Разработаны рекомендации для усовершенствования методов профилактики и лечения бесплодия в регионе, согласно которым необходимо учитывать достоверные факторы риска развития бесплодия, а также обратить особое внимание на такие ведущие этиологические факторы как трубно-перитонеальный и эндокринный. Внедрена в практику методика определения риска развития бесплодия у отдельно взятой женщины, созданная на основании клинико-анамнестических данных и статистического анализа, что позволяет выделить группу риска по бесплодию для ранней профилактики.
Ключевые слова: бесплодие, распространенность, факторы риска, структура, методы лечения.
SUMMARY
Hasayan O.V. Infertile marriage: reasons, extension, structure, risk factors. – Manuscript.
The dissertation on competition of scientific degree of candidate of medical sciences on a speciality 14.01.01 – Obstetrics and Gynaecology – SD "Institute of Pediatrics, Obstetrics and Gynaecology Academy of medical Sciences of Ukraine", Kyiv, 2008.
We have interviewed 2000 of fertile women by the unified protocol developed according to the World Health Organization standards. We have found out that infertility extension in Bukovinian region is 14.2%. Levels of primary (48.6%) and acquired (51.4%) sterility do not differ much.
As a result of statistical processing of the data received we have defined the main risk factors of infertility incidence for married couples: man”s and women’s contact with toxic substances; complications during previous pregnancies and labours; long-term, painful, and irregular periods; use of ineffective contraception methods (calendar method, method of interrupted intercourse); hirsutism; sexually transmitted diseases, especially chlamidiosis.
Full clinical-diagnostic examination has been made for 150 infertile married couples. In the examined population women’s infertility has been found in 63.4% of the observed couples, men’s infertility – in 5.3% of the observed couples, both partners – 30%, undiscovered infertility reason – 1.3 %.
Leading etiological factors of women’s infertility in the region are salpingian peritoneal (54.9%) and endocrine (49.3%). Their frequency is high in comparison with the other geographical regions. Combination of 2, 3 or 4 infertility factors has been noticed in 71.8% of the examined women.
We have defined the effectiveness of the different methods of infertility treatment of women in the region: conservative – 52.0%, surgical – 38.8%, additional reproductive technologies – 31.3%.
We have developed the recommendations for the improvement of the methods of preventing and treating infertility on the regional level.
Key words: infertility, extension, risk factors, structure, methods of treatment.
ПЕPЕЛIК ТЕРМІНІВ І УМОВHИХ СКОРОЧЕНЬ
ВООЗ – Всесвітня організація охорони здоров’я
ДРТ – допоміжні репродуктивні технології
ЛГ – лютеїнізуючий гормон
17-ОКС – 17-оксикетостероїди
ПКТ – посткоїтальний тест
СЗРП – синдром затримки розвитку плода
ФСГ – фолікулостимулюючий гормон
ХВГП – хронічна внутрішньоутробна гіпоксія плода
ХПН – хронічна плацентарна недостатність