The risk concept of operative treatment of fibroids based on epigenetic determinants, clinical evidence, anaemnesis, menstrual disorders, gynecological diseases, extragenital pathology, ultrasound data, immunohistochemistry and histological examinations of nodes are developed in this study. The samples were obtained during the conservative myomectomy or hysterectomy in 158 patients aged 32 to 45 years. The control group included samples of biopsies of normal myometrium taken from the same patients. 
The status of DNA methylation of genes ESR1α, PgR-B and WIF1 have been examined in myoma nodes of 60 patients. Isolation of DNA:the received tissue samples were grounded into pieces to 2 g, which are then lysed in order to isolate and transfer the DNA unmethylated cytosine residues to thymine while maintaining unchanged methylated cytosine residues.Then PCR have been performed.Sequencing was carried out in the center of collective use ""Gene"" at the on Institute of Molecular Biology of V.A. Engelhardt RAS based on standard protocol using forward primers and kit reagents ABI PRISM® BigDye ™ Terminator v. 3.1. The standart methodics of ultrasound diagnostics, immunohistochemistry and histological examinations have been used in all patients.
We have prepared computerized programme based on Microsoft Office Excel for  
analyzing the risk of development of progressive course of myoma uteri of every patient.
The 3 groups of women have been formed based on likelihood of developing of rapid growth of fibroids: 
low (p<0,29),moderate ( 0,29<p<0,59),high risk(0,6<p<1).
The monitoring and contraception taking into account fertile plans are permissible in low risk.
In case of moderate risk it is necessary to focus on status of DNA methylation of  WIF1  gene : if it is not methylated- the monitoring and contraception taking into account fertile plans are permissible ; if it is methylated ,as well as in case of high risk, it is recommended to realize reproductive plans considering apparent likelihood of operative treatment.
This algoritm can be used by specialists as additional instrument  for management patients with fibroids.

14 - PERSONALISED ALGORITM IN PATIENTS WITH MYOMA UTERI AFTER MYOMECTOMY BASED ON EPIGENETIC DETERMINANTS