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Infertility is one of the most serious and dramatic medico-social problems. Currently the solving of this problem is impossible without using assisted reproductive technology (ART). But not every infertile couple knows about the presence of ART and its methods. Medical workers, regardless of their specialty and educational attainment, are the main information source and a tool for forming public opinion to a certain degree. According to that, it is of interest to study the medical students' and workers' level of awareness of different methods ART and their attitude to it. Participants, methods, and results. We carried out an anonymous questionnaire survey of 136 medical students and workers aged 20 51 (on an average 25±0.03) -- 109 women (80.1%) and 27 men (19.9%). Medical students, doctors and nurses of different Moscow clinics (n = 410) were identified using the method of continuous sample and then randomized 1:3. We used following entry criteria: consent to participate in research, absence of fertility disorders, absence of skills in ART. Statistical data analysis STATISTICA 8.0 (StatSoft Inc., USA). Description statistics and one-factorial dispersion analysis were used. The data of the study show, that most of interviewed students and medical workers (97.2%) suggest that they know enough about ART and they attitude to it is positive. At once the awareness level of cryopreservation of gametes is low -- only 76.4% of respondents know about it and only 61.1% noted, that they attitude to it is positive. 73.6% of respondents think that they could resort to the ART in case they have fertility disorders, 96.2% of them would prefer IVF and embryo transfer. Surrogate motherhood and gamete donation are acceptable for 1.9% equally. 26.4% of research participants couldn't resort to the ART, they would prefer an adoption. According to the data of the study, it is evident, that the attitude to ART is independent of educational attainment, gender and religion. 83.1% had higher or incomplete higher education, 16.9% -- secondary education. 16.9% were Muslim, 75.7% were Orthodox Christians, 2.9% were Catholic. At once there is a dependence of expressed opinionon on the marital status (only 35% were married) and presence of children (27% had children) -- the level of acceptability of ART was higher among married (97.9%) and having children (100%). Conclusion: The results of the study indicate low information awareness and alert attitude to ART even between some medical workers. And with it the motivation towards using ART is higher among married couples and couples, having children. [ABSTRACT FROM AUTHOR]

At present, miscarriages are an important problem of the public health. Each quarter pregnancy in Russia finishes as miscarriage (Roszdravnadzor, 2009). So search of the technologies for optimization of the pregnancy outcomes is a topical reproductology problem. The Purpose of the study was: the determination of clinical efficiency and acceptability of the non-surgical technology for isthmico-cervical deficiency correction in women from the group of the high risk of miscarriages by means of unloading obstetric pessary. Materials and Methods: 186 pregnancy women were included in the clinical prospective study. All of they were treated according with the threat of the interruption of pregnancy in hospital. The criteria of inclusion to the study were: the age 18-45 years, the organic or functional isthmico-cervical deficiency and the high degree of the risk of miscarriages. Inflammatory and malignant cervical and vaginal diseases were the criteria of exclusion. All pregnant women got the treatment by drugs or suppositories of progesterone before 16 weeks of pregnancy, by sedative therapy and magnesia therapy. 10 (5.4%) women were treated by tocolytics (gynipral) for 3 days with the following therapy by niphedipin for ending of clinic symptoms of the threat of the interruption to pregnancy. The medicamental treatment was lasting from 3 to 10 days. After the medicamental therapy was ended, all women were randomized to 2 groups. Both groups had not the statistical differences on the age and factor of the risk of miscarriages (p > 0.05). The unloading obstetric pessary (ZAO "Medical enterprise Simurg", Vitebsk, Belorussia) were entered for 108 pregnant (the investigating group) at period of pregnancy from 14 to 22 weeks. Pessary was deleted at 37 weeks or with beginning of parturiate activity. The surgical correction of isthmico-cervical deficiency was made in 78 pregnant women (the control group). They was selected by method "case-control". The cervical stitches were taken out at 36-37 weeks or with beginning of parturiate activity. For statistical analysis the package of the applied programs STATISTICA 8.0 (StatSoft Inc., USA) was used. The validity of difference was investigated by non-parametryc criterion of Wilcoxon-Mann-Whitney, the validity was acknowledged as reliable under p < 0.05. The Study was conducting in 2007-2009. [ABSTRACT FROM AUTHOR]

Varicose disease of the pelvic organs is a fairly common disease, which is traditionally associated with dyspareunia and chronic pelvic pain caused by impaired blood supply to the uterus and uterine appendages. The disease is often accompanied by secondary ovarian disfunction, which entails a complex of reproductive disorders, including female infertility. Laparoscopy is a compulsory component of a comprehensive examination of patients with suspected varicosity pelvic organs. Laparoscopy detects the cause of chronic pelvic pain and the presence of varicose veins in the ovaries and broad ligament of the uterus. The main topic of the study was to determine the diagnostic value and therapeutic possibilities of laparoscopy in women suffering from infertility with varicose veins of the uterine appendages. Materials and Methods: In the period from 1 year to 12 years were examined in 1408 women with infertility and chronic pelvic pain of unknown etiology. Causes of pelvic pain detected by microbiological study, cytological study and histological study, ultrasound angioscanning with a color flow mapping, selective retrograde venography of the kidneys and ovaries. Therapeutic and diagnostic laparoscopy was performed for all patients at the final stage of the study. Results and Discussion: Laparoscopic examination detected that the cause pelvialgy in 634 patients (45.0%) is a chronic inflammation of uterine appendages, in 469 patients (33.3%) is a tumor and tumor-like formations of ovaries, in 248 patients (17.6%) is a external genital endometriosis and in 27 patients (1.9%) is a pronounced adhesions of the abdominal cavity. Varicose change tube and ovarian veins were found in 97 patients (6.9%). In 30 patients (2.1%) were found pathological changes in the pelvis. Echosclerotherapy used for the treatment of patients with varicose appendages of the uterus, as there was no effect on previously conducted by therapeutic interventions (duration 2-5 years). Echosclerotherapy done through the introduction of endovascular venous mesovarium controlled laparoscope ethoxysklerolum 0.5% or 0.25% thrombovar. Expected therapeutic effect was based on the cessation of blood reflux from the venous vessels to the ovaries and fallopian tubes, preventing the deposit and venous blood circulation, reducing pelvic pain and improvement of ovarian blood flow. Substantial reduction in the intensity of pelvic pain was observed in 68 out of 97 patients (70.1%) in women with isolated varicose veins of the uterine appendages in 27 out of 30 patients (90.0%), as a result of the treatment when observed over 3 years. Recovery of reproductive function (with the exclusion of male factor infertility) was detected in 24 out of 97 patients (24.7%), and in 15 patients was isolated varicosity appendages of the uterus (50.0%). Conclusions: The use of therapeutic and diagnostic laparoscopy can verify the presence of varicose veins of the uterine appendages at 6.9% women with infertility and chronic pelvic pain of unknown etiology, including a 4.8% combined with other pelvic diseases in 2.1% -- isolated. Intraoperative sclerotherapy ovarian veins helps to reduce the intensity pelvialgy at 61.2% of patients with concomitant varicose veins of the uterus and appendages in 90.0% when isolated, allows to achieve a pregnancy, respectively, at 13.4% and 50% of women. You must use the modern assisted reproductive technology to realize the full potential fertility restoration in this category of patients. [ABSTRACT FROM AUTHOR]

Currently demographic situation in Russia can be described as reproductive crisis. According to official statistics data (Rosstat, 2008) only 5 of 10 occurred pregnancies terminates in labor (52%), 4 of them terminates in abortion (39%), 1 of them terminates in first-trimester miscarriage or extrauterine pregnancy (9%). In 1997-2008 0- to 17-year-old children's share of population decreased by 26% (p < 0.01). There is a marked uptrend of its' continuing decreasing -- in 1997-2000 6.8%, in 2001-2004 -- 7.5%, 2005-2008 -- 8.4%. In 2004-2008 morbidity rate of menstrual disorders among 10- to 14-year old and 15- to 17-year-old girls increased by 17% (p < 0.05). The highest rate of menstrual disorders among 10- to 14-year-old girls have been registered in 2006 (1387 per 100 000), in 2004 it was 1153.8, in 2008 -- 1358.8 (+17.8%, p < 0.05). The highest rate of menstrual disorders among 15- to 17-year-old girls have been registered in 2007 (4689.8 per 100 000), in 2004 it was 3901.0, in 2008 -- 4555.9 (+16.8%, p < 0.05). The highest rate of oophoritis and salpingitis among 15- to 17-year-old girls have also been registered in 2007 (1502.2 per 100 000), in 2004 it was 1333.0, in 2008 -- 1428.6 (+7.2%, p < 0.1). We studied the rate of gynecological diseases and disorders, revealing during preventive examination of the employees of the enterprise (13- to 18-year-old girls) and got the same results. We found that its rate is 1257% and increases during puberty twice (p < 0.05). The main problems of gynecological health of adolescent girls are infection-inflammatory diseases of genitals, disorders of the establishment of menstrual cycle, dysmenorrhea, hyperandrogenia and unwished pregnancy, which in 86-90% terminates in abortion. According to Rosstat (2008), in 2004-2008 690495 10- to 19-year-old girls were underwent an abortion. Over this period of time the amount of abortions decreased by 30.9% (160-170 in 2004, 111330 in 2008, p < 0.01), but at once there are such threatening features of abortions as increasing rate of miscarriages (11.2% ain 2005, 13.7% in 2008, p < 0.1) and terminations of repeated pregnancies (11% in 2005 and 13.6 in 2008, p < 0.1). According to Rosstat (2008), there was 94.3% first time pregnant among girls under the age of 14 years old, who were underwent an abortion, 70.6% among 15- to 17-year-old girls (p < 0.05), and only 53.9% (p < 0.01) among 15- to 19-year-old girls. The complex medico-social study of gynecological health of adolescent girls leaving at 4 different regions of Russia revealed the leading factors, determining future mother's reproductive health. They are ecologo-geographical, socio-cultural and socio-hygienic factors which can indirectly influence somatic health and physical development. To increase the potential value of Russian adolescent girls some measures should be assumed: it is necessary to better the existing living conditions, to optimize physical and sexual development, medical activity, sexual behavior, to raise the level of reproductive health education, efficiency and availability of gynecological care of adolescents, to optimize contraceptive help. [ABSTRACT FROM AUTHOR]

Objective. To study features of histamine metabolism in patients with chronic pelvic pain associated with external genital endometriosis. Methods. For quantitative assessment of histamine level in peripheral blood was taken from 100 patients which than was centrifuged. In blood serum histamine concentration was determined by enzyme-linked immunosorbent assay method with reagents «Histamine ЕLISA» on the machine BAE-1000 Histamine (Labor Diagnostika Nord - LDN, Hermany). A pain syndrome was assessed by Visual Analog Scale (VAS), quality of life assessment - by Endometriosis Health Profile Questionnaire (EHR-30), level of anxiety was determined by Spielberger-Khanin questionnaire. The results. Showed statistically higher histamine level in patients with severe pain according to VAS. After assessment of results obtained from Spielberger-Khanin questionnaire 100% experimental group's women with external genital endometriosis (n = 60) were noted to be have high level of state and trait anxiety, then 40% women of control group (n = 16) have moderate level of anxiety. The incidence of depression in women with chronic pelvic pain was 58.3% (n = 35) and the main part (n = 20) were women with severe stage of pelvic pain according to VAS. Conclusions. Psycho emotional condition of women with external genital endometriosis associated pelvic pain characterized by higher depression and anxiety levels, with significant decrease quality of life. Direct relationship also was found between pain syndrome intensity and histamine level in peripheral blood in patients with external genital endometriosis.