Oral Presentation

Adenomyosis and infertility: the therapy control

Liudmila Karakhalis (RU), Grigory Penjhoyan (RU), Angela Jhigolenko (RU), Nelly Papova (RU), Alexei Bezrukov (RU), Vladislav Ponomarev (RU)

[Karakhalis] Kuban State Medical University , [Penjhoyan] Kuban State Medical University , [Jhigolenko] Kuban State Medical University , [Papova] Kuban State Medical University , [Bezrukov] Kuban State Medical University , [Ponomarev] Kuban State Medical University

Adenomyosis is a common gynecology disease, that appears in reproductive age. Its prevalence is from 5 to 70% The adenomyosis is a reason of infertility in 30% of women. Objectives: to estimate the ultrasound markers of adenomyosis in infertility. Material and methods: 49 patients with adenomyosis have been examined; they were divided into two groups according to intensity of dyspareunia: 1st group consists of 26 patients (53.1%) and 2nd - 23 patients (46.9%). The age in both groups were 31.7±3.2 years. It has been performed the ultrasound assessment on 5-7th and 22-25th days of menstrual cycle with estimating of indexes resistance indexes (RI) on arteries uterine and Hatle index (ProFocus 2202, Denmark; HD15 USA, and SonoScape SSI – 1000, China). Results: this prospective study has shown that apart from adenomyosis the prevalence of inflammatory pelvic disease was (43.7%), cervical ectopy (22.7%), fibroid uterus (13.4%). The pregnancy rate was 70.4%, delivery in 53,4% of cases, the artificial abolition in 45.7%. There were 29.6% of women who haven't pregnancies at all. The RI of right arteries uterine (RAU) in 1 group was 1.02±0.107, 2nd - 0.97±0.14; RI left arteries uterine (LAU): 0.92±0.091 and 1.05±0.22 respectively. The Hatle index was 205.46±9.651 and 204.35±13.87 in 1st and 2nd groups respectively. Women of the fist group were treated with Dienogest during 6 months, in the second group were treated with agonists gonadothropin-releasing hormone. As a result of treatment RI RAU in the 1st group decreased to 0.7±0.08 and RI LAU – to 0.75±0.8 (Ñ€< 0,005). In the 2nd group RI RAU decreased to 0.8±0.1 and RI LAU – 0.76±0.12, respectively (Ñ€< 0,005). The Hatle index decreased to 177.81±11.42 and 183.09±9.38 in 1st and 2nd groups respectively (Ñ€< 0,005). Conclusion: the application of RI arteries uterine and Hatle indexes permits to estimate the therapy duration with gestagens or agonists gonadothropin-releasing hormone in adenomyosis.