Premature ovarian insufficiency (POI) is a serious problem in reproductive medicine and is a polyetiological disease, with up to 30% of POI cases associated with an autoimmune factor. Since the cohort of patients with POI is heterogeneous in terms of clinical and laboratory data, variability of complaints and symptoms, an individual approach to the complex treatment of POI is required with the introduction of new technologies and taking into account the leading etiological factors.

OBJECTIVE

To evaluate the effectiveness of the use of new surgical technologies in the complex treatment of POI based on the dynamics of the patients’ condition and the profile of serum autoantibodies.

MATERIAL AND METHODS

A comprehensive examination and treatment including new surgical technologies was carried out on 26 patients with POI. Clinical and laboratory data, the psycho-emotional and physical state of patients before and after surgical treatment, including the profile of serum autoantibodies using a modified enzyme-linked immunosorbent assay, were assessed in comparison with 18 women with normal ovarian reserve.

RESULTS

It has been shown that using one-staged laparoscopic activation of ovarian function or with using a tube scalpel in the complex treatment of POI leads to an improvement in the physical and psycho-emotional state of patients already in the early postoperative period, as well as to an improvement in ultrasound indicators of ovarian reserve and vascularization of the ovarian parenchyma. Surgical treatment of POI is safe in terms of increasing the level or triggering the production of autoantibodies in patients.

CONCLUSION

Laparoscopic activation of ovarian function is effective in the complex treatment of patients with POI and is safe in relation to the initiation of autoimmune processes and can be used in the absence of effect from conservative therapy.