Состояние репродуктивной системы и овариального резерва у женщин с опухолями и опухолевидными образованиями яичников (отдаленные результаты)

In recent years there has been an increase in benign tumors of the ovaries from 11% to 25% of all tumors of the genital organs. This group of diseases occurs in active reproductive age with almost 60% of patients and has a significant impact on women's ovarian reserve. Until the present it still remains unstudied the effect of tumors and tumor-like formations of ovaries on ovarian reserve depending on the type, size, and surgical methods of treatment. The need for medical intervention in newly diagnosed asymptomatic cysts of small size is controversial issue, as well as the feasibility of surgical treatment when they have uncomplicated clinical course.В последнее время отмечается рост доброкачественных образований яичников с 11% до 25% всех опухолей половых органов. Почти у 60% пациенток данная группа заболеваний возникает в активном репродуктивном возрасте и оказывает значительное влияние на овариальный резерв женщин. До настоящего времени остается до конца не изученным влияние опухолей и опухолевидных образований яичников на овариальный резерв, в зависимости от вида, размеров и хирургических методов лечения. Спорными являются вопросы необходимости медицинского вмешательства при впервые выявленных бессимптомных кистах малых размеров, целесообразности хирургического лечения при их неосложненном клиническом течении

Long-term outcomes of treatment of infertile female patients with endometrioid ovarian cysts

The objective. To study long-term outcomes of treatment of infertile patients with endometrioid ovarian cysts depending on a surgical technique of cystectomy. Patients and methods. The study included 120 female patients with infertility and endometrioid cysts of the ovaries. Group 1 comprised 60 patients, who received operative treatment using a novel technique of cystectomy; group 2 - 60 patients, who underwent traditional cystectomy. Hormonal, echographic and Doppler parameters of ovarian reserve were examined before and after operative treatment. In the postoperative period, reproductive function was realized in a natural way, and also with the help of assisted reproductive technologies. Male factor infertility was excluded. Occurrence of pregnancy was assessed for36 months from the moment of operative treatment. The control group consisted of 60 fertile women without operative intervention on the uterine appendages who had 2 or more children. Results. A moderate decrease of ovarian reserve was diagnosed in patients with endometrioid cysts of the ovaries as compared with the control group. In patients of group 1, a significantly less decrease of ovarian reserve after the operation was noted as compared with patients of group 2. Occurrence of intrauterine pregnancy in groups 1 and 2 was 58% and 36.6%, respectively. The frequency of spontaneous pregnancy in group 1 was 25%, in 2 - 10%. All other intrauterine pregnancies occurred with the help of assisted reproductive technologies. Conclusion. The innovative technique of cystectomy of endometrioid ovarian cysts and assisted reproductive technologies are the most effective methods of treatment of patients with endometrioid ovarian cysts and infertility

Long-term outcomes of treatment of infertile female patients with endometrioid ovarian cysts

The objective. To study long-term outcomes of treatment of infertile patients with endometrioid ovarian cysts depending on a surgical technique of cystectomy. Patients and methods. The study included 120 female patients with infertility and endometrioid cysts of the ovaries. Group 1 comprised 60 patients, who received operative treatment using a novel technique of cystectomy; group 2 - 60 patients, who underwent traditional cystectomy. Hormonal, echographic and Doppler parameters of ovarian reserve were examined before and after operative treatment. In the postoperative period, reproductive function was realized in a natural way, and also with the help of assisted reproductive technologies. Male factor infertility was excluded. Occurrence of pregnancy was assessed for36 months from the moment of operative treatment. The control group consisted of 60 fertile women without operative intervention on the uterine appendages who had 2 or more children. Results. A moderate decrease of ovarian reserve was diagnosed in patients with endometrioid cysts of the ovaries as compared with the control group. In patients of group 1, a significantly less decrease of ovarian reserve after the operation was noted as compared with patients of group 2. Occurrence of intrauterine pregnancy in groups 1 and 2 was 58% and 36.6%, respectively. The frequency of spontaneous pregnancy in group 1 was 25%, in 2 - 10%. All other intrauterine pregnancies occurred with the help of assisted reproductive technologies. Conclusion. The innovative technique of cystectomy of endometrioid ovarian cysts and assisted reproductive technologies are the most effective methods of treatment of patients with endometrioid ovarian cysts and infertility

Paraportal localisation of an endometriotic ovarian cyst and its influence on ovarian reserve and intensity of chronic pelvic pains

The objective. To assess the influence of paraportal and peripheral localisation of an endometriotic ovarian cyst on ovarian reserve and the quality of life of patients. Patients and methods. The study included 100 patients with monolateral endometriotic ovarian cysts with sizes from 2 to 8 cm and chronic pelvic pains associated with external genital endometriosis. Two groups were singled out: group 1 consisted of 30 patients with paraportal localisation of the cyst and chronic pelvic pain; group 2 – 70 patients with peripheral localisation of an endometriotic cyst and chronic pelvic pain. The control group comprised 30 patients with preserved reproductive function without ovarian cysts. Ovarian reserve was assessed by ultrasound and hormonal examinations including antral follicle count, power Doppler imaging with vascularisation (VI) and flow indices (FI), anti-Mullerian (AMH) and follicle-stimulating hormone (FSH) testing. The intensity of chronic pelvic pains was assessed by the Biberoglu and Behrman scale. Laparoscopic surgery was performed, paraportal or peripheral localisation of the cyst and the firmness of capsular attachment were confirmed intraoperatively. Results. In patients with endometriotic cysts a decrease of ovarian reserve by 22–50% was found as compared with women from the control group: AMH – 36%, FSH – 37.4%, AF – 50%, VI – 43%, FI – 22.7%. Examination of ovarian reserve in patients with paraportal location of endometriomas found its significant decrease and a more marked intensity of chronic pelvic pains as compared with the results in case of peripheral localisation of a cyst. Conclusion. Paraportal localisation of an endometriotic cyst conditions a more significant decrease of ovarian reserve as compared with its peripheral localisation. In paraportal localisation of an endometriotic cyst the quality of life decreases to a greater extent due to more intense chronic pelvic pain. © 2019, Dynasty Publishing House. All rights reserved

The first freshwater molluscs from Wrangel Island, Arctic Russia

The first finding of a freshwater snail, Sibirenauta sibiricus (Westerlund, 1877), in one of the lakes on Wrangel Island (north-eastern Russia) is reported. No freshwater mollusc species have hitherto been known from this island. Specimens from the island are morphologically compared with the type series of the species. How aquatic molluscs may have migrated to the Arctic island is briefly discussed