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Background. Ovarian endometriosis has the most aggressive effect on the ovarian reserve compared to other types of benign ovarian neoplasms. Laparoscopic cystectomy with pathomorphological verification remains the gold standard for the diagnosis of endometriosis in clinical practice. It is the lack of clear criteria for predicting damage to the ovarian reserve after surgical treatment and the future reproductive potential of a woman, as well as the inability to personalize treatment, that determined the purpose and objectives of this study. Aims to develop a score scale for predicting changes in the ovarian reserve after cystectomy in ovarian endometriosis based on a comprehensive preoperative assessment of basic clinical, ultrasound, and molecular-biochemical parameters. Materials and methods. A single-center observational cohort prospective comparative study was conducted for 5 years. The study included 238 women aged 24.4 3.1 years with pathomorphologically verified ovarian endometriosis, who came to the clinic with complaints of pain of varying intensity. Results. The content of anti-Muller hormone (AMH) less than 1.5 ng / ml was significantly highly correlated with the unfavorable outcome of surgery (r=0.723). The largest diameter of the formation more than 5 cm (r=0.826) and its main localization (r=0.743) correlated most strongly with a decrease in HR and intraovarian blood flow after cystectomy. The ROC analysis (receiver operating characteristic) and the evaluation of the area under the curve the AUC indicator (area under ROC curve) revealed that the determining value of the cut off point for serum LDH was 107.35 U/l, for IL-8 94.55 pg/ml and IL-6 82.4 pg/ml, with an increase in which the probability of reducing AMH increases by more than 50%. Conclusions. The point scale system including preoperative assessment of ultrasound parameters (endometrioma size, localization, and bilaterality) and biochemical markers of toxicity in serum helps to predict changes of ovarian reserve after cystectomy (LDH, IL-6, IL-8).

Objective. To evaluate the efficacy of Intraovarian autoplasmotherapy (platelet-rich plasma/PRP) in the activation of ovarian function in patients with diminished ovarian reserve and “poor” response in the in vitro fertilization (IVF) cycles, as well as its influence on the quality of life. Patients and methods. A total of 120 patients with diminished ovarian reserve and a history of IVF cycle failure who refused to use donor oocytes were included in the study. All patients underwent intraovarian PRP therapy based on the proprietary technology. The quality of life, the ovarian function, and the results of the embryo stage in the IVF cycle were monitored for 6 months. Results. The conducted study demonstrates a positive effect of intraovarian PRP therapy on the functional state of the ovaries and on the results of the embryo stage in IVF in the cohort of patients with diminished ovarian reserve and “poor” response in previous unsuccessful IVF cycles. The findings also indicate changes in the quality of life, an improvement in sexual function, and positive dynamics in the emotional state. Conclusion. Intraovarian PRP therapy allows patients with infertility and diminished ovarian reserve to avoid using donor oocytes and to obtain their own genetic material. This technology has a positive effect on the quality of life, having a certain anti-age effect in all groups of examined women, the duration of which has yet to be clarified. Key words: infertility, “poor” response, intraovarian PRP therapy, IVF cycle failure, diminished ovarian reserve

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