[Hormone replacement therapy at women with fertility problems and proofs of hypergonadotropic hypoovarism].

The premature ovarian failure (POF), is the main precondition for the origin and the progress of the hypergonadotropic hypoovarism in part of the women with infertility. The significant decrease of the ovarian reserve, makes the treatment of these patients very difficult and problematic, still pregnancy is observed at 5-10% of them. Objective of the research: To study the effect of the Hormone Replacement Therapy (HRT) on the values of FSH before and after the treatment of women with POF, as well as its effect on the percentage of effective pregnancy. 47 infertile women with high values of FSH were included in the study and they followed a 2-4 month treatment with Trisequens tabl. The results of the ART were reported after the reduction of the FSH levels to the normal values. At the end of the treatment followed, the values of the FSH of 41 from 47 patients (87,23%), were reduced to normal range and necessary reproductive procedures were performed. Dividing the patients in 5 groups by age, it was found that the results depend to the greatest extend on this factor. In the group of women up to 30, pregnancy occurred in 25%, between 30 and 35 years this percentage decreased to 22,2%; in the group 35-40 years it sharply decreased to 10% and over 40 years the percentage was 0%. The total percentage of conceived patients for the whole last contingent is 13,4%. The patients with POF and high levels of FSH are worth to follow a Hormone Replacement Therapy before undertaking the oocyte donation.

[About stepwise uterine devascularization in early post-partum haemorrhages].

Bleedings are the leading cause for mother's mortality rate worldwide and that is why the authors face once more the abdominal operative methods for definite copying the early post partum haemorrhages (EPH). They share their experience gained already with 46 cases when EPH has definitively been copied by means of stepwise uterine devascularization of the vessels with atonic bleedings and ligation of a. iliaca interna presenting with laceration of the lower uterine segment and vagina as well. Hysterectomy has been performed only when the uterus has already exhausted its fertile capacities in a structural and functional aspect, e.g. after numerous abortions, deliveries and experienced Caesarean sections, intra-partum septic conditions, appoplexio uteri, etc. According to authors' opinion, the stepwise uterine devascularization is the method of choice for EPH surgical copying during which woman' fertility is, in fact, preserved. With this method, no complications typical of the various compression methods applied to overcome the puerperal bleedings such as B-Linch sutures, haemostatic sutures of 'multiple squares' type as well as U-shape compression sutures have been observed at all.