THE SPECIFICITY OF THE OVARIAN RESERVE OF WOMEN WITH CHRONIC SALPINGOOPHORITIS

Aim. The research was conducted for the assessment of the impact of chronic salpingoophoritis on the ovarian reserve of women in various phases of reproductive age.Materials and methods. A prospective, controlled and open cohort study was performed in 2013-2018 (n=202). The main group consisted of women with chronic salpingoophoritis (ChrSO) who applied for preconception consultation (n=138). In accordance with the reproductive age phase, the main group was divided into subgroups: the early reproductive age period (ERP, n=44), the peak reproductive age period (PRP, n=56), the late reproductive period (LRP, n=38). The control group consisted of conditionally healthy women of reproductive age (n=64). The ovarian reserve (OR) was estimated on the basis of the serum level of antimullerian hormone (AMH), inhibin B, estradiol, follicle stimulating hormone (FSH), an ultrasoundbased assessment of the number of antral follicles (AF), and the ovarian volume. Results. The age of women ranged from 18 to 40 years. Based on the discriminant analysis, it was found that the main indicators determining the specificity of the OR in ChrSO, depending on the phase of reproductive age, are the number of antral follicles, estradiol level and AMH (Wilks’ lambda = 0.35503, p<0.0001). The specificity of the OR of women with ChrSO (difference from the control group), regardless of the phase of reproductive age, initially and when evaluated after 6 months, is determined by the number of AF and the level of estradiol and AMH; the number of AF and AMH is determined with a similar estimate after 12 months. The specificity of the OR in ChrSO, which is dependent on the reproductive age phase, has been proved through the analysis with the neural networks training(the proportion of correct answers is more than 80%). The linear relationships were established between the values of each OR parameter in women with ChrSO. Initially, when estimating after 6 and 12 months, linear regression equations were calculated, allowing the values of individual OR parameters to be calculated over 6 and 12 months.Conclusion. Chronic salpingoophoritis (ChrSO) is associated with a decrease in ovarian reserve in women of reproductive age. The effect of ChrSO on some parameters of the ovarian reserve depends on the age phase of the reproductive period, which increases with time (after 6, 12 months). The presence of ChrSO in women planning future pregnancies requires preventive and therapeutic measures aimed at preserving the ovarian reserve and the preferred implementation of fertility in early reproductive age before the ovarian reserve starts to decline.

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The effect of prophylactic bilateral salpingectomy on ovarian reserve in patients who underwent laparoscopic hysterectomy

Journal of Ovarian Research ◽

10.1186/s13048-021-00825-w ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Shizhuo Wang ◽

Jiahui Gu

Keyword(s):

Ovarian Cancer ◽

Ovarian Reserve ◽

Premenopausal Women ◽

Laparoscopic Hysterectomy ◽

Ovarian Tumors ◽

Reproductive Age ◽

Control Group ◽

Significant Difference ◽

Bilateral Salpingectomy ◽

The Impact

Abstract Background Bilateral salpingectomy has been proposed to reduce the risk of ovarian cancer, but it is not clear whether the surgery affects ovarian reserve. This study compares the impact of laparoscopic hysterectomy for benign disease with or without prophylactic bilateral salpingectomy on ovarian reserve. Methods Records were reviewed for 373 premenopausal women who underwent laparoscopic hysterectomy with ovarian reserve for benign uterine diseases. The serum anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and three-dimensional antral follicle count (AFC) were assessed before surgery and 3 and 9 months postoperatively to evaluate ovarian reserve. Patients were divided into two groups according to whether they underwent prophylactic bilateral salpingectomy. The incidence of pelvic diseases was monitored until the ninth month after surgery. Results There was no significant difference between the two surgery groups in terms of baseline AMH, E2, FSH, LH, and AFC (all P > 0.05). There was no difference in potential bias factors, including patient age, operative time, and blood loss (all P > 0.05). There was also no significant difference between the two groups 3 months after surgery with respect to AMH (P = 0.763), E2 (P = 0.264), FSH (P = 0.478), LH (P = 0.07), and AFC (P = 0.061). Similarly, there were no differences between groups 9 months after surgery for AMH (P = 0.939), E2 (P = 0.137), FSH (P = 0.276), LH (P = 0.07) and AFC (P = 0.066). At 9 months after the operation, no patients had malignant ovarian tumors. The incidences of benign ovarian tumors in the salpingectomy group were 0 and 2.68 % at 3 and 9 months after surgery, respectively, and the corresponding values in the control group were 0 and 5.36 %. The incidences of pelvic inflammatory disease in the salpingectomy group were 10.72 and 8.04 % at 3 and 9 months after surgery, respectively, while corresponding values in the control group were 24.13 and 16.09 %. Conclusions Prophylactic bilateral salpingectomy did not damage the ovarian reserve of reproductive-age women who underwent laparoscopic hysterectomy. Prophylactic bilateral salpingectomy might be a good method to prevent the development of ovarian cancer. Larger clinical trials with longer follow-up times are needed to further evaluate the risks and benefits.

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ESTIMATION TO EFFICIENCY OF THE MULTIFUNCTION METHOD ОF ENDOMETRIOSIS OVARIЕS TREATMENT

Wiadomości Lekarskie ◽

10.36740/wlek202005106 ◽

2020 ◽

Vol 73 (5) ◽

pp. 868-872

Author(s):

Iryna M. Nikitina ◽

Volodymyr I. Boiko ◽

Svitlana A. Smiian ◽

Tetiana V. Babar ◽

Natalia V. Kalashnyk ◽

...

Keyword(s):

Gonadotropin Releasing Hormone ◽

Inhibin B ◽

Reproductive Age ◽

Sexual Life ◽

Control Group ◽

Women Of Reproductive Age ◽

Releasing Hormone ◽

Antral Follicles ◽

Group I ◽

Laparoscopic Removal

The aim: The aim of the study was to improve the results of treatment of patients with endometriosis by using a combination method of therapy. Materials and methods: For two years, 136 women of reproductive age who underwent laparoscopic surgeries for ovarian endometriosis were monitored: Group I (n = 24) did not receive any hormonal treatment in the perioperative period; Group II (n = 32) – received gonadotropin-releasing hormone agonists within 3 months after surgery; Group III (n = 80) prior to laparoscopic removal of the ovarian cyst used gonadotropin-releasing hormone agonists – Triptorelin 3.75 mg intramuscularly for 2 months, as well as three months after surgery. The control group consisted of 30 healthy women of reproductive age with regular menstrual periods. All patients underwent transvaginal ultrasound, counting the number of antral follicles before and after treatment. Serum hormone levels (FSH, prolactin, thyrotropic hormone, anti-Mullerian hormone, inhibin B) were determined by enzyme-linked immunosorbent assay on Cobas e-411 analyzer (Roche Diagnostics, Switzerland) on day 2-3 of the menstrual cycle and on day 2–3 of the first menstrual period after the end of treatment. Laparoscopic removal of the cyst was performed with exfoliation of the cyst, hemostasis on the wound surface of the bed of the cyst was performed with a bipolar electrocoagulator. Bipolar coagulation and resection of the ovarian tissue with no potential was used during surgical treatment of the ovaries, which made it possible to preserve the intact portion of the ovary as much as possible. Results: Analysis of ovarian reserve indices, namely number of antral foliculs, number of antral follicles, AMG, and inhibin B levels in all examined patients with ovarian endometriomas were significantly lower than those of the control group before the start of treatment: in the ovarian endometrial group group 1.26 times (p <0.01), inhibin B – 1.5 times (p <0.01), the number of antral follicles – 1.2 times (p <0.01), due to the development dystrophic changes of the follicular apparatus due to prolonged compression, hypoxia, fibrosis in the ovaries. Patients who planned pregnancy were advised to have an active sexual life before menstruation was restored. In 23 (46.9%) of 49 patients who had reproductive plans, pregnancy occurred without first menstruation after a course of gonadotropin-releasing hormone agonists, 12 (24.5%) women became pregnant during the first three menstrual cycles. Extracorporeal fertilization was recommended for women who did not have pregnancy within 6 months of surgery. For two years in women who did not plan pregnancy, recurrence of endometriosis was not observed. Conclusions: The combination of laparoscopic treatment with gonadotropin-releasing hormone agonists in patients with endometriosis with infertility allowed to restore reproductive function in 71.4% of women, which indicates the effectiveness of the treatment method used. In addition, it helps to achieve lasting remission and addresses the socio-social problems of women’s health and maternity.

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Risk Factors Associated with Impaired Ovarian Reserve in Young Women of Reproductive Age with Crohn’s Disease

Intestinal Research ◽

10.5217/ir.2019.00103 ◽

2020 ◽

Vol 18 (2) ◽

pp. 200-209 ◽

Cited By ~ 1

Author(s):

Yue Zhao ◽

Baili Chen ◽

Yao He ◽

Shenghong Zhang ◽

Yun Qiu ◽

...

Keyword(s):

Risk Factors ◽

Crohn’S Disease ◽

Young Women ◽

Ovarian Reserve ◽

Disease State ◽

Reproductive Age ◽

Control Group ◽

Women Of Reproductive Age ◽

Factors Associated ◽

Active Disease

Background/Aims: Crohn’s disease (CD) primarily affects young female adults of reproductive age. Few studies have been conducted on this population’s ovarian reserve status. The aim of study was to investigate potential risk factors associated with low ovarian reserve, as reflected by serum anti-Müllerian hormone (AMH) in women of reproductive age with CD.Methods: This was a case-control study. Cases included 87 patients with established CD, and healthy controls were matched by age, height and weight in a 1:1 ratio. Serum AMH levels were measured by enzyme-linked immunosorbent assay.Results: The average serum AMH level was significantly lower in CD patients than in control group (2.47±2.08 ng/mL vs. 3.87±1.96 ng/mL, respectively, P<0.001). Serum AMH levels were comparable between CD patients and control group under 25 years of age (4.41±1.52 ng/mL vs. 3.49±2.10 ng/mL, P=0.06), however, serum AMH levels were significantly lower in CD patients over 25 years of age compared to control group (P<0.05). Multivariable analysis showed that an age greater than 25 (odds ratio [OR], 10.03; 95% confidence interval [CI], 1.90–52.93, P=0.007), active disease state (OR, 27.99; 95% CI, 6.13–127.95, P<0.001) and thalidomide use (OR, 15.66; 95% CI, 2.22–110.65, P=0.006) were independent risk factors associated with low ovarian reserve (serum AMH levels <2 ng/mL) in CD patients. Conclusions: Ovarian reserve is impaired in young women of reproductive age with CD. Age over 25 and an active disease state were both independently associated with low ovarian reserve. Thalidomide use could result in impaired ovarian reserve.

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Relationship of the ovarian reserve with autoimmune thyroid diseases in the reproductive period

Terapevticheskii arkhiv ◽

10.26442/00403660.2019.10.000095 ◽

2019 ◽

Vol 91 (10) ◽

pp. 14-18

Author(s):

O R Grigoryan ◽

N S Krasnovskaya ◽

R K Mikheev ◽

I S Yarovaia ◽

E N Andreeva ◽

...

Keyword(s):

Ovarian Reserve ◽

Inhibin B ◽

Reproductive Age ◽

Fmr1 Gene ◽

Normal Range ◽

Women Of Reproductive Age ◽

Antral Follicles ◽

Antithyroid Antibodies ◽

Healthy Women ◽

The Status

Aim. To compare ovarian reserve in healthy women of reproductive age - carriers of antithyroid antibodies (ATA) and in healthy women of reproductive age negative for ATA. Materials and methods. 70 healthy women of young reproductive age in the state of euthyroidism (from 18 to 38 years old) were examined. Participants were divided into equal groups (n=35) depending on the status of the presence of antithyroid antibodies (AT-TPO, AT-TG). On the 2nd-4th days of the menstrual cycle, the following markers of the ovarian reserve were determined: serum levels of anti-Müllerian hormone (AMG), inhibin B, FSH, LH, estradiol, testosterone and progesterone, as well as ultrasound parameters - the number of antral follicles and the volume of the ovaries. In addition, to determine the predisposition to premature ovarian failure, an analysis was performed to the number of CGG repeats in the FMR1 gene. Results and discussion. Statistically significantly differs such parameters as the level of estradiol and testosterone, while the differences were not clinically significant. All the parameters evaluated were within the normal range, the main predictors of the ovarian reserve (levels of AMG and inhibin B, the number of antral follicles) remained in the normal range. An increase in the number of repeats of CGG in the FMR1 gene was not detected in any of the participants in the study. Conclusion. In healthy young reproductive age women, the status of ATA does not have a direct effect on the ovarian reserve.

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Modern approaches to the treatment of bacterial vaginosis and mixed nonspecific vaginitis

HEALTH OF WOMAN ◽

10.15574/hw.2017.124.89 ◽

2017 ◽

pp. 89-95

Author(s):

O.V. Golyanovsky ◽

◽

V.V. Mehedko ◽

M.A. Budchenko ◽

◽

...

Keyword(s):

Bacterial Vaginosis ◽

Standard Treatment ◽

Main Group ◽

Reproductive Age ◽

Control Group ◽

Complete Disappearance ◽

Complete Elimination ◽

Women Of Reproductive Age ◽

High Effectiveness ◽

Treatment Regimens

The objective: to evaluate the effectiveness of treatment of women with various dysbiotic vaginal conditions with Limenda. Materials and methods. 58 women of reproductive age with BV and mixed nonspecific vaginitis participated in the study. The main group included 30 women, whose treatment was carried out with Limenda drug. The control group consisted of 28 women, whose treatment was performed according to the standard scheme using a combination of drugs. Results. Based on the results of control tests, complete elimination of pathogens occurred in 29 (96.67%) patients of the main group and in 26 (92.86%) patients of the control group. Five days after the treatment, all 30 (100%) women in the main group noted complete disappearance of symptoms on the control visit, and 2 (7.14%) of the control group complained of minor discomfort in the vagina, which required continued treatment. The conclusion. For the treatment of nonspecific vaginitis and bacterial vaginosis, especially chronic and often recurrent forms, it is better to use combined local remedies. The results of this study reliably testify to the high effectiveness of the combined drug Limenda compared with standard treatment regimens. Key words: vaginitis, bacterial vaginosis, vaginal biocenosis, conditional resistance, metronidazole, miconazole, Limenda.

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Characteristics of phenotypes (clinical variants) of polycystic ovary syndrome in women of reproductive age

Reproductive health of woman ◽

10.30841/2708-8731.2.2021.232519 ◽

2021 ◽

Vol 2 ◽

pp. 27-31

Author(s):

V.G. Syusyuka ◽

M.Y. Sergienko ◽

G.I. Makurina ◽

O.A. Yershova ◽

A.S. Chornenka

Keyword(s):

Polycystic Ovary ◽

Free Testosterone ◽

Main Group ◽

Reproductive Age ◽

Control Group ◽

Women Of Reproductive Age ◽

Ovary Syndrome ◽

Comprehensive Examination ◽

Clinical Variants ◽

Research Show

The objective: on the basis of a comprehensive examination of women of reproductive age to establish the frequency of phenotypes (clinical variants) of polycystic ovary syndrome (PCOS).Materials and methods. 34 patients (main group) who complained of menstrual disorders and/or dermatopathies by recommendation of a dermatologist were examined. The control group is represented by 30 women without gynecological and somatic pathology. The mean age of women in the main group was 26,4±0,9 years and 29,1±0,9 years in the control group (p>0,05). The age of women in the study groups ranged from 18 to 35 years. Patients underwent a comprehensive examination to assess the severity of hirsutism and the severity of acne, as well as the body mass index was determined. All women underwent ultrasound examination in the dynamics and quantitative assessment of the concentration of hormones in the blood plasma, namely cortisol, thyroid-stimulating hormone, prolactin, free testosterone and its index, androstenedione, dehydroepiandrosterone sulfate, 17-α-OH-progesterone, sex hormone binding globulin. Variation-statistical processing of the results was carried out using the program «STATISTICA 13».Results. The results of the conducted research show that 73,5% had menstrual irregularities, and 52,9% – infertility. Acne and hirsutism in every 3rd woman were combined and were diagnosed in 47,1% and 41,2% of women, respectively. Ultrasound signs of polycystic ovaries were found in 94,1% of patients according to the criteria for the diagnosis of PCOS, and in 88,2% – anovulation. According to the laboratory examination, hyperadrogenism was found in 55,9%, which is confirmed by statistically significant (p<0,05) predominance in the main group compared with the control group of androstenedione, free testosterone and its index. In addition, it should be noted statistically significant (p<0,05) higher levels of 17-α-OH-progesterone and prolactin in the main group, but their indicators were within the reference values of the norm. Analyzing the frequency of phenotypes (clinical variants) of PCOS, it was found that phenotype A (classical) occurred in 32,4%. Phenotype B (incomplete classical) was diagnosed in 14,7%, and phenotype C (ovulatory) – only 8,8%. The most often, namely in 15 (44,1%) women with PCOS, the phenotype D (non-androgenic) was established.Conclusions. The results of the conducted research show that in women with PCOS clinical symptoms are characterized by menstrual dysfunction (73,5%), infertility (52,9%) and dermatopathies, namely acne (47,1%) and hirsutism (41,2%). According to the laboratory exanination, hyperadrogenism was found in 55,9%, which is confirmed by statistically significant (p<0,05) predominance in the main group compared with the control group of androstenedione, free testosterone and its index. Among the clinical variants of PCOS, the non-androgenic phenotype (phenotype D) was the most often diagnosed, the frequency of it was 44,1%. Classical (phenotype A) and incomplete classical (phenotype B) were found in 32,4% and 14,7%, respectively. It should be noted that only 8,8% of women with PCOS are diagnosed with phenotype C (ovulatory).

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Ovarian aromatase activity in endometriosis

Journal of obstetrics and women s diseases ◽

10.17816/jowd62217-22 ◽

2013 ◽

Vol 62 (2) ◽

pp. 17-22 ◽

Cited By ~ 2

Author(s):

Valentina Mikhaylovna Denisova ◽

Vladimir Vsevolodovich Potin ◽

Mariya Igorevna Yarmolinskaya ◽

Yekaterina Mikhaylovna Timofeyeva

Keyword(s):

Antral Follicle ◽

Reproductive Age ◽

Control Group ◽

Aromatase Activity ◽

Women Of Reproductive Age ◽

Antral Follicles ◽

Gonadotropin Releasing Hormone Agonist ◽

Healthy Women ◽

Key Enzyme

Aromatase is the key enzyme, which converts androgens into estrogens. To study the role of aromatase in pathogenesis of endometriosis 57 patients and 15 healthy women of reproductive age were examined. Aromatase activity was detected by reaction of estrogens on aromatase inhibitor letrozol intake. Ovarian source of detected aromatase activity was proved by suppression of reaction on letrozole intake during therapy with gonadotropin- releasing hormone agonist. Aromatase activity in recalculation on antral follicle in endometriosis patients withII–IV stages was higher than in healthy women, though total ovarian aromatase activity was not differed from control group because of low number of antral follicles in endometriosis patients. The disturbance of folliculogenesis in endometriosis is connected probably with hyperestronaemia, which has ovarian and extragonandal origin.

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Clinical experience of non-hormonal correction of the luteal phase deficiency in women of reproductive age

HEALTH OF WOMAN ◽

10.15574/hw.2019.140.24 ◽

2019 ◽

pp. 24-26

Author(s):

T.R. Streltsova ◽

◽

N.R. Simonov ◽

Keyword(s):

Menstrual Cycle ◽

Blood Loss ◽

Luteal Phase ◽

Main Group ◽

Reproductive Age ◽

Control Group ◽

Second Phase ◽

Menstrual Disorders ◽

Women Of Reproductive Age ◽

Cycle Disorders

The objective: to study the clinical efficacy of two schemes of using the monocomponent herbal preparation Cyclodynon® in women of reproductive age with complaints of various menstrual cycle disorders diagnosed with latent hyperprolactinemia and second phase failure of the menstrual cycle based on the results of clinical and hormonal studies. Materials and methods. The study included 60 patients aged 25–38 years suffering from PMS. The main group (n = 30) received Cyclodynon® in an ascending pattern: from 1 to the 14th day of the menstrual cycle – 40 drops 1 time a day and from the 15th day to the end of the cycle – 40 drops 2 times a day. The control group (n = 30) – 40 drops 1 time per day until the end of the cycle for three menstrual cycles. Results. After 3 months in the main group there was a more significant decrease in the level of prolactin (from 28.3 to 18.4 ng / ml) as compared with the control (from 27.8 to 23.1 ng / ml). Increased progesterone and estradiol production was also more significantly observed in the main group. The dynamics of normalization of the duration of the menstrual cycle and the volume of blood loss was also more significant in the main group and amounted to 93.3%. Conclusion. The use of an increasing treatment regimen with Cyclodynon® in women with a luteal phase deficiency on the background of hyperprolactinemia has advantages over the use of a standard continuous regimen with respect to a more rapid normalization of hormonal homeostasis, the duration of the menstrual cycle and blood loss. Key words: luteal phase deficiency, hyperprolactinemia, menstrual disorders, Cyclodynon®.

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The effect of prophylactic bilateral salpingectomy on ovarian reserve in patients who underwent laparoscopic hysterectomy

10.21203/rs.3.rs-230207/v1 ◽

2021 ◽

Author(s):

Shizhuo Wang ◽

jiahui gu

Keyword(s):

Ovarian Cancer ◽

Ovarian Reserve ◽

Premenopausal Women ◽

Laparoscopic Hysterectomy ◽

Ovarian Tumors ◽

Reproductive Age ◽

Control Group ◽

Significant Difference ◽

Bilateral Salpingectomy ◽

The Impact

Abstract Background Bilateral salpingectomy has been proposed to reduce the risk of ovarian cancer, but it is not clear whether the surgery affects ovarian reserve. This study compares the impact of laparoscopic hysterectomy for benign disease with or without prophylactic bilateral salpingectomy on ovarian reserve. Methods Records were reviewed for 373 premenopausal women who underwent laparoscopic hysterectomy with ovarian reserve for benign uterine diseases. The serum anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and three-dimensional antral follicle count (AFC) were assessed before surgery and 3 and 9 months postoperatively to evaluate ovarian reserve. Patients were divided into two groups according to whether they underwent prophylactic bilateral salpingectomy. The incidence of pelvic diseases was monitored until the ninth month after surgery. Results There was no significant difference between the two surgery groups in terms of baseline AMH, E2, FSH, LH, and AFC (all P > 0.05). There was no difference in potential bias factors, including patient age, operative time, and blood loss (all P > 0.05). There was also no significant difference between the two groups 3 months after surgery with respect to AMH (P = 0.763), E2 (P = 0.264), FSH (P = 0.478), LH (P = 0.07), and AFC (P = 0.061). Similarly, there were no differences between groups 9 months after surgery for AMH (P = 0.939), E2 (P = 0.137), FSH (P = 0.276), LH (P = 0.07) and AFC (P = 0.066). At 9 months after the operation, no patients had malignant ovarian tumors. The incidences of benign ovarian tumors in the salpingectomy group were 0% and 2.68% at 3 and 9 months after surgery, respectively, and the corresponding values in the control group were 0% and 5.36%. The incidences of pelvic inflammatory disease in the salpingectomy group were 10.72% and 8.04% at 3 and 9 months after surgery, respectively, while corresponding values in the control group were 24.13% and 16.09%. Conclusion Prophylactic bilateral salpingectomy did not damage the ovarian reserve of reproductive-age women who underwent laparoscopic hysterectomy. Prophylactic bilateral salpingectomy might be a good method to prevent the development of ovarian cancer. Larger clinical trials with longer follow-up times are needed to further evaluate the risks and benefits.

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Clinical and Anamnestic, Immunological, Echographic, and Hysteroscopic Features of Chronic Endometritis Associated with Impaired Reproductive Function

Annals of the Russian academy of medical sciences ◽

10.15690/vramn927 ◽

2018 ◽

Vol 73 (1) ◽

pp. 5-15

Author(s):

A. I. Ishenko ◽

A. L. Unanyan ◽

E. A. Kogan ◽

T. A. Demura ◽

J. M. Kossovich

Keyword(s):

Immunohistochemical Analysis ◽

Reproductive Technologies ◽

Main Group ◽

Reproductive Age ◽

High Expression ◽

Control Group ◽

Women Of Reproductive Age ◽

Chronic Endometritis ◽

Infertile Women ◽

Subgroup Ii

Background: The widespread prevalence of infertility, the low effectiveness of assisted reproductive technologies (ART), and the high incidence of chronic endometritis (CE) in infertile women determine the relevance of the considered problem. The aim of the study was to determine the clinical and anamnestic, laboratory, and instrumental features of CE associated with infertility and unsuccessful IVF cycles in women of reproductive age. Materials and methods: The study enrollred 150 women of reproductive age with morphologically established CE (main group, n=120) and without CE (control group, n=30). A subgroup I of the main group included 64 patients with infertility and IVF failures, a subgroup II – 56 fertile women. In addition to anamnesis collection and identification of CE clinical features, all patients underwent infectious screening, immunological and immunohistochemical analysis, ultrasound examination of pelvic organs with dopplerometry, and office hysteroscopy. A comparative analysis of the data obtained from subgroups of the main group was conducted. Results: Histological study of endometrial pipelle-biopsy specimens on the 7−10th day of the cycle revealed CE in all patients of the main group. We found prevalence of mean duration of CE in the subgroup I relative to subgroup II ― 5.5±0.06 years and 2.4±0.07 years, respectively (p0.001). Infectious screening showed that 58 (90.6%) patients of the I subgroup had sterile endometrial seeding which was 16.9 times higher than in subgroup II (p0.0001). Immunological analysis determined the presence of AEAT in all patients of the subgroup I, 43 of which (67.2%) were above 265 U/ml, while 51 (91.1%) of subgroup II had no AEAT (p0.001). Immunohistochemical analysis of the endometrium on the 18th−24th day of the cycle established high expression of CD16 , CD20 , CD56 , and HLA-DRII in 58 (90.6%) patients of the subgroup I, whereas in 54 patients (96.4%) of II subgroup high expression of CD16 and CD20 with low amount of CD56- and HLA-DRII-positive cells was registered (p0.001). We determined prognostically significant clinical and anamnestic risk factors predisposing to the development of infertility in patients with CE (p0,05). We revealed certain echographic, dopplerometric, and hysteroscopic criteria of CE demonstrating the critical disruption of endometrial receptivity in infertile women. Conclusion: Most patients (90.6%) with infertility had autoimmune component of CE characterized by prolonged (more than 5 years) course, high serum level of AEAT, sterile endometrial crops, and high expression of inflammation markers CD16 , CD20 , CD56 and HLA-DRII .

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