Palyha I. Forecasting and prophylaxis of unsuccessful attempts auxiliary genesial technologies.

Dissertation work is devoted to depression of frequency of unsuccessful attempts of auxiliary genesial technologies on the basis of studying of new aspects of pathogenesis of female sterility, and also improvement and introduction of algorithm of prognostic and treatment-and-prophylactic actions. Scientific justification of rising of efficiency of auxiliary genesial technologies at women with unsuccessful preliminary attempts is presented. New pathogenetic aspects of unsuccessful attempts of auxiliary genesial technologies which consist in decrease of the relative area and optical density of an expression of LIF in superficial and glandular epithelium, and also in stroma an endometrium are established; depression of optical density of an expression of VEGF in stroma the endometrium, received in the period of assumed "implantation windows"; decrease of systolo-diastolic ratio, index of resistance and pulsatsinny index of basal and spiral arteries in day of introduction of triger of an ovulation and in day of transfer of an embryo in cavity of the uterus and depression of the maintenance of VEGF and GM-CSF in cervical slime in day of carrying out a puncture of follicles and in day of transfer of an embryo in a cavity of the uterus. The obtained data allow to prove scientifically need of development of new algorithm of prognostic and treatment-and-prophylactic actions for depression of frequency of unsuccessful attempts of auxiliary genesial technologies. The main features of premorbidal background, a gynecologic case rate and the sterility reason at women with unsuccessful attempts of auxiliary genesial technologies are established. Informative markers of efficiency of auxiliary genesial technologies on the basis of the received clinical, hemodynamic, endocrinologic, immunohistochemical, morphological and microbiological results are presented nayboly. It allowed to offer new mathematical model of forecasting of efficiency of auxiliary genesial technologies at women with the previous unsuccessful attempts and to show its sensitivity, specificity, value of positive and negative result, and also the general accuracy of the assumption. The new algorithm of forecasting and prophylaxis of unsuccessful attempts of auxiliary genesial technologies with use of new model of forecasting and the referred hormonal preparation of a functional condition of ovaries and an endometrium is developed and introduced.