Chermak I. Barreness at women of late reproductive age: diagnostics and tactics treatment.

The dissertation is devoted a decrease problem frequencies infringements to reproductive function at women of late reproductive age on the basis of studying of new aspects of patogenesise female barreness taking into account age of patients and presence accompanying genital pathology, and also workings out of algorithm of diagnostic and treatment-and-prophylactic actions. New aspects of patogenesise female barreness at women of late reproductive age on the basis of the established interrelations between age of women, presence accompanying genitale pathologies and a condition ovarial reserve are established. One of principal causes of infringement of reproductive function at these patients is presence genital endometriosis, especially endometriome, and leiomyoma of uterus which lead to development low ovarial reserve that dictates necessity of use of auxiliary reproductive technologies. In patogenesise developments low and very low ovarial reserve the leading part are played by essential decrease antimullere hormone that leads to changes of a functional condition ооцитов. It is shown, that at women of late reproductive age frequency of approach of pregnancy does not depend on schemes of stimulation of function ovaries and character embriologicale grants, thus efficiency of treatment of barreness is defined by a condition ovarial reserve of the patient. Use donor ооcytes is shown patients is more senior 42 years with lowered ovarial reserve more than on 50,0 %. On the basis of the received results scientifically proved approach is developed for the decision of a problem of rendering of medical aid at treatment of barreness at women of late reproductive age. Comparative aspects of a clinical current of pregnancy at women of late reproductive age are shown at spontaneous development gestation and at use of auxiliary reproductive technologies. It has allowed to define principles of conducting pregnancy and sorts, and also to offer algorithm of the diagnostic and treatment-and-prophylactic actions directed on decrease of frequency of reproductive losses and perinatal pathology.