Оцінювання ефективності проактивного менеджменту жінок репродуктивного віку з функціональними кістами яєчника

The significant frequency of ovarian tumor-like formations in women of fertile age, the ambiguity of their impact on reproductive health and fertility determines the relevance of the problem. The increased frequency of functional ovarian cysts (FOC), which has been observed in recent years, is explained by the influence of external and internal factors, the general increase in gynecological morbidity. The relationship between vitamin D deficiency, the tendency to relapse of FOC and a decrease in ovarian reserve is also considered.The objective: to assess the effectiveness of proactive management of patients with FOC.Materials and methods. The study involved 65 women of reproductive age (from 19 to 38 years old) with follicular cysts and corpus luteum cysts with an O-RADS score of 2–3. The I group consisted of 35 persons: 15 women who were operated on for ovarian apoplexy and 20 women with painful apoplexy on the background of FOC, who received a complex of hormonal and metabolic therapy for 6 months. The treatment included a combined estrogen-gestogen drug; a complex of vitamins and microelements; an extract of common primrose fruit; cholecalciferol 20,000 IU (once a week). The II group included 15 patients with FOC who received a similar complex of hormonal and metabolic therapy. The comparison group consisted of 15 women with FOC who were under dynamic observation and did not receive proactive therapy. The effectiveness of the proposed proactive management was assessed using the following parameters: regularity of the menstrual cycle, restoration of ovulation, and absence of recurrence of FOC within 12 months after completion of hormonal-metabolic therapy.Results. The use of early hormonal-metabolic therapy significantly reduced the frequency of menstrual cycle disorders (94.3%), contributed to the restoration of ovulatory menstrual cycles after discontinuation of combined estrogen-gestogen drugs (91.4%), and prevented recurrences of FOC (97.1%).Conclusions. The results allow to recommend the implementation of proactive management of FOC to reduce the frequency of recurrences and improve the reproductive health of this group of women.