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The objective of the investigation was to show the advisability of using optical coherence tomography (OCT) for noninvasive diagnostics and monitoring of treatments in gynecological practice for female patients of reproductive age. Materials and Methods. OCT studies were performed during standard gynecological procedures like laparoscopy and colposcopy, as well as in course of pelvic inflammatory diseases of cervical neoplasia, with the use of an OKT1300U (BioMedTech, Russia). 330 patients of reproductive age (aged 18–45) were examined. The methods used for numeric processing of the OCT images were based on an analysis of histograms and on calculation of the first derivative of the OCT signal over depth. Results. The use of OCT with numeric processing of the images increases the sensitivity of laparoscopy diagnosis of latent chronic salpingitis from 43.5 to 96.0%. In the case of minimal endometriosis, OCT can be used as a substitute for excisional biopsy for the visualization and verification of endometrioid heterotopias. The use of OCT in the case of cervical neoplasia in female patients of reproductive age enables a considerable decrease in surgical aggression during the diagnosis and treatment of cervical intraepithelial neoplasia and early forms of cancer. Conclusion. The use of OCT helps to maximize individualization and organ preservation during the diagnosis and treatment of gynecological pathology, and therefore to preserve the reproductive potential of young female patients.