The objective: of the study was to investigate the indicators of ovarian reserve in infertile women of reproductive age with non-operated ovarian endometriomas more than 3 cm in diameter. Patients and methods. It were examined 63 patients of reproductive age with ovarian endometriosis, including 33 with unilateral ones and 30 with bilateral. The control group consisted of 30 conditionally somatically healthy women of reproductive age with secondary tubal infertility, with regular ovulatory menstrual cycle. All the women were operated on. Prior to the surgery it were studied biochemical and sonographic markers of ovarian reserve, and after pathological study of operational materials – histological markers. Results. It was registered decrease in biochemical, ultrasonographic and histological indicators of ovarian reserve compared to control. Conclusion. The authors conclude that endometriosis directly affects ovarian reserve and ovarian reserve should be assessed not only after it, but before surgery in women with endometriomas and reproductive disorders. It is important to determine the tactics of their management. Key words: endometrioma, ovary, ovarian reserve, operation, Anti-Mьllerian hormone, inhibin B, FSH, estradiol, the number of antral follicles.

ISSn 2309-4117 Г.В. РУТИНСЬКА заочний аспірант кафедри акушерства та гінекології Донецького національного медичного університету ім. Максима Горького В.М. АСТАХОВ д. мед. н., професор, завідувач кафедрою акушерства та гінекології Донецького національного медичного університету ім. Максима Горького О.М. НОСЕНКО д. мед. н., професор кафедри акушерства та гінекології № 1 Одеського національного медичного університету Контакти: Рутинська Ганна Володимирівна Донецький НМУ ім. Максима Горького, кафедра акушерства та гінекології 84404, Красний Ліман, Кірова, 27 тел.:

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The article presents modern literature data on the role of defective deep placentation in the development of great obstetrical syndromes, bioavailable progesterone and its receptors in the formation of the placenta and the development of pregnancy, mechanisms of development of resistance to bioavailable progesterone, and a scheme of the pathogenesis of progesterone deficiency during pregnancy as one of the main causes of great obstetrical syndromes. Modern data on the development of resistance to bioavailable progesterone in adolescence, in patients with endometrioid disease, polycystic ovary syndrome and idiopathic recurrent pregnancy loss are presented. The therapeutic possibilities of prophylaxis of great obstetrical syndromes with resistance to bioavailable progesterone are described. Research data on the use of highly selective progestogen with increased affinity for progesterone receptors dydrogesterone for the prevention of great obstetrical in pregnant women with resistance to bioavailable progesterone are presented. Key words: great obstetrical syndromes, defective deep placentation, progesterone, progesterone receptors, bioavailable progesterone resistance, adolescence, endometrioid disease, polycystic ovary syndrome, idiopathic recurrent pregnancy loss, prevention, dydrogesterone.

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