Women Of Late Reproductive Age Research Articles

Factors associated with successful pregnancy in women of late reproductive age with uterine fibroids who undergo embryo cryopreservation before surgery.

The objective of this study is to determine the factors associated with successful pregnancy in women of late reproductive age with uterine fibroids who undergo embryo cryopreservation before surgery (ECBS). Patients who underwent in vitro fertilization treatment with controlled ovarian stimulation from November 2010 to January 2017 in our university hospital were included. Twenty-two patients older than 35 years of age at the first visit with cavity-distorting uterine fibroids underwent ECBS, a three-step therapeutic approach consisting of oocyte pick-up, myomectomy and embryo transfer (ET), which are performed in this order. We retrospectively calculated the pregnancy rate and determined the factors associated with successful pregnancy. The mean age at ET of the patients who underwent ECBS was 40.9 years, with a pregnancy rate per ET of 36.8% (21/57). Of 22 patients, 10 (45.5%) successfully continued pregnancy beyond 12 weeks of gestation (ongoing pregnancy). An ongoing pregnancy was observed only among the patients with more than three frozen embryos. The ongoing pregnancy rates of patients with ≤five fibroids and ≤5 cm in the maximal diameter were significantly higher compared to the respective remaining group (90.0% vs 14.3% and 87.5% vs 33.3%). ECBS is an effective strategy for infertile women of late reproductive age with cavity-distorting uterine fibroids, especially when it is applied to the patients who can freeze at least three embryos before myomectomy, with five or less fibroids smaller than 5 cm in the maximal diameter.

Менеджмент дефіциту вітаміну D у пацієнток з дисгормональними поєднаними проліферативними захворюваннями репродуктивних органів

The lack of vitamin D, according to WHO, is a pandemic. Studies conducted in different countries show the problem of vitamin D deficiency regardless of geographical latitudes in people of different age, nationality, vitamin D intake with food, even in those countries where there is no shortage of sunny days. Low level of vitamin D is considered as an independent predictor of the formation and progression of obesity, insulin resistance, PCOS, increased risk of endometriosis, uterine leiomyoma. Along with the influence on many vital processes in the human body, vitamin D plays a very important role in regulating the reproductive function of women. D-hormone affects the reproductive organs both directly, by binding to receptors (VDR), and mediated, through stimulation of the synthesis of steroid hormones and other effects. The objective: to study the effectiveness of clinical management of vitamin D deficiency in women with combined dyshormonal proliferative diseases of the reproductive organs. Materials and methods. The study involved 350 women of active and late reproductive age, residents of the Lviv region, who applied for preventive examination or with complaints of menstrual irregularity, infertility, miscarriage, chronic pelvic pain. The complex examination included ultrasonographic screening of the pelvic organs, mammary glands, thyroid gland, for hysteroscopy, endometrial needle biopsy, diagnostic / operative laparoscopy. Level 25(OH)D in the serum was determined by the enzyme immunoassay. I group consisted of 50 women without gynecological and concomitant pathology at the time of enrollment, group II – 300 patients with dyshormonal proliferative pathology of the reproductive organs. Results. Level 25(OH)D in the blood serum averaged 33.8±2.5 ng/ml occurred in 62.0% of women without gynecological pathology and only in 21.6% of women with dyshormonal pathology of the reproductive organs, lack of vitamin D(25(OH)D 22.3±1.5 ng/ml) was detected in 24.0% and 37.7%, respectively. Deficiency of vitamin D(25(OH)D 13.8±4.6 ng/ml) in women without gynecological and somatic pathology was diagnosed in 5.0% of cases and in 36.3% of women with benign proliferative pathology of reproductive organs (p<0.0001), with a severe deficit of vitamin D(25(OH)D in the serum from 4 to 9 ng/ml occurred in 73.7% of the latter.) A differential correction of vitamin D deficiency and deficiency with the use of preventive and curative doses of cholecalciferol Сonclusion. The dose of cholecalciferol (vitamin D3) 2000 IU/day is a sufficient preventive dose with an initial adequate level of vitamin D, but insufficient to eliminate its deficiency. Admission cholecalciferol in a daily dose of 100 mcg (4000 IU) with vitamin D deficiency allows after 3 months to reach 25–28 ng/ml 25(OH)D in the blood serum, but does not result in the level of 25(OH)D 40–50 ng/ml. Admission of 6000 IU/day cholecalciferol with severe vitamin D deficiency allows to reach 25(OH)D 40–50 ng/ml on average after 2.8±1.2 months in the absence of undesirable effects. Key words: vitamin D, vitamin D deficiency, combined dyshormonal proliferative diseases of the reproductive organs, cholecalciferol.

Показатели клеточного и гуморального иммунитета у больных лейомиомой матки в репродуктивном возрасте

Objective: to determine changes in clinical and immunological parameters in patients with uterine leiomyoma, depending on the reproductive age. Study design: cohort prospective comparative study. Materials and methods. Investigation and surgical treatment of 220 patients of reproductive age was conducted. The main group consisted of 190 women aged 18-45 years, including 110 patients of early age (18-35 years) and 80 women of late reproductive age (36-45 years). Criteria for inclusion in the main group were uterine leiomyoma and the woman's reproductive age. The control group included 30 healthy women aged 18-45 years with normal reproductive function and no gynecological diseases. Results. Immunological parameters of peripheral blood of women with uterine leiomyoma were characterized by a statistically significant increase in comparison with the control group. The maximum and reliable values of the growth in the number of lymphocytes, the absolute content of CD3 +, CD8 +, CD19 + and CD16 + / 56 + lymphocytes, the NST test, complementary activity and circulating immune complexes of serum were determined in women of early reproductive age (p<0,05-0,001). Quantitative values of these parameters in patients of late age had an intermediate character and significantly lower values than at an early age, but did not reach the level of the control group. inclusion. Leiomyoma in reproductive age was accompanied by intensity of cellular and humoral immunity. The immune response in patients with uterine leiomyoma was differentiated depending on the period of reproductive age and was more pronounced in patients 18-35 years of age.

Anti-müllerian hormone as an fertility indicator in women of late reproductive age

Anti-müllerian hormone as an fertility indicator in women of late reproductive age

Use of oral contraceptives for management of acne vulgaris and hirsutism in women of reproductive and late reproductive age.

Hormonal contraception in both reproductive and late reproductive age, as well as contraceptive action, is used also for other indications like dysmenorrhoea, menstrual disorders, endometriosis, acne vulgaris, and hirsutism. Acne vulgaris and hirsutism are important signs related to hyperandrogenaemia and present a serious medical problem for the patients and a challenge for medical doctors in terms of effective treatment. The application of hormonal contraception to treat acne vulgaris and hirsutism requires knowledge of the mechanism of antiandrogenic actions and the possible contraindications and complications. These data are presented in this review.

ОСОБЕННОСТИ РЕПРОДУКТИВНОГО ЗДОРОВЬЯ ЖЕНЩИН, БОЛЬНЫХ РАССЕЯННЫМ СКЛЕРОЗОМ

Introduction. The incidence of multiple sclerosis (MS) is two times higher in women, and the debut of the disease falls on young reproductive age, which makes the problem urgent. Purpose: to assess the characteristics of the reproductive health of women with MS in different age periods. Material and methods. A prospective study was carried out in parallel groups and a case-control study of women of early and late reproductive age with a reliable diagnosis of MS. Results. During pregnancy, there was a significant decrease in the frequency of exacerbations of MS in comparison with the pre-gravity period; voluntary infertility and childlessness is registered in 21.3 % and 32 % of women, respectively. An increase in the concentration of follicle stimulating hormone (FSH) means an increase in the degree of disability on the Expanded Disability Status Scale (EDSS) and the duration of the disease. The decrease in the concentration of dehydroepiandrosterone sulfate (DHEA-S) corresponds to a higher degree of disability on the EDSS scale and the duration of the disease. Conclusion. Pregnancy has a protective effect on the clinical course of MS. Infertility in most cases is voluntary, but at the same time hypergonadotropic condition and hypoandrogenia are observed in women with MS already in the early reproductive age, which interferes with the steroid synthetic function of the ovaries and can cause impaired fertility.

Relationship between serum anti-Mullerian hormone with vitamin D and metabolic syndrome risk factors in late reproductive-age women

The relationship between serum anti-Mullerian hormone (AMH) with vitamin D (25OH-D) and metabolic syndrome (MetS) risk was evaluated in healthy, late reproductive-age (35–49 years) women with regular menstrual cycles. Among the 291 participants (mean age = 42.5 years), most (76.6%, n = 223) were serum vitamin D insufficient (<20 ng/ml). Mean serum levels of AMH and vitamin D were 2.04 ng/mL and 15.9 ng/mL, respectively. There was no correlation between AMH and 25OH-D after adjustment for age (r = −0.093, p = 0.113). Subjects with higher MetS score, higher waist circumference, and higher diastolic blood pressure had significantly higher serum AMH levels when adjusted for age, but the association attenuated when BMI was included. There was no significant correlation between MetS risk components with serum level of AMH or vitamin D. In conclusion, there was no association between AMH with serum 25OH-D or MetS risk factors in this population.

Melatonin: influence on life quality and personality profile of women of late reproductive and pre-menopausal age with endometrial pathology

The aim of the work. To investigate the relationship of melatonin with the quality of life and the profile of the personality of women of late reproductive and premenopausal age with the pathology of the endometrium.Materials and methods. 45 women aged 36–55 years with endometrial diseases were examined. All patients underwent hysteroscopy. The personality profile was assessed using the FPI test. To study the quality of life, the SF-36 questionnaire was used. The data was processed using the Spearman rank correlation.Results. As a result of the correlation analysis of data on melatonin concentration and SF-36 scales, our study found that the value of melatonin did not affect the quality of life associated with health. However, if we evaluate trends, then the highest of the reduced correlation coefficients is of some interest. It’s about role physical functioning. The correlation coefficients of the melatonin index and the scales of the FPI questionnaire looked as follows: all significant correlation coefficients had a negative sign, that is, the personality properties corresponding to these coefficients were associated with a low concentration of melatonin. The ordering of the FPI scales by decreasing the significance of the correlation coefficients helped to identify the personal profile of hypomelatoninemia in the examined women. First of all, it was characterized by high levels of depressiveness and emotional lability.Conclusions. In the psychopathological structure of the personality of women of late reproductive and pre-menopausal age with endometrial pathology burdened with hypomelatoninemia, depressive and emotional lability is predominate. Reducing the secretion of melatonin is also associated with increased spontaneous aggressiveness, neuroticism and irritability.

ВЕГЕТАТИВНІ ПОРУШЕННЯ НА ФОНІ ПАТОЛОГІЇ ЕНДОМЕТРІЯ В ПІЗНЬОМУ РЕПРОДУКТИВНОМУ ТА ПРЕМЕНОПАУЗАЛЬНОМУ ПЕРІОДІ

Захворювання ендометрія є поширеною гінекологічною патологією, частота якої значно збільшується до періоду пременопаузи. Цей віковий період пов’язаний також із високим відсотком переходу початкових вегетативних змін та порушень в більш тяжкі стани. Аналіз особливостей соматичних і вегетативних проявів допомагає диференціювати їх психосоматичний або психовегетативний характер і оптимізувати комплексну терапію.Мета дослідження – виявити ознаки вегетативної дисфункції (ВД) у жінок пізнього репродуктивного та пременопаузального віку, які страждають від патології ендометрія (ПЕ).Матеріали і методи. Вивчено клініко-анамнестичні особливості, вегетативний профіль, психологічний статус і якість життя 325 жінок 35–55 років із патологією ендометрія. Для діагностики ВД використовували бальний опитувальник A. M. Вейна. Профіль особистості оцінювали у 176 жінок групи з ПЕ за допомогою тесту FPI, призначеного для діагностики психічних станів і властивостей особистості. Для вивчення якості життя використовували опитувальник здоров’я SF-36.Результати досліджень та їх обговорення. Згідно з результатами тестування за опитувальником Вейна, у 74,5 % пацієнток виявлена виражена вегетативна дисфункція. Узагальнюючи отримані результати, перш за все слід відзначити дуже високі бали ВД при ПЕ – в ¾ випадків вони були вище норми, в кожному другому – перевищували 27 балів, хоча в групі ПЕ був представлений майже весь спектр станів вегетативного профілю: від 3 до 60 балів, при можливих від 0 до 60. При цьому лише 11,6 % жінок із вираженою ВД зверталися за медичною допомогою у зв’язку з патологією вегетативної системи. Встановлено, що наявність вегетативних порушень асоціюється з підвищеною невротичністю пацієнток, зниженням якості життя і підвищеною частотою рецидивів патології ендометрія.Висновки. Зроблено висновок про те, що поєднання патології ендометрія з вегетативною дисфункцією істотно обтяжує прогноз лікування, у зв’язку з чим слід вивчати стан вегетативного профілю при обстеженні жінок пізнього репродуктивного та пременопаузального віку з патологією ендометрія.

The problem of "thin" endometrium in reproductive medicine: experience of application of recombinant Interleukin-2 to prepare patients to assisted reproductive technologies programs

Introduction. “Thin” endometrium is known affect negatively to reproductive function. Treatment of “thin” endometrium remains a problem and subject of future major studies.&#x0D; Aim. To justify the possibility of applying of recombinant interleikina-2 person late reproductive age patients with “thin” endometrium before using assisted reproductive technologies.&#x0D; Matherials and Methods. We examined a total of 64 late reproductive age women. Three groups of patients were analyzed. The first investigated group included 25 women with histologically proven chronic endometritis; the comparison group included 20 patients with endometrium of the early proliferative phase; the second investigated group included 19 patients with “thin” endometrium, with indications for the conduct of in vitro fertilization. Interleukin 2, interleukin-4, tumor necrosis factor alpha, interleukin-1β, Interleukin-6, interleukin-8, interleukin-10, IFN-γ concentrations were determined by enzyme linked immunosorbent assay in serum and aspirates from the uterine cavity in first investigated group and comparison group. Vaginal ultrasonic examination was made for women of second investigated group in first and second phase of menstrual cycle before and after recombinant human interlejkinom-2 treatment. Statistical data processing was performed using application software package Statistica 6.0 (StatSoft, Ink. 1994–2001), adapted for biomedical research. P &lt; 0.05 was considered significant.&#x0D; Results. Were found that concentrations of interleukin 2, interleukin-10 significantly reduced and concentrations of tumor necrosis factor alpha, interleukin-1β, Interleukin-6 and interleukin-8 significantly increased in aspirates from the uterine cavity in women of late reproductive age with chronic endometritis. All changes occur at the local level in chronic endometritis. Endometrial thickness a statistically significant increase after use of recombinant human interlejkinom-2 in patients with infertility and chronic endometritis.&#x0D; Conclusions. Application of recombinant interleukin-2 in patients with “thin” endometrium can become optimal schema therapy, which requires further study.

Interrelation of melatonin with quality of life and personality properties of patients with endometrial pathology in the late reproductive and premenopausal period

The aim of the work is to investigate the relationship of melatonin with the quality of life and the profile of the personality of women of late reproductive and premenopausal age with the pathology of the endometrium.Materials and methods. 45 women aged 36-55 years with endometrial diseases were examined. All patients underwent hysteroscopy.The personality profile was assessed using the FPI test. To study the quality of life, the SF-36 questionnaire was used. The data was processed using the Spearman rank correlation.Results. As a result of the correlation analysis of data on melatonin concentration and SF-36 scales, our study found that the value of melatonin did not affect the quality of life associated with health. However, if we evaluate trends, then the highest of the reduced correlation coefficients is of some interest. It's about role physical functioning.The correlation coefficients of the melatonin index and the scales of the FPI questionnaire looked as follows: all significant correlation coefficients had a negative sign, that is, the personality properties corresponding to these coefficients were associated with a low concentration of melatonin. The ordering of the FPI scales by decreasing the significance of the correlation coefficients helped to identify the personal profile of hypomelatoninemia in the examined women. First of all, he was characterized by high levels of depressiveness and emotional lability.Conclusions. In the psychopathological structure of the personality of women of late reproductive and pre-menopausal age with endometrial pathology burdened with hypomelatoninemia, depressive and emotional lability is predominate. Reducing the secretion of melatonin is also associated with increased spontaneous aggressiveness, neuroticism and irritability.

Endometrial pathology and reproductive profile of women in late reproductive and premenopausal age

The aim of the study was to determine the features of the structure of intrauterine pathology and obstetric and gynecological history of women in the late reproductive and premenopausal period.Materials and methods. In the observational cross-sectional retrospective study by the continuous sampling method, 849 histories of the disease of women of all age groups with pathology of endometrium were selected. Inclusion criteria: presence of one or more endometrium pathologies - endometrial polyp, endometrial hyperplasia, chronic endometritis, intrauterine sinechia.Results and conclusions. More than a third of patients (37.3%) with pathology of endometrium are women of late reproductive and premenopausal age. Women of late reproductive and premenopausal age are a group of high-risk endometrium pathology, whose structure is dominated by endometrial polyps and endometrial hyperplasia, in combination with endocrine-related pathology. Current is the development of a comprehensive system of diagnosis, prevention and treatment of endometrial pathology in women of late reproductive and premenopausal age on the basis of the etiopathogenetic personified approach.

Somatic status of the patients with different forms of endometrial pathology in late reproductive age and premenopausal period

The objective: to study the relationship of extragenital pathology and pathology of the endometrium in women of late reproductive and premenopausal age. Patients and methods. In an observational cross-sectional study by a solid sample included 325 women 35–55 years old, average age 41.1±0.27 years old, suffering from various types of pathology of the endometrium. The survey included a study of complaints, anamnesis, complete physical and hysteroscopic examination. Results. Based on these data, it can be concluded relatively high prevalence of somatic diseases among women with PE in the late reproductive and premenopausal age. Almost 3/4 of cases examined in this study, there was at least one of extragenital diseases. In addition, the often observed multiple extragenital diseases: one-third of patients suffered two or three extragenital diseases, and every ninth observed four or more extragenital diseases. Moreover, multiple extragenital diseases associated with endometrial hyperplasia rather than with endometritis, endometrial polyps or synechiae, and hyperplasia with atypia, they met 2.2 times more often than in other forms of pathology of the endometrium. In the structure of genital comorbid factors associated with an increased incidence of somatic certainly dominated uterine fibroids and ovarian cysts. In our study, it is in respect of uterine fibroids showed the greatest number of significant relationships. Conclusion. High associativity extragenital predictors and uterine pathology in late reproductive and premenopausal age indicates the need to change the treatment paradigm fragmented, focused on major diseases and easy to miss the sight of the significant impact of comorbidity on the overall health and quality of life of the patient. Key words: endometrial pathology, late reproductive age, premenopausal, extragenital pathology.

Risk factors for recurrence of endometrial hyperplasia in women of late reproductive and premenopausal age

According to many researchers, hyperplastic endometrial processes are not precancerous diseases. However, recurrent endometrial hyperplastic processes, as well as their combination with genital and extragenital pathologies, significantly increase the risk of malignant transformation of the endometrium. Late reproductive and premenopausal age is associated with an increase in the frequency of endometrial hyperplastic processes, extragenital pathology and operative interventions on the internal genitalia. The limited possibilities of conservative treatment in connection with concomitant diseases and the tendency of an increase in the recurring hyperplastic processes of the uterus make the problem of studying various aspects of hyperplastic endometrial processes in women of this age period extremely urgent.The purpose of research: to identify risk factors for recurrence of endometrial hyperplasia in women of late reproductive and premenopausal age.Materials and methods. We studied the clinical and medical history and long-term results of treatment of 276 women aged 35–54 years with endometrial hyperplastic processes. All patients underwent diagnostic and therapeutic hysteroscopic procedures were carried out. In 88 (31.9%) women for 1.5 years after treatment were observed relapses of the disease. These patients accounted for Рц group, the remaining 188 women included in the group K. Data processing was performed using variation statistics method, Mann-Whitney ranking test, χ2-test and Fisher’s exact test.Results and conclusions. It should be noted the high rate of recurrence of endometrial hyperplastic processes in women of late reproductive and premenopausal age and lack of nosological specificity of recurrent endometrial hyperplastic processes. At the same time, recurrence of endometrial hyperplastic processes significantly increased the risks against the backdrop of giperpolimenorei, endometrioid disease, especially, adenomyosis and ovarian cysts. The greatest chances of recurrence were associated with the presence of patients extragenital diseases: gastrointestinal disorders, iron deficiency anemia, thyroid and breast cancer, vegetative-vascular dystonia. Within the framework of all investigated factors, the chances of recurrence of endometrial hyperplastic processes are most significant increased at the vegetative-vascular dystonia, and the pathology of the lacteal and thyroid gland.

Clinical-anamnestic features and quality of life in women with endometrial pathology on the background of uterine myoma.

A total of 325 women 35-55 years old suffering from various forms of endometrial pathology were examined. It was found that 110 (33.8%) patients had combination of endometrial pathology and uterine myoma. They made up the main group (group MM), the reference group consisted of 215 women without uterine myoma (group K). It was established that group with uterine myoma is characterized by increased extragenital morbidity: cardiomyopathy (p&lt;0.009), hypertension (p&lt;0.03), obesity stage III-IV (p&lt;0.006), iron-deficiency anemia (p&lt;0,02), vegetative-vascular dystonia (p&lt;0,03) and nervous system diseases (p&lt;0,01) were significantly more common. The presence of uterine myoma is associated with increased risk of recurrence of endometrial hyperplasia and polyps. These data suggest that in the pathophysiology of uterine myoma in women of late reproductive and premenopausal age with endometrial pathology somatic and somatoform disorders play a more significant role than concomitant or previous genital pathology. In late reproductive age and menopause period endometrial lesions are combined with uterine myoma in every third patient. Somatic factors have a greater impact on the development of uterine myoma than reproductive. The presence of uterine myoma is an additional criterion of reduceof quality of life and burdens the prognosis of treatment of endometrial pathology in late reproductive age and premenopausal period.

Качество жизни женщин с бесплодием и патологией эндометрия в поздний репродуктивный период

Research has shown that infertile women are less satisfied with their lives than fertile women, as their mental, communicative, sexual and emotional well-being is undergoing a number of changes, especially in the late reproductive period when the proportion increases anxiety and depressive disorders. The objective: сompare the quality of life parameters in infertile and fertile women of late reproductive age with endometrial pathology. Patients and methods. The study included 237 women 35–44 years with different clinical forms of endometrial pathology. A questionnaire health SF-36 is used for studying the quality of life. Results. The study of quality of life showed that patients with infertility compared with fertile women significantly higher assessed and psychological (p&lt;0.008) and the physical component of their health (p&lt;0.02), showed the greatest difference in emotional functioning (p&lt;0.002). It was revealed that the longer the sterility, the worse the patients rated their physical functioning (с=-0.32, p&lt;0.001) and mental health (с=-0.25, p&lt;0.02), and the higher their overall health satisfaction (с=0.28, p&lt;0.004).A subjective satisfaction with the physical and mental state is assessed. It was found that the age lowers the quality of life assessment more than a period of infertility. According to data obtained in the study of quality of life does not depend from infertility factors, but is largely determined by the presence of children. Conclusions. It is concluded that the quality of life of secondary infertile women closest to the profile of fertile women; patient late reproductive age with infertility and endometrial pathology more satisfied with their lives than fertile women with endometrial pathology similar age. Key words: endometrial pathology, late reproductive period, infertility, quality of life.

ОБСТЕЖЕННЯ ЖІНОК ПІЗНЬОГО РЕПРОДУКТИВНОГО ВІКУ З ЦУКРОВИМ ДІАБЕТОМ ПЕРЕД ЕКСТИРПАЦІЄЮ МАТКИ

ОБСТЕЖЕННЯ ЖІНОК ПІЗНЬОГО РЕПРОДУКТИВНОГО ВІКУ З ЦУКРОВИМ ДІАБЕТОМ ПЕРЕД ЕКСТИРПАЦІЄЮ МАТКИ

Сравнительная характеристика перинатальных осложнений у женщин позднего репродуктивного возраста после ЭКО с собственными и донорскими ооцитами

Сравнительная характеристика перинатальных осложнений у женщин позднего репродуктивного возраста после ЭКО с собственными и донорскими ооцитами

Premenstrual syndrome in women of early and late reproductive age

The article discusses the specific psycho-emotional status, autonomic regulation and pain phenomena of young women and women in the middle of the childbearing period who suffer from premenstrual syndrome. The study involved 72 women aged from 16 to 25 years and 51 between the ages of 30 and 38 years. The identified clinical features could be applied for further research on the development of pathogenetic methods to treat the disease in women in different age groups.

SYSTEM OF MEASURES FOR REPRODUCTIVE HEALTH IMPROVEMENT IN WOMEN OF LATE REPRODUCTIVE AGE WITH INFERTILITY

Aim - to develop and evaluate the effectiveness of the system of the medical and organizational measures aimed at improvement of reproductive health in women of late reproductive age with infertility, and at increase in the effectiveness of the IVF programs. Materials and methods. The study of the efficiency of the developed system of measures was carried out in a representative group (650) of women 35-44 years old (mean age - 37.01+ 1.74 years) with infertility, living in the Samara region and referred to the medical center «Dynasty» for treatment with in vitro fertilization. The following methods of research were used: direct observation, organizational experiment, sociological and analytical methods. Results. The main components of the developed system of events are: medical measures (extended timely examination and treatment; comprehensive assessment of women's reproductive health based on proposed medical criteria, the use of new medical technologies); social measures (individual program of social and hygienic rehabilitation); organizational measures (automation of infertility register control, routing of patients depending on the initial state of health). Implementation of the developed system of measures can improve women's reproductive health according to the criteria of objective and subjective evaluation: it reduces the incidence of miscarriage from 37.5% to 15.3% (p