility in patients with external genital endometriosis and uterine leiomyoma. The lack of a change in the level of the SEFR-A indicates a low risk of relapse of the disease 12 months after the combined treatment, and in case of its increase - infertility treatment in endometriosis and uterine leiomyoma is ineffective.