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Pelvic pain syndrome associated with adenomyosis is a common disease in women of reproductive age. Frequency of detection in the population varies from 10 to 53%. The aim - to study the clinical and anamnestic risk factors of pelvic pain, with adenomiose. Materials and methods. The study included 120 (n=120) patients with diffuse adenomyosis with pain and painless form of the disease who underwent examination and treatment in the gynecological Department of the Central clinical hospital №6 of Russian Railways in Moscow. Each patient was provided with an individual card, which was encrypted 171 sign. The studied parameters reflected the passport and anthropometric data, information about education, social status, presence of occupational hazards, complaints, illness. Results. Burdened gynecological and somatic histories, manifested a low health index, a more pronounced hereditary a family history of neoplastic diseases are contributing factors, and high prevalence of postponed surgeries, chronic, long-term ongoing inflammatory processes of the pelvic organs to create a favorable background for the further progression of chronic pelvic pain syndrome in adenomiose.

The analysis of recent data on the prevalence and effectiveness of various treatments for pelvic organ prolapse in women justifies the need to study compliance surgical and “conservative” approach in the treatment of this disease .

The article indicated the relevance of pelvic floor dysfunction in women of reproductive age. The dependence of the vaginal biotope and cervical disease from having NTD revealed the earliest pathognomonic sign of of pelvic floor dysfunction.

Chronic endometritis (CE) is a cause of a reproductive loss in 30-35% of the cases (E.B. Johnston-Macannany et al., 2009). 80–90% of patients are women of reproductive age. Today there is no strict algorithm of observing women with CE, including all links of pathogenesis. Latent course, absence of clinical manifestation, lack of self-descriptiveness of routine methods of diagnosis define difficulties of prevention and treatment of CE. Studying possible mechanisms of development of CE, creation of the most effective methods of diagnostics, treatment and rehabilitation of the patients with such a disease are the most urgent problems of modern obstetrics and gynecology.

Objective: To evaluate the effectiveness of combined therapy of endometriosis-associated infertility. Materials and Methods: 69 (n = 69) patients with infertility and verified diagnosis of genital endometriosis, were included in the study. In dependence of the medication, patients were divided into two groups. I group included patients (n = 34) only with surgical treatment, group II (n = 35) - patients with combined therapy (surgical treatment + hormone therapy). After surgery patients from II group received dydrogesterone 10 mg per day from the 14th to the 25th day of the menstrual cycle, for 6 months, according to the instruction. The effectiveness of treatment was assessed by the frequency of clinical pregnancy within a year. Results: The analysis revealed statistically significant differences in the pregnancy rate. So, with the use of surgical treatment, the pregnancy rate within 6 months reached 23.5%, which is consistent with the literature, while using the combined treatment, the pregnancy rate for 6 months was 37.1% (p = 0.2195), but there were no statistically significant differences. However, after a year of follow-up in women with the combined therapy applied, the pregnancy rate was 1.5 times higher, compared to only surgical approach (N=26-76.5% versus N=15-44.1% p = 0.004 (p<0.005). However, the 12-month pregnancy rate was 1.5 times higher in the group with the complex management compared to mono-surgical treatment. Conclusions: In our opinion, considering all the pathogenetic peculiarities of endometriosis, patients with endometriosis-associated infertility require hormonal support during the second phase of the menstrual cycle, which allows to overcome the possible insufficiency of early implantation and increasing the incidence of pregnancy and improving the prediction of perinatal outcomes. [ABSTRACT FROM AUTHOR]