HEALTH OF WOMAN. 2018.5(132):50–54; doi 10.15574/HW.2018.132.50

Strelko G. V.
MС «Family Source»

The objective: study of the anatomical and functional status of the uterus and ovaries in poor responders in ART programs.

Materials and methods. Determination of the anatomical features and functional status of the uterus and ovaries in «poor responders» to exclude a clinically significant pathology that would affect the success of the ART program was performed by ultrasound scanning with the study of topografts, sizes, contours, echostructure of the uterus and ovary and determination of the volume of the ovaries and the number of antral follicles. Blood flow in the vessels of the stroma of the ovaries, as one of the important criteria for assessing the possible ovarian response, was assessed using color Doppler mapping.

Results. «Poor responders» patients have a smaller sise of ovaries and a reduced number of antral folicles, which can be explained by the surgical interventions carried out according to the type of ovarian resection and the cysts removal. In addition, during the transition from the follicular to luteal phase, there is no decrease in the vascular resistance of the dominant follicle, which slows the process of ovulation and reduces the likelihood of fertilization in conditions of increased vascular resistance.

Conclusion. Ultrasound examination of the uterus and ovaries and doplerometric investigation of peryfollicular blood flow allows us to thoroughly approach both the evaluation of the ovarian response and the endometric readiness for implantation, which dictates the need for an individual selection of preconceptional preparation and treatment programs for ART.

Key words: anatomical and functional state, pelvic organs, ovarian reserve, peryfollicular blood flow, poor responders.

REFERENCES

1. Aleksandrova NV, Marchenko LA. 2007. Sovremennyie podhodyi k otsenke ovarialnogo rezerva u zhenschin s prezhdevremennoy nedostatochnostyu yaichnikov (obzor literaturyi). Problemyi reproduktsii 2:22–29.

2. Apresyan SV. 2003. Optimizatsiya vosstanovleniya fertilnosti u zhenschin s trubno-peritonealnyim besplodiem. Avtoref. dis. kand. med. nauk. M:24.

3. Aksenenko VA. 2001. Sostoyanie reproduktivnogo zdorovya i profilaktika retsidivov u bolnyih s vospalitelnyimi zabolevaniyami pridatkov matki. Avtoref. dis. dokt. med. nauk. M:14–16.

4. Besplodnyiy brak. Sovremennyie podhodyi k diagnostike i lecheniyu: rukovodstvo. Pod red. GT Suhih, TA Nazarenko. 2-e izd., ispr. i dop. M, Geotar-Media. 2010:784.

5. Boyarskiy KYu, Gaydukov SN, Chkuaseli AS. 2009. Faktory, opredelyayuschie ovarialnyi rezerv zhenschiny (obzor literaturyi). Zhurnal akusherstva i zhenskih bolezney 58;2:65–71.

6. Gasparov AS, Hachatryan AK. 2013. Intraoperatsionnaya i laparoskopicheskaya ehografiya v reproduktivnoy ginekologii: prakticheskoe posobie. M, MIA:72.

7. Sudoma IO. 2005. Syndrom slabkoi vidpovidi yaiechnykiv u tsyklakh ekstrakorporalnoho zaplidnennia u patsiientok z adenomiozom. Ukrainskyi medychnyi chasopys 2(46):92–101.

8. Falkone T, Herd VV. 2014. Reproduktivnaya meditsina i hirurgiya. Per. s angl. pod red. GT Suhih. M, Geotar-Media:947.

9. Hachkuruzov SG. 1999. UZI v ginekologii. Simptomatika. Diagnosticheskie trudnosti i oshibki. SPb, Elbi:661.

10. Yuzko AM, Rudenko NG. 2014. Lechenie besplodiya s ispolzovaniem vspomogatelnyih reproduktivnyih tehnologiy v Ukraine. Zdorove zhenschiny 3:153–157.