В статье представлен анализ данных за последние 70 лет, вошедших в базу данных PubMed, о гиперплазии эндометрия (ГПЭ), которая занимает ведущие позиции в структуре гинекологических заболеваний и является основным фактором риска злокачественного новообразования эндометрия – рака эндометрия (РЭ). Отражена хроника классификации ГПЭ с акцентом на изменении в динамике обозначения и актуальности аденоматозной ГПЭ. Показано, как действующая классификация ГПЭ, благодаря тому что спектр синонимов ограничен двумя вариантами, позволяет максимально повысить воспроизводимость диагноза, улучшить взаимодействие акушера-гинеколога с патологоанатомом и снизить долю неэффективного лечения. Результаты последних исследований о распространенности и факторах риска ГПЭ и РЭ отличаются от ранее принятых и разрушают «триаду Бохмана», конкретизированы риски развития ГПЭ при приеме тамоксифена и нюансах менопаузальной гормональной терапии. Обозначены результаты исследований, направленных на диагностику ГПЭ и РЭ. Представленные в обзоре различия в этиопатогенезе, распространенности, диагностике, факторах риска развития и прогрессирования в злокачественный процесс представляют 2 вида ГПЭ (без атипии и с атипией) как абсолютно разные заболевания эндометрия, объединенные в одну классификацию.

Adenomyosis is a benign neoplastic process of the uterus, one of the forms of endometrioid disease. The negative impact of this pathology on the outcome of ART programs is associated with impaired implantation and loss of pregnancy in the early stages. We studied the levels of regulatory transport proteins (α2-MG, α1-AT, LF and ALB) and cytokines (IL-8, IL-6, TNF-α, INF-γ) in the blood serum of infertile patients with grade 1-2 adenomyosis and their influence on the outcomes of IVF programs. The study included 97 women. The main group consisted of 60 infertile patients with grade 1-2 adenomyosis, the comparison group consisted of 37 healthy women with male factor infertility. The embryos were cultured in one-step Irvine medium. The quality of embryos was assessed according to international standards (scale Gardner D.K. et al., 2001). Selective transfer of no more than 2 good quality embryos was performed on the 5th day of development. The effectiveness of IVF programs was assessed by the incidence of clinical pregnancy (CNB) according to ultrasound data on days 21-23 after embryo transfer. The study showed that the immunological profile of some factors of innate immunity: pro-inflammatory cytokines (TNF-α, IL-6, chemokine IL-8 and IFN-γ) and immunoregulatory proteins (a2-MG and a1-AT and Lf) in the blood serum of women with adenomyosis, entering the IVF program, has significant differences from the indicators of healthy women. In particular, they have decreased levels of a2-MG and a1-AT and increased concentrations of the cytokines TNF-α, IL-6, chemokine IL-8, and lactoferrin. Changes in indicators in response to CVD also differed in patients with adenomyosis and healthy women. Adenomyosis is a benign neoplastic process of the uterus, one of the forms of endometrioid disease. The negative impact of this pathology on the outcome of ART programs is associated with impaired implantation and loss of pregnancy in the early stages. We studied the levels of regulatory transport proteins (α2-MG, α1-AT, LF and ALB) and cytokines (IL-8, IL-6, TNF-α, INF-γ) in the blood serum of infertile patients with grade 1-2 adenomyosis and their influence on the outcomes of IVF programs. The study included 97 women. The main group consisted of 60 infertile patients with grade 1-2 adenomyosis, the comparison group consisted of 37 healthy women with male factor infertility. The embryos were cultured in one-step Irvine medium. The quality of embryos was assessed according to international standards (scale Gardner D.K. et al., 2001). Selective transfer of no more than 2 good quality embryos was performed on the 5th day of development. The effectiveness of IVF programs was assessed by the incidence of clinical pregnancy (CNB) according to ultrasound data on days 21-23 after embryo transfer. The study showed that the immunological profile of some factors of innate immunity: pro-inflammatory cytokines (TNF-α, IL-6, chemokine IL-8 and IFN-γ) and immunoregulatory proteins (a2-MG and a1-AT and Lf) in the blood serum of women with adenomyosis, entering the IVF program, has significant differences from the indicators of healthy women. In particular, they have decreased levels of a2-MG and a1-AT and increased concentrations of the cytokines TNF-α, IL-6, chemokine IL-8, and lactoferrin. Changes in indicators in response to CVD also differed in patients with adenomyosis and healthy women.

Adenomyosis is a benign neoplastic process of the uterus, one of the forms of endometrioid disease. The negative impact of this pathology on the outcome of ART programs is associated with impaired implantation and loss of pregnancy in the early stages.We studied the levels of regulatory transport proteins (α2-MG, α1-AT, LF and ALB) and cytokines (IL-8, IL-6, TNF-α, INF-γ) in the blood serum of infertile patients with grade 1-2 adenomyosis and their influence on the outcomes of IVF programs. The study included 97 women. The main group consisted of 60 infertile patients with grade 1-2 adenomyosis, the comparison group consisted of 37 healthy women with male factor infertility.The embryos were cultured in one-step Irvine medium. The quality of embryos was assessed according to international standards (scale Gardner D.K. et al., 2001). Selective transfer of no more than 2 good quality embryos was performed on the 5th day of development. The effectiveness of IVF programs was assessed by the incidence of clinical pregnancy (CNB) according to ultrasound data on days 21-23 after embryo transfer. The study showed that the immunological profile of some factors of innate immunity: pro-inflammatory cytokines (TNF-α, IL-6, chemokine IL-8 and IFN-γ) and immunoregulatory proteins (a2-MG and a1-AT and Lf) in the blood serum of women with adenomyosis, entering the IVF program, has significant differences from the indicators of healthy women. In particular, they have decreased levels of a2-MG and a1-AT and increased concentrations of the cytokines TNF-α, IL-6, chemokine IL-8, and lactoferrin. Changes in indicators in response to CVD also differed in patients with adenomyosis and healthy women.Adenomyosis is a benign neoplastic process of the uterus, one of the forms of endometrioid disease. The negative impact of this pathology on the outcome of ART programs is associated with impaired implantation and loss of pregnancy in the early stages. We studied the levels of regulatory transport proteins (α2-MG, α1-AT, LF and ALB) and cytokines (IL-8, IL-6, TNF-α, INF-γ) in the blood serum of infertile patients with grade 1-2 adenomyosis and their influence on the outcomes of IVF programs.The study included 97 women. The main group consisted of 60 infertile patients with grade 1-2 adenomyosis, the comparison group consisted of 37 healthy women with male factor infertility.The embryos were cultured in one-step Irvine medium. The quality of embryos was assessed according to international standards (scale Gardner D.K. et al., 2001). Selective transfer of no more than 2 good quality embryos was performed on the 5th day of development. The effectiveness of IVF programs was assessed by the incidence of clinical pregnancy (CNB) according to ultrasound data on days 21-23 after embryo transfer.The study showed that the immunological profile of some factors of innate immunity: pro-inflammatory cytokines (TNF-α, IL-6, chemokine IL-8 and IFN-γ) and immunoregulatory proteins (a2-MG and a1-AT and Lf) in the blood serum of women with adenomyosis, entering the IVF program, has significant differences from the indicators of healthy women. In particular, they have decreased levels of a2-MG and a1-AT and increased concentrations of the cytokines TNF-α, IL-6, chemokine IL-8, and lactoferrin. Changes in indicators in response to CVD also differed in patients with adenomyosis and healthy women.

The article presents the results of the analysis of the clinical case of the torsion of the uterine appendages with the erasure of the clinical picture lasting 3 months. Ultrasound diagnostic capabilities in the correctness of accurate diagnosis and choice of adequate treatment are shown. The objective is substantiation of the choice of the tactics for organ-preserving surgical intervention in the torsion of the uterine appendages based on ultrasound investigation. Conclusions. Organ-preserving tactics for surgical treatment of the torsion of uterine appendages is possible when the disease is several months old. The main sign of the ovarian torsion was the presence of spirally twisted vessels inside the vascular pedicle of the ovary, which was detected in the color Doppler mapping mode, which allowed correctly diagnosing this pathological condition.