[The place of laparoscopy in the diagnosis and treatment of ovarian cysts]. / Mesto laparoskopii v diagnostike i lechenii ovarial'nykh kist.

Laparoscopy as a diagnostic and therapeutic tool was tried in 56 patients. Laparoscopy was indicated in ovarian cysts detected by ultrasound, sterility, suspected external endometriosis. The diagnosis at laparoscopy coincided with histological pattern of the removed neoplasms in 100% in relation to malignancy. Endoscopic interventions had complications in 1.8% of cases. Recurrences were not recorded 18 months.

[Oligomenorrhea syndrome in infertile patients]. / Sindrom oligomenorei u patsientok s besplodiem.

The paper presents the results of comprehensive studies of 100 infertile patients with oligomenorrhea. Familial predisposition to the impairments in the menstrual and reproductive functions was established as was a high rate of primary infertility and pregnancy wastage. Ninety per cent of the patients demonstrated ovarian dysfunction from the puberty, refractory anovulation was registered in the majority of the patients (70 per cent), intermittent in 22 and persistent ovulation only in 8 per cent of the examinees. Clinical and laboratory investigations confirmed hyperandrogenism in 80 per cent and hyperprolactinemia in 28 per cent of the patients. Laparoscopy demonstrated a high incidence of ovarian polycystosis (57 per cent), inflammatory genital changes (47 per cent), uterine myoma (7 per cent), and endometriosis of the external genitalia (7 per cent). There was no evidence of correlation between the content of plasma hormones, ovulatory disorders and endoscopic findings.

[Clinico-dermatoglyphic correlations in patients with hyperandrogenia]. / Kliniko-dermatoglificheskie paralleli u patsientok s giperandrogeniei.

A clinical dermatoglyphic study of 100 infertile hyperandrogenic patients demonstrated signs of androgenization in all of those. Their dermatoglyphic parameters differed from normal. Hyperandrogenic patients with treatment-resistant infertility showed a higher degree of androgenization and more significant deviations of dermatoglyphic parameters, as compared to the patients whose treatment resulted in pregnancy. Dermatoglyphic characteristics should be taken into account in predicting the practicability of treatment in patients with infertility due to hyperandrogenism.

[Disorders of the hypothalamo-hypophyseal system as a cause of infertility in hyperprolactinemia]. / Narushenie gipotalmo-gipofizarníkh vzaimosviazei, kak prichina vesplodiia pri giperprolaktinemii.

The purpose of the study was to describe hypothalamopituitary functional status of females with infertility in combination with hyperprolactinemia. To this end, changes in prolactin, LH, FSH and TSH in response to the administration of releasing hormones (Gn--RH and TRH) and the dopamine antagonist metoclopramide were assessed in 28 patients with hyperprolactinemic amenorrhea and 5 normal cycling women. Lactotrophs were found to be resistant to functional tests, the resistance increasing as the prolactin level went up. Gonadotrophic and thyrotrophic response to functional tests, on the contrary, increased with the progress of hyperprolactinemia. A conclusion is drawn that stable hyperprolactinemia is a result of disturbance in lactotrophic receptor apparatus, for which reason lactotrophs are no longer sensitive to dophamine inhibiting effect on prolactin secretion.

[Diagnostic possibilities of laparoscopy in ovarian cysts]. / Diagnosticheskie vozmozhnosti laparoskopii pri ovarial'nykh kistakh.

Laparoscopy was used for the diagnosis of ovarian cysts in 90 patients. Ovarian cysts detected by ultrasonic examination, sterility, suspected external genital endometriosis were the indications for laparoscopy. In 32 cases the cysts were found in laparoscopy. In 23 patients a diagnostic puncture of the cyst and a subsequent cytologic examination were carried out. All the patients in whom ovarian cysts were diagnosed were operated on (endoscopically or via laparoscopy). Laparoscopic diagnoses coincided with the histologic findings in examinations of the removed formations in 100% of cases.

[Results of laparoscopy in patients with polycystic ovary syndrome after surgical treatment]. / Rezul'taty laparoskopii u patsientok s sindromom polikistoznykh iaichnikov, perenesshikh khirurgicheskie metody lecheniia.

Laparoscopic studies have been done in 42 patients after laparotomic ovarian wedge resection (group 1), 12 women after laparoscopic ovarian thermocauterization (group 2) and 24 patients after laparoscopic ovarian wedge resection (group 3). Prominent adhesions were found out in the pelvis in group 1 women and milder ones in group 2 patients. The incidence of adhesions was significantly lower in group 3. It suggests that wedge resection using laparoscopy represents a method of choice for surgical ovarian correction.

[Clinical and laboratory findings in patients with infertility and various forms of hyperandrogenism]. / Kliniko-laboratornye pokazateli u patsientok s besplodiem pri razlichnykh formakh giperandrogenii.

The study groups included 120 infertile females with hyperandrogenism: group I-47 patients with androgenic adrenal hyperfunction; group II-51 patients with androgenic adrenal and ovarian hyperfunction; group III-22 patients with androgenic ovarian hyperfunction. The patients with an adrenal pattern of hyperandrogenism demonstrated lower degrees of androgenization (lower hirsutism and clitorism) as well as a less pronounced impairment of the menstrual cycle versus the examinees from the other groups mentioned.

[Danazol action on 5'-nucleotidase activity in mouse peritoneal macrophages]. / Deistvie danazola na aktivnost' 5'-nukleotidazy peritoneal'nykh makrofagov myshei.

The paper reports the results of danazol action in vivo and in vitro on 5'-nucleotidase activity of mouse peritoneal macrophages. The results showed, that danazol at a concentration of 10 M (the pharmacologic level in women taking 600 mg/day) significantly stimulated the enzyme activity.

[Occurrence of microorganisms in chronic salpingitis in infertile women]. / Chastota vydeleniuia mikroorganizmov pri khronicheskikh sa'lpin- gitakh u zhenshchin, stradaiushchikh besplodiem.

The authors presented the results of microbiological study of internal genitalia of 22 females operated on for tubal infertility caused by chronic salpingitis (all of them were subjected to laparoscopic or laparotomic intervention with subsequent salpingoovariolysis and fimbriostomatoplasty). Cervical discharge, endometrial biopsy specimens, tissue and contents of sactosalpinx as well as abdominal exudates were subjected to bacteriological study. Quantitative and qualitative assessment of aerobic and anaerobic microflora composition was made. The findings stated the variety of inflammation activity levels disregarding the degree of anatomical changes in the genitalia. However, microorganisms were detected in the focus of inflammation only in the acute stage of the inflammation in the true pelvis.

[Value of roentgenography of the bones of the skull vault and the sella turcica for the prognosis of the effectiveness of the treatment of infertility in patients with hyperandrogenia]. / Znachenie rentgenografii kostei svoda cherepa i turetskogo sedla v prognozirovanii éffektivnosti terapii besplodiia u patsientok s giperandrogeniei.

Thorough clinical and roentgenological examinations of the skull were conducted in 83 infertile patients with hyperandrogenism. The parameters of their health status evidenced various degrees of androgenism. The roentgenological picture of their skull and Turkish saddle was significantly different from the normal one. A small and round-shaped pattern of the Turkish saddle was significantly more often documented in the hyperandrogenic females whose infertility treatment was a failure. These prognostic criteria should be considered when the practicability of the treatment for this pattern of infertility is discussed.

[Clinico-diagnostic indicators and late results of the treatment of infertility in hyperprolactinemia]. / Kliniko-diagnosticheskie pokazateli i otdalennye rezu'ltaty lecheniia besplodiia pri giperprolaktinemii.

Clinical manifestations of various hyperprolactinemia-associated conditions were studied in infertile females. The results of hormone therapy were evaluated with regard to various preparations employed, pregnancy outcomes in those females were followed up.

[Androgenization in patients with polycystic ovary syndrome]. / Androgenizatsiia u bol'nyh s sindromom polikistoznyh iaichnikov.

150 infertile patients with the polycystic ovary syndrome (PCOS), aged 19 to 36 years, have been investigated. PCOS was diagnosed on the basis of clinical symptoms, and the diagnosis was verified by laparoscopy, followed by histologic investigation of ovarian biopsy specimens. Hirsutism was found in 43% of the patients, while hair growth was marginal in 30% and normal in 27%. Testosterone (T) levels were increased significantly (p less than 0.05) in the PCOS patients with hirsutism or marginal hair growth, as compared to reference values.

[Endoscopic surgery in the treatment of polycystic ovary syndrome]. / Endoskopicheskaia hirurgiia v lechenii sindroma polikistoznyh iaichnikov.

202 patients with the polycystic ovary syndrome (PCOS) were investigated and divided into three groups depending on the variant of endoscopic surgical correction of polycystic ovaries. The highest conception rate (70.6%) was noted in group III; the ovaries of patients in this group were reduced to normal size as a result of dissection. We conclude that endoscopic resection of polycystic ovaries with reduction of ovarian size to normal limits may be considered a preferred variant of surgical treatment for PCOS.

[Comparative study of the diagnostic value of hysterosalpingography and laparoscopy]. / Sravnitel'noe izuchenie diagnosticheskoi cennosti gisterosal'pingografii i laparoskopii.

A total of 100 women had either hysterosalpingography with watersoluble Verografin or lipidsoluble Jodlipol for the assessment of tubal patency. Of these, all had laparoscopy. Laparoscopy have been shown to be the best test of tubal abnormalities. Hysterosalpingraphy with lipidsoluble contrast medium is poorly informative while the method of investigating the tubal pathology and cannot be used in clinical practice.

[The causes of infertility in hyperprolactinemia]. / O prichinakh besplodiia pri giperprolaktinemii.

A study was made of function of the hypothalamohypophyseal system in women with infertility combined with hyperprolactinemia. Changes in the levels of prolactin, LH, FSH and TSH in response to the administration of releasing hormones (gonado- and thyroliberin) and metoclopramide (dopamine antagonist) were determined in 28 women with hyperprolactinemic amenorrhea and in 5 women with a normal menstrual cycle. Resistance of lactotrophs to functional tests was revealed. It grew with an increase in a prolactin level. On the contrary, a response of gonado- and thyrotrophs to functional tests grew with an increase in a degree of hyperprolactinemia. The authors arrived at a conclusion that stable hyperprolactinemia resulted from disorder of the receptor apparatus of lactotrophs with the resultant nonsusceptibility of the latter to an inhibitory effect of dopamine to prolactin secretion. Proceeding from their own and literature data, the authors propose for discussion a scheme of fertility disturbance in stable hyperprolactinemia.

[Diagnostic and surgical laparoscopy in polycystic ovary syndrome]. / Diagnosticheskaia i operativnaia laparoskopiia pri sindrome polikistoznykh iaichnikov.

A total of 202 patients with polycystic ovaries were involved in examination. The study has distinguished the laparoscopic signs of polycystic ovaries: smooth glossy tightly stretched surface of the ovaries with a characteristic vascular pattern or loops; the presence of subcapsular cysts. Ovarian section shows small cysts with transparent or yellowish contents. The histologic signs are thickening of the protein coating, increased count of primary, secondary and cystic atretic follicles (by 2-5 times) and a lowered level of tertiary follicles. Clinical and hormonal signs include disordered rhythm of the menstrual cycle, stable anovulation, a high (over 2) LH/FSH index, an elevated T level. Laparoscopic resection of the ovaries to make their size normal is a method of choice among this technique, standard or wide ovarian biopsy.

[The polycystic ovary syndrome and increased body mass]. / Sindrom polikistoznyh iaichnikov i izbytochnaia massa tela.

Eighty patients with the polycystic ovarys syndrome (PCOS) and excessive body weight were investigated. Weight loss was achieved by means of a diet in 60 patients, and acupuncture in 20 patients. This kind of treatment resulted in pregnancy in 27 (33.7%) patients. Therefore therapeutic diet or acupuncture may be recommended as the first stage of treatment for weight reduction in PCOS patients.

[The characteristics of the hormonal interrelationships in a pregnancy stimulated with parlodel]. / Osobennosti gormonal'nykh vzaimootnoshenii pri beremennosti, stimulirovannoi parlodelom.

The study of hormonal balance in the presence of pregnancy and labor in females with a history of infertility treated with parlodel failed to reveal any negative effect of elevated prolactin levels on the fetoplacental system. No differences in the course of pregnancy and labor were revealed as compared to the untreated age-matched. Weight and height figures of neonates born to parlodel-treated mothers were similar to those from the control group. There was no evidence of malformations or developmental defects in the studied group of neonates.

[The effect of a decrease in body weight in patients with the polycystic ovary syndrome]. / Vliianie snizheniia massy tela u bol'nykh s sindromom polikistoznykh iaichnikov.

Eighty patients with the polycystic ovaries syndrome and excessive body mass were examined. In 60 patients body mass reduction resulted from diets and in 20 it occurred over the course of acupuncture. Such treatment resulted in pregnancy in 27 (33.7%) patients. Therefore, diets or acupuncture for body mass reduction are recommended for patients with polycystic ovaries and obesity as the first stage of treatment.

[Immunological studies of peripheral blood in patients with external genital endometriosis and infertility]. / Immunologicheskie issledovaniia perifericheskoi krovi bolnykh naruzhnym genital'nym éndometriozom, stradaiushchikh besplodiem.

Immunoregulatory lymphocytes of SD2-, SD4-, SD8- and SD2-phenotypes have been assayed using monoclonal antibodies in peripheral blood of infertile women with external genital endometriosis and tubal-peritoneal infertility. The tested cells did not markedly differ from those in control fertile patients. Serum concentrations of immunoglobulin M were increased in women with endometriosis. Immunoglobulin concentrations widely varied in the peritoneal fluid, with a statistically significant elevation of IgA and IgM in women with tubal-peritoneal infertility.