- The efficiency of general applicable methods of correction of the morphofunctional structure of endometrium in ART treatment of infertility
The efficiency of general applicable methods of correction of the morphofunctional structure of endometrium in ART treatment of infertility
HEALTH OF WOMAN. 2018.2(128):103–108; doi 10.15574/HW.2018.128.103
Suslikova L. V. , Serbenuyk A. V.
Ukrainian State Institute of Reproduction Shupyk National Medical Academy of Postgraduate Education, Kiev
Clinic of Reproductive Technologies, USIR of the National Medical Academy of Postgraduate Education named after PL Shupika, Kyiv
The article evaluates the effectiveness and analyzes the expediency of the use of estrogen drugs in the treatment programs using ART in accordance with the standard protocol (through the use of controlled stimulation of supravulation of estrogen preparations) and in the program for the embryotransfer of vitrified embryos in previous unsuccessful attempts (due to an increase in the daily dose of estradiol) for correction of different degrees of lagging development of endometrium and improvement of clinical consequences of treatment with ART methods in a patient with unsuccessful attempts of treatment of the tubal-peritoneal infertility factor.
The objective: was to evaluate the effectiveness of estrogen application for correcting the different degrees of lag in the development of the endometrium and to improve the clinical consequences in patients with unsuccessful attempts to treat infertility with a tubal peritoneal factor in repeated infertility treatment programs using ART methods: 1) according to a standard protocol; and 2) embryotransfer of vitrified embryos.
Materials and methods. The study included 283 patients with unsuccessful attempts to treat the methods of VRT infertility with a tubal peritoneal factor with varying degrees of lag in the development of the endometrium. Of these, in 180 cases, a moderate lag in the development of the endometrium was detected and in 103 cases – a marked lag in the development of the endometrium. To correct the various degrees of lag in the development of the endometrium during the standard CSC protocol and in the preparation program for the transfer of vitrified embryos, estrogen preparations were used in patients.
Results. In the ART treatment program (CP + ET), the additional use of estrogen preparations in the CS did not result in an increase in the thickness of the endometrium with a lag in the development of the endometrium (of varying severity) on the 7-th day of the CA. There was no improvement in treatment outcomes for CHNV-P and indicators of pregnancy loss in the first trimester. In the Cryo-ET program, a gradual increase in HRT of a daily dose of estradiol from the 7th day of the treatment cycle in patients with a marked lag in the development of the endometrium did not ensure an increase in the thickness of the endometrium to normal. Clinical consequences of the CHHVP parameters and the frequency of early reproductive losses in the Cryo-ET program are significantly inferior to those observed in women with normal endometrial development. In women with a moderate lag in the development of the endometrium on the 7-th day of the CRIO-ET cycle, an increase in the dose of estradiol provided normalization of the M-echo.
Conclusion. In the case of lagging development of the endometrium, the improvement of the state of the main homeostasis in the endometrium and the elimination of the developmental lag of the endometrium with a marked developmental lag will be topical.
Key words: infertility, methods of assisted reproductive technology, hypoplasia of the endometrium.
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