Lytvak O. Intertility for women with the leiomyoma of uterus: diagnostics and tactic of treatment

Dissertation work is devoted to the decline of frequency of violations of reproductive function for women with the leiomyoma of uterus on the basis of study of new aspects of pathogeny of woman intertility, and also improvement and introduction of algorithm of diagnostic, treatment-and-prophylactic and rehabilitation measures. The algorithm of diagnostic and treatment-and-prophylactic measures, directed on the increase of efficiency of proceeding in reproductive function on the basis of the modified method of operative treatment, personified tactic of preoperative preparation and postoperative rehabilitation is improved and inculcated, and also improved embriotransfer in the programs of auxiliary reproductive technologies. Use for women with intertility and leiomyoma of uterus of continuous intracorporal laparoscopic guy-sutures on an uterus during a myomectomy, unlike dense and the unevenly strung knots of extracorporeal guy-sutures, results in the maintainance of microcirculatory river-bed with the enough body of functionings vessels in a myometrium, due to the even distributing of tension of material of guy-sutures in the area of edges of wound and to the even distributing of pressure of material of guy-sutures on fabrics, that substantially reduces a tissue hypoxia and to the ischemia myometrium, which is instrumental in the decline of risk of formation of areas of necrosis in the area of alteration, and also physiology programed resorption of material of guy-sutures. Principal reasons of unsuccessful attempts of auxiliary reproductive technologies is the pathological multidirectional influence of pathological co-factors of development of intertility for patients with the leiomyoma of uterus (autoimmune conflict is on background endocrine violations or endometrioidal defeat of uterus and ovaries; pathogens which influence on endometrium during operative interferences with to the cavity of uterus) which changes a hemomicrocirculatory river-bed pathologically, as ovaries and endometrium, the same changes receptivity of hormone-producing cages, that directly reduces efficiency of adequate review on medicinal stimulation in the program of auxiliary reproductive technologies. Efficiency of the method of auxiliary reproductive technologies improved by us for women with intertility and leiomyoma of uterus depends on age of women and makes in active reproductive age - 46,7%, in and late - 33,3% accordingly at simultaneous norma- lization haemodynamic indexes of perfusion (VFI)/vascularizations (VI) and intensities of blood stream (FI) (р<0,05) of leiomyoma of uterus are on verge of miometrics/ endometrium, and also parameters system to hemostasis.