Modern capabilities of reproductive function realization for patients affected by deep infiltrative endometriosis

Abstract

It is agreed that endometriosis is a disease that has a negative impact on fertility. Factors causing decrease in fertility in patients with endometriosis are very diverse: peritoneal factors, including changes in peritoneal fluid, adhesions, changes in anatomy of pelvis and impaired properties of peritoneum which may also lead to the tubal factor of infertility; ovarian factors which are linked with endocrine and ovulatory changes and lead to disturbance in oocyte quality and quality of embryos; factors leading to implantation disturbances. There are different types of strategies for overcoming infertility, caused by endometriosis: medication therapy, surgical treatment and/or methods of IVF. Cases that are presented in this article are not a routine practice and most likely are an exclusion, but they serve as examples of conceiving of women with hypergonadotropic ovarian insufficiency and reduced ovarian reserve with the use of their own oocytes after longtime and combined treatment of severe forms of infiltrative and extragenital endometriosis with unordinary approach to drug therapy.

Keywords

endometriosis / infertility / miscarriage / reduced ovarian reserve / hypergonadotropic ovarian insufficiency / assisted reproductive technologies / aromatase inhibitors / melatonin / dienogest

References

[1] 1.Адамян Л.В., Кулаков В.И., Андреева Е.Н. Эндометриозы: руководство для врачей. – 2-е изд. – М.: Медицина, 2006. [Adamyan LV, Kulakov VI, Andreeva EN. Endometriosy: rucovodstvo dlya vrachei. 2nd ed. Moscow: Meditsina; 2006. (In Russ.)]

[2] 2.Ярмолинская М.И., Денисова В.М. Роль регуляторных молекул в патогенезе нарушений репродуктивной функции у больных наружным генитальным эндометриозом // Журнал акушерства и женских болезней. – 2015. – Т. 64. – № 3. – С. 81–91. [Yarmoliskaya MI, Denisova VM. The role of regulatory molecules in patogenesis of disorders of reproductive function in patients with pelvic endometriosis. Journal of obstetrics and women’s diseases. 2015;64(3):81-91. (In Russ.)]. doi: 10.17816/JOWD64381-91.

RIGHTS & PERMISSIONS

Yarmolinskaya M.I., Durneva E.I.