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346 The new approach in management of benign ovarian tumors complicated by infertility
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  1. V Artyomenko
  1. Odessa National Medical University, Obstetrics and Gynecology, Odessa, Ukraine

Abstract

Objectives The aim of our research was to improve the management of benign ovarian tumors (BOT) complicated by infertility.

Methods The hypothalamus-hypophysis-adrenals-ovaries, protease-protease inhibitors systems and uterus-ovaries vascular Doppler figures were examined in 120 reproductive age (27.3±1.47 years) women with BOT suffering from infertility (2–7 years) before and after organ-saving operations along with 25 healthy non-pregnant women (25.3±1.32 years) as a control group.

Results After the operations the obtained figures of regulatory systems functional state were not normalized leading to tumor relapses and other reproductive system organs diseases. They showed misbalance in hormonal correlations, significant elastase decrease with elevation of some protease inhibitors and local character of the ovarian vessels functional state.

For that reason after the surgery the differential therapy was performed by combined abdominal and vaginal pulsing vacuum daily for 14 days separately and in a concert with hormonal therapy (estrogen-gestagen complexes) during 3–6 menstrual cycles.

The differential approach was based on the severity of obtained systemic disorders and menstrual cycle type.

After the treatment in most of the patients we revealed the significant improvement and normalization of hypothalamus-hypophysis-adrenals-ovaries, protease-protease inhibitors systems and uterus-ovaries vascular Doppler figures.

During the first year of observation 84 women became pregnant (70%).

Conclusions The proposed approach for management of women with BOT suffering from infertility is effective and pathogenetically grounded, normalizing woman’s hormonal axis, protease-protease inhibitors and ovarian vascular systems function, leading to menstrual and reproductive system restoration.

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