Design: Level II, Canadian Task Force

Setting: National Referral Center, Department of Operative Gynecology.

Patients or Participants: A comprehensive treatment of infertility was performed in 127 patients of reproductive age with POI, including the stages of outpatient counseling, preoperative preparation of the examined patients with comprehensive diagnosis including thyroid function, surgical treatment and postoperative management with ovarian function stimulation in the presence of conditions and indications.

Interventions: All patients included in the study underwent a one-stage surgical method for activating of ovarian function during surgery according to the method of Prof. L.V. Adamyan.

Measurements and Main Results: Using new variants of enzyme immunoassay, a significantly higher frequency of detection of serum autoantibodies to steroidogenic enzymes, FSH, estradiol, progesterone and thyroid peroxidase was shown in patients with POI compared with women with normal ovarian reserve. The clinical efficacy of complex treatment of infertility in patients with reduced ovarian reserve was evaluated with the development of their own clinical and laboratory criteria for the appropriateness of using methods of surgical activation of ovarian tissue from the standpoint of reproductive function.

Conclusion: It has been established that infertility treatment in patients with reduced ovarian reserve, subable to use methods of surgical activation of ovarian tissue, can be effective in women under 40 years of age with idiopathic premature ovarian insufficiency at occult and biochemical stages, in the absence of combined factors of infertility. Also, the results obtained contribute to the identification of the most effective autoimmune markers of premature ovarian failure, which can be used for diagnosis, clarification of pathogenesis and search for new approaches to therapy of early stages of the disease.