[THE STATE OF FALLOPIAN TUBES IN WOMEN WITH UROGENITAL CHLAMYDIA AND INFERTILITY].

The aim of this work was to assess the state of the fallopian tubes in women with urogenital chlamydia (UC) and infertility. 344 women 18-49 y.o with infertility have been investigated. UC was detected in 133 of them -38.7%, (main group), UC was absent in 211 (61.3%) patients (comparision group). In the main group prevailed the tubal or tubal peritoneal factor of infertility (51.9% versus 19.4% in the comparison group, p<0.001). UC in women in the main (62.4%) was in the form of mixed infection. Obstruction of the fallopian tubes and adhesions in the pelvic region were more often detected in patients of the main group (p<0.05). The most pronounced lesions of the fallopian tubes were observed in women with chlamydial mixed infection. Adhesive process in the small pelvis was established by laparascopy in 72.2% of women in the main group and in 27.8% in the comparison group (p<0.001). There was a correlation between the extent of the adhesion process in the small pelvis and the presence of chlamydial mixed infection. A histological study was carried out of the tissues of the fallopian tubes in 12 women diagnosed with an ectopic pregnancy, 5 of whom had UC. Women with UC have alternating areas with signs of acute inflammation and various stages of the reparative processand in 4 women with UC the above mentioned signs and sclerosis were detected also in the the submucosa, which can cause destruction of the functional activities of the fallopian tubes and obstruction as well. All this causes a violation of the transport of spermatozoa, the embryo and leads to a ectopic pregnancy and infertility. Obtained results explain the inefficiency of restoring reproductive function in women after elimination of UC with preserved patency of the fallopian tubes.

[OVARIAN RESERVE AND EFFECTIVENESS OF IVF IN WOMEN OF VARIOUS AGE GROUPS].

The purpose of this study is a comparative assessment of ovarian reserve parameters and the effect of these indices on the features of follicle and oogenesis in women of different age groups. A retrospective analysis of IVF results was conducted in 101 patients aged 21 to 49 years. All patients were divided into 4 groups according to age: I group up to 30 y.o. - 45 women, II group - 31-35 y.o - 14 women, III group - 36-40 y.o. - 26 women, IV Group - 41 or more - 16 women. A low ovarian reserve was found in the majority (84,6%) of women in group III and in all women in group IV. It was found that the lowest total dose of rFSH / hMG was used in women aged 21-30 years and 31-35 years, and in women in the age range of 36-40 years, the consumption of drugs was significantly higher and tended to further increase in the age group 41 аnd more years. A large consumption of rFSH/hMG is necessary to overcome the growing FSH level in the process of aging of the reproductive system and the reduced AMH level. However, at the same time, compared age groups had significant differences in the number of oocytes and embryos obtained. With age, a significant reduction in the number of mature oocytes and embryos obtained after follicle puncture and fertilization has been identified. The most promising in terms of pregnancy were the I and II groups. With age, the frequency of pregnancy decreased. The number of pregnancies was statistically lower in the III age group compared to groups I and II. In the IV group, no cases of pregnancy were recorded. Thus, it can be concluded that age is a statistically significant factor affecting the success of infertility treatment by IVF.