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Study Objective: To assess, based on 3D-ultrasonography data, endometrial receptivity to implantation in women who have undergone conservative surgery for ovarian endometriomas (OE). Study Design: This was a prospective, comparative, clinical study. Materials and Methods: One hundred and seventy-two women who had undergone excision of OE were examined in the study: 114 patients with anti-Müllerian hormone (AMH) levels below 1.2 ng/mL (Group I, including subgroup A made up of 44 women younger than 35 and subgroup B made up of 70 women aged 35 to 40) and 58 patients with AMH ≥1.2 ng/mL (Group II). 3D-ultrasonography was performed at six and 12 months after cyst removal (between days 6 and 8 after ovulation). The VOCAL software was used to assess endometrial volume and volumetric blood flow indices, such as vascularization index (VI), flow index (FI), and vascularizationflow index (VFI). Study Results: One year after the surgery, endometrial volume in women from subgroup IA and Group II and volumetric blood flow indices in women from Group II did not significantly differ from population mean values. In subgroup IB endometrial gland volume remained reduced throughout the observation period; hemodynamics did not improve in either the endometrium (VI: 2.39 ± 1.57% after six months and 2.32 ± 1.44% after 12 months) or the subendometrial layer (VI: 10.96 ± 5.68% and 11.86 ± 4.59%, respectively). Conclusion: The structural and hemodynamic abnormalities revealed in the endometrium in the postoperative period should be viewed as factors worsening endometrial receptivity to implantation. Keywords: ovarian endometriosis, endometrial disorders, 3D-ultrasonography, volumetric blood flow indices.

Эндометриоз занимает второе место в структуре гинекологической заболеваемости [1]. Общепринятой тактикой при эндометриоидных образованиях яичников (ЭОЯ) является их удаление лапароскопическим доступом: цистэктомия или резекция яичника [2-4]. Частота рецидивов эндометриоза после хирургического лечения составляет 6,4% через 2 года, 10%-через 3 года, 19,9%-через 5 лет и 30,9% спустя 6 лет [5]. Высокий процент рецидивов эндометриоидных образований яичников (РЭОЯ), по мнению H. Park и соавт.

Benign ovarian tumors (BOT) have a significant impact on fertility and are associated with infertility, which, in turn, relates to endometrial receptivity and depends on the ovarian status, forming the so-called endometriopathy. Objective. To study the morphological and functional features of the endometrium in patients of reproductive age before and after ovary-sparing surgery for BOT according to 2D and 3D ultrasounds. Patients and methods. The study included 145 patients who underwent surgery for BOT. Patients were divided into two groups. Group 1 included 75 patients with diminished ovarian reserve (OR), group 2 included 70 patients with normal OR. Diminished OR was defined as serum Anti-Müllerian hormone (AMH) level <1.1 ng/mL. Pelvic ultrasound (US) was performed in the mid-secretory phase before and 6–12 months after surgery. We measured endometrial thickness, endometrial pattern, visualization of basal and spiral arteries by 2D ultrasound, volume and volumetric blood flow in the endometrial and subendometrial regions by 3D ultrasound. Results. The analysis revealed endometrial dysfunction in patients with diminished OR before and after surgery, however there was a trend towards improvement in all the examined parameters after 12 months. In patients with normal OR before surgery, endometrial parameters did not differ from the population, but more persistent abnormalities were noted in the postoperative period. Conclusion. The 3D ultrasound technique provides an objective assessment of morphological and functional features of the endometrium and allows to identify markers of endometrial dysfunction. Key words: benign ovarian tumors, volumetric blood flow, ovarian reserve, 3D ultrasound, endometrium

Objective. To study the morphological and functional characteristics of the endometrium in patients of reproductive age before and after unilateral adnexectomy using a three-dimensional (3D) ultrasound imaging. Patients and methods. A total of 113 patients after unilateral adnexectomy were examined. The mean age of patients was 32.85 ± 4.01 years. Two patient groups were identified: group 1 (n = 51) consisted of patients with mature teratomas; group 2 (n = 62) included patients who underwent surgery for epithelial ovarian tumors (endometrioid (30; 48.4%), serous (21; 33.9%), and mucinous (11; 17.7%) cystadenomas). The 3D ultrasound examination of pelvic organs was performed in the middle luteal phase of the menstrual cycle before surgery and at 6, 12 months after it. The endometrial thickness, volume, and ultrasound pattern were studied, as well as volumetric vascularity indices: vascularization index (VI), flow index (FI), and the vascularizationflow index (VFI). Based on the ESHRE consensus (2022), the ovarian reserve was assessed. Results. The improvement of endometrial perfusion was noted at 12 months after surgery. In patients with ovarian teratomas, compensatory restoration of morphological and functional properties of the ovary and endometrium was recorded. The opposite pattern was observed in the group of patients with epithelial tumors. Thus, patients operated on for ovarian endometriomas had an extremely thin endometrium (3.5 ± 0.1 mm), whose values were 1.5 times lower compared to those of patients with serous and mucinous cystadenomas; the glandular layer volume was expectedly low (1.1 ± 0.9 cm3). Conclusion. The minimum effective restoration period for the collateral ovary after unilateral adnexectomy is at least 6 months. The qualitative and quantitative parameters of 3D Doppler velocimetry can be used as predictors of the endometrial morphological and functional state in patients of reproductive age. Key words: 3D ultrasound, mature teratomas, cystadenomas, endometrium, endometrioid cysts, VOCAL