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Сlinical and epidemiological aspects and individual prognosis of infertile marriages in Republic of Moldova


Author: Şmugurov Valentina
Degree:doctor of medicine
Speciality: 14.00.01 - Obstetrics and Gynecology
Year:2008
Scientific adviser: Olga Cerneţchi
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific consultant: Larisa Spinei
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution:
Scientific council:

Status

The thesis was presented on the 27 November, 2007
Approved by NCAA on the 24 January, 2008

Abstract

Adobe PDF document0.29 Mb / in romanian

Keywords

Sterility (infertility) women’s and men, structure, risk factors, reproduction women’s and men, extragenital and genital pathology, individual prognosis

Summary

The thesis deals with the study of peculiarities of distribution, structure and the risk factors, that forming development of infertile marriages in Republic of Moldova. The actuality of this problem is caused through the reduction of birth-rate, the migration of families in age of reproduction in the economic developed countries and the increase of the rate of general population's mortality last years.

The distribution of infertility has studied on the basis of questionnaire, clinical and instrumental examination of 2994 married couples from North, Central and South parts of the Republic.

For the first time has established that infertility in the territory of Moldova constitutes 13,7%, with the reliable higher indicator on 5% in the urban areas (17,1%) than in the rural one. There are not important differences in the distribution of infertility in the rural areas of the various regions of the Republic.

On the whole, from the infertility are suffered the young married couples (22 - 35 age), with the duration of marriage till 4 years. It was established that 50 % of infertile husbands and wives were exposed in their work activity to different harmful factors of the trade environment. As compared with the fertile married couples it was met for 2 time more frequently. The same situation was observed for distribution of pernicious habits among them (the beginning of smoking from earliest years, the use of alcohol etc.).

There were obtained the new data that characterize the role of extragenital and genital pathology in the beginning and evolution of infertility. As the confirmations of this results are served more high indicators for general morbidity, for different nosologic forms of somatic pathology, surgical operations on organs of pelvic cavity and diseases of genitals. The genital pathology, both among males and females, is characterized with the high number of the inflammatory processes.

It was determined the structure of primary and secondary infertility, characteristic for Republic of Moldova, with the help of systematic and structural analysis that permits to reflect the etiology and pathogenesis of this illness. The secondary infertility was met in 1,4 times more frequently than primary one. The proportion of female infertility was 52,3%, mixed (female + male) – 36,9%. For infertility in Republic of Moldova is characteristic the poly etiology. It is specific and it is meet in majority cases the tubal-peritoneal-endocrine form of the infertility. The «clean» forms of the infertility are met in no more than 21,9%, with the high level of the endocrinal infertility.

There was for the first time determined and measured the role of the complex of the risk factors that for certain influencing the beginnings and evolution of infertility among males and females; there was proposed and adjusted the mathematical models for the individual prognosis of probable appearance of this pathology and for the forming of the groups with the different degree of risk; there was substantiated the differentiated complexes of the preventive and sanitary measures in this work.