Aim. To investigate the modern condition of the problem of infertility and obstetric complications in endometriosis and the main management aspects of women with endometriosis in pregnancy planning. Materials and methods. The article presents a systematic literature review on the results of search for studies in electronic databases MEDLINE, PubMed, EMBASE, Cochrane Library and eLibrary. Results. Endometriosis is one of the most common causes of infertility. A cascade of adverse reactions caused by endometriosis prevents a successful pregnancy. Currently, there is an evidence that patients with endometriosis have a high risk of several obstetric complications, such as spontaneous miscarriage, premature birth, preeclampsia, low birth weight and gestational diabetes. Progestogens belong to the first line of therapy of endometriosis, and dydrogesterone is a drug that meets all the necessary requirements. The use of dydrogesterone in the treatment of endometriosis helps to reduce the negative symptoms of endometriosis, improve the quality of life and increase fertility. Dydrogesterone is the only progestogen that has two effective regimens for endometriosis, which allows prescribing therapy for women who are planning pregnancy and for those who have already realized their reproductive plans. Dydrogesterone is the only progestogen that has been suggested to increase the chances of pregnancy in women with endometriosis. Dydrogesterone has been shown to be effective in supporting the luteal phase in ART programs, treating threatening and recurrent miscarriages. Conclusion. Endometriosis is associated with infertility and a high risk of obstetric complications. Dydrogesterone has a number of advantages compared to other progestogens.

Aim. To investigate the modern condition of the problem of adenomyosis and its impact on womens reproductive function. Material and methods. The article presents a systematic literature review on the results of research search in electronic databases MEDLINE, PubMed, EMBASE, Cochrane Library and Elibrary. Results. Adenomyosis is a common but insufficiently studied disease. Modern imaging methods, such as transvaginal ultrasound and MRI, make it possible to diagnose adenomyosis at the early stages of the disease and perform the organ-preserving surgery. A medical treatment of adenomyosis requires to develop a lifelong management plan, the choice depends on the womans age, reproductive status and clinical symptoms. Currently, there is evidence of a negative impact of adenomyosis on fertility and pregnancy outcomes. Dienogest, a 19-norsteroid derivative, is a progestin with high selectivity to progesterone receptors, it exerts a hypogonadotropic effect and an antiproliferative effect on the endometrium. A mild regime of supression of ovarian function provides adequate conditions for blood supply to the uterus before planning a pregnancy. The immunomodulating effect of progestin may be useful for implantation and fetal protection to pregnancies occurring after treatment. Dienogest treatment increases the effectiveness of IVF cycles for adenomyosis of varying severity. Conclusion. The review summarizes the aspects of prevalence, comorbidity, risk factors, classification, mechanism of pathogenesis, clinical manifestations, diagnosis, treatment of adenomyosis, impact on fertility and pregnancy outcomes.