Zhegulovych Y. New approaches to the diagnosis, treatment and prevention of ovarian apoplexy for preservation and restoration of reproductive function.

The dissertation presents the original results of the study which was aimed at improving the effectiveness of treatment of ovarian apoplexy (OA) and was supported by clinical, instrumental, and laboratory investigations. The study suggests newly developed hemostatic methods which are safe for women's reproductive health and can be employed in minimally invasive surgery on the ovary. The dissertation highlights the long-term effects of OA treatment depending on the tactics (conservative or operative), access to the organ, operative complexity and hemostatic method. The dynamics of recovery of the ovarian reserve and ovulatory-menstrual cycle in women, who suffered OA, was studied by comparing the effects of hemostatic techniques and the suggested compression hemostasis methods which do not require the use of electrosurgery. The findings of the integral assessment of ovarian reserve (OR) and its recovery were the worst for monopolar cutting and coagulation (the surgical department), slightly better for bipolar coagulation, and rather better for ligature hemostasis which was carried out without the use of electrosurgery. The best outcomes and the fastest morphofunctional recovery of OR in the post-operative period were observed after compression hemostasis performed with the application of the technique described in the current study. The conservative management of OA was unlikely to change the ovarian reserve markers. The assessment of reproductive function and fertility in women after the use of a range of tactics and methods for OA treatment showed different results.