• Optimization of prevalual preparation of endometry before the treatment аrt methods in patients with tubal-periotional infertility by application of the injection-screetching procedure

Optimization of prevalual preparation of endometry before the treatment аrt methods in patients with tubal-periotional infertility by application of the injection-screetching procedure

HEALTH OF WOMAN. 2018.4(130):87–91; doi 10.15574/HW.2018.130.87

Suslikova L. V. , Serbenuyk A. V. 
Ukrainian State Institute of Reproduction of the Shupyk National Medical Academy of Postgraduate Education, Kyiv
Shupyk National Medical Academy of Postgraduate Education, Kyiv
Clinic of Reproductive Technologies UDIR Shupyk National Medical Academy of Postgraduate Education, Kiev

The article presents an analysis of literature data and the results of own prospective studies of the application of the local iatrogenic injury method with the parallel introduction of plasma enriched with platelets into the basal layer of the endometrium in pregravid preparation for treatment with assisted reproductive technologies (ART) in patients with tubal peritoneal infertility and marked lag development of the endometrium.

The objective: was to determine the optimal time for the injection of scratch scratching in pregravid preparation before the next cycle of ART treatment in patients with tubal peritoneal infertility and marked lag in the development of the endometrium.

Materials and methods. The study included 109 patients with unsuccessful attempts to treat ART with a tubal peritoneal factor of infertility with a marked degree of lag in the development of the endometrium according to absolute indications. The subjects were divided into three groups. Group A – 47 patients who experienced a marked lag in the development of the endometrium during the control stimulation of superovulation during ART (ETC + ET) and suggested the application of the procedure of injection scaling of the endometrium on the 7th day of the stimulation cycle (CA). Group B – 32 patients who underwent the procedure of injection endometrial scratching on the 22nd day of the menstrual cycle (MC), which preceded the repeated cycle of CGI + ET. Group B – 30 patients who underwent the procedure of injection endometrial scratching on the 8th day of the MC, which preceded the repeated cycle of CCN + ET.

Results. The use of injection scratches is more effective in improving the clinical outcomes of ART by using the methods of ART (CAS + ET) in the case of a pronounced delay in the development of the endometrium in the follicular phase of the CA on the 6th to 7th day of gonadotropin use. During treatment with ART, the frequency of pregnancy for each transfer of embryos (CHNBPE) was significantly lower, amounting to 9.4% (3 of 32) in group B and 7.1% (2 of 28) in group B than CHNBPE in group A – 27.7% (13 of 47). The frequency of early reproductive losses in group A was 23.1% (3 of 13), in group B – 66.7% (2 of 3), in group B – 50% (1 of 2).

Conclusion. During the study of the optimal period for the appointment of injection scratching, it was found that injection endometrial scratching using autoplasma enriched with platelets demonstrates the best pregnancy rate for each transfer of embryos and low early reproductive loss if performed in the follicular phase of the stimulation cycle by 6–7th day of gonadotropins).

Key words: infertility, methods of assisted reproductive technology, hypoplasia of the endometrium, hysteroscopy, plasma-riched platelets.

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