OBJECTIVE

To study the histological structure of ovarian tissue in women with diminished ovarian reserve to identify clinical and morphological parallels between the effectiveness of infertility treatment and the morphological structure of the follicular apparatus.

MATERIAL AND METHODS

A retrospective analysis of the results of histological examination of 42 tissue samples of the ovarian cortical layer obtained as a result of the surgical stage in the framework of the complex treatment of infertility in 21 patients with a diminished ovarian reserve at the Academician V.I. Kulakov National Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia. All examined patients underwent surgical intervention: laparoscopy, revision of the pelvic organs, biopsy of the cortical layer of both ovaries, followed by its fragmentation and one-stage reimplantation into the ovarian thickness, hysteroscopy, endometrial biopsy, chromohydrotubation. After surgery, all patients underwent ovarian stimulation. The characteristics of the response to ovarian stimulation were compared with the data of histological examination of ovarian tissue samples obtained during the operation.

RESULTS

The results of the morphofunctional assessment of the ovarian follicular apparatus state in this group of patients indicate profound changes in various structures of the ovaries (in the surface epithelium, vascular component, stroma of the cortical layer). Data on the state of the ovarian follicular apparatus in patients with a reduced ovarian reserve, along with an assessment of clinical and laboratory data (levels of follicle-stimulating, luteinizing, anti-Müllerian hormones, estradiol, etc) and ultrasound data (including folliculometry), make it possible to give recommendations on the expediency of surgical treatment.

CONCLUSIONS

A timely surgical intervention will prevent the development of irreversible changes in the ovarian tissue and increase the effectiveness of treatment.