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Aim. Is specification of the nature and frequency of concomitant forms of genital endometriosis and other estrogen-dependent diseases (EDD) for the infertile women with severe peritoneal endometriosis (PE), as well as the assessment of the ovarian reserve condition for the patients of different ages. Materials and methods. The total 142 infertile women with severe peritoneal endometriosis (IIIIV stage of the external genital endometriosis according to the American Fertility Society classification) were examined at the age of 32.33.2 years (minmax = 2340 years). The clinical status assessment was conducted, using a standard set of diagnostic procedures, prescribed for the inclusion of patients in the IVF program. The ovarian reserve was estimated by the level of the anti-Mullerian Hormone level determined by the immunoenzyme method. Results. The concomitant 2-sided endometriotic ovarian cysts (96%), myoma (19.7%) and the adenomyosis (16.9%) were most common for the patients with severe peritoneal endometriosis. The severely reduced the anti-Mullerian Hormone rates (0.4 ng/ml) were much higher among patients 35 years old (24.6% compared to 10.6% for younger patients; p=0.028). Conclusion. The infertility for severe peritoneal endometriosis is supported by concomitant estrogen-dependent diseases, of which 2-sided endometriomas, adenomyosis and uterine myoma are of the most pathological. The low efficiency of IVF in the treatment of patients with severe peritoneal endometriosis and concomitant estrogen-dependent diseases is explained by the aggravation of the embryonic and endometrial factors for the infertility. The other reason that worsens the results of IVF for such patients is late reproductive age (35 years) that increases the observed reduction of the ovarian reserve.

Aim. To assess the efficacy and safety of using the homeopathic drug Mastopol for the relief of mastalgia in women with infertility, including those associated with endometriosis, as well as to study the drug tolerability and adherence to the treatment, as well as to determine its antiproliferative and analgesic effects in patients of the study cohort. Study design: open-label, randomized, non-comparative, observational study. Material and methods. 79 infertile women with mastalgia (67 with cyclic mastalgia and 12 with acyclic mastalgia) were examined and treated with Mastopol. Mastopol was prescribed 1 tablet 3 times a day sublingually. The course of treatment was 8 weeks. The efficacy of mastalgia relief was assessed using a Visual Analogue Scale (VAS). Treatment outcomes were considered good if pain severity by the VAS decreased by 4 or more points from the baseline levels at the end of Mastopol treatment course. Results. One Mastopol treatment course provided good treatment outcomes in 76,2% of patients with cyclic mastalgia and in 33,3% of patients with acyclic mastalgia. There were no adverse reactions or complications in patients treated with Mastopol. Conclusions. Mastopol has established itself as a quite effective and safe drug in patients of the study cohort; if there is an insufficient effect, Mastopol can supplement traditional pharmacological agents recorded in the current clinical guidelines.