HEALTH OF WOMAN. 2019.2(138): 49–52; doi 10.15574/HW.2019.138.49

Bagatko O. V.
Medical Center «Mother and Child», Kyiv

The objective: was to study the effectiveness of stimulation of ovulation in women with tuboperitoneal infertility, depending on the drug used.

Materials and methods. To achieve this goal, 239 patients with tuboperitoneal infertility were examined, which were randomly divided into two groups I (main, n=118) and II (comparisons, n=121). Women of the main group for KOS were prescribed a single subcutaneous injection of corypholitropin alfa into the abdominal wall at the beginning of the follicular phase of the menstrual cycle at a dose of 150 μg. Women in the comparison group received daily injections of follitropin beta 150–225 IU for 6–12 days. After denudation the maturity and quality of the eggs was evaluated.

Results. The average duration of superovulation stimulation in women of the main group was 8.43±0.01 days, and in the comparison group 10.51±0.03 days (p<0.05). The number of obtained oocytes was 17.68±0.51 in group I, 14.58±0.25 in group II (p<0.05); mature oocytes 14.35±0.24 and 10.16±0.19 respectively (p<0.05).

When analyzing the quality of oocytes, it was determined that 77.78% of mature eggs were obtained in the I group, and 62.5% – in the II group (p<0.05). Among mature oocytes in both groups only in two thirds of cases (74.15% and 69.0%; p<0.05) they were of high quality, while in the other there were some changes in their structure.

Conclusion. Optimal for young women with tuboperitoneal infertility is a short COS protocol using prolonged-action rFSH, which allows to get more high-quality oocytes with reduction the stimulation period.

Key words: tuboperitoneal infertility, in vitro fertilization, stimulation of superovulation, follicle-stimulating hormone, oocyte.

REFERENCES

1. Bulavenko OV, Lovkina OL. (2013). Novi pidkhody v korektsii stanu endometriiu u zhinok reproduktyvnoho viku iz pervynnym stres-indukovanym nepliddiam. Elektronnyi resurs.  Biomedical and biosocial anthropology 21: 150–154. Rezhym dostupu: http://nbuv.gov.ua/UJRN/bba_2013_21_39

2. Yuzko AM. (2017). Zhenskoe besplodie trubnogo proishozhdeniya. Zdorove zhenschiny 2: 126–131.

3. Yuzko OM, Zhylka NIa, Rudenko NH, Aloshyna HM, Yuzko TA. (2007). Dopomizhni reproduktyvni tekhnolohii v Ukraini. Zhinochyi likar 3: 8–12.

4. Petrovich EA, Manuhin IB. (2010). Innovatsionnyiy podhod k lecheniyu trubno-peritonealnogo besplodiya. Ginekologiya 3 (12): 15–20.

5. Suhih GT, Nazarenko TA. (2010). Besplodnyiy brak. Sovremennyie podhodyi k diagnostike i lecheniyu. M, GEOTAR-Media: 788.

6. Hryshchenko MH. (2010). Prohnozuvannia efektyvnosti ekstrakorporalnoho zaplidnennia u zhinok z trubno-perytonealnym bezpliddiam na pidstavi vyvchennia imunnoho homeostazu v folikuliarnii ridyni. Suchasni medychni tekhnologii 4: 12–18.

7. Pouwer AW, Farquhar C, Kremer AM. (2012). Long-acting FSH versus daily FSH for women undergoing assisted reproduction (Review). The Cochrane Library 6: 233–239. https://doi.org/10.1002/14651858.CD009577

8. Gabaraeva VV, Kalugina AS. (2015). Sravnitelnaya effektivnost preparata korifollitropin-alfa v programme donorstva ootsitov. Problemyi reproduktsii 5: 58–62.

9. Ekstrakorporalnoe oplodotvorenie i ego novyie napravleniya v lechenii zhenskogo i muzhskogo besplodiya (teoreticheskie i prakticheskie podhody): Rukovodstvo dlya vrachey. (2000). Pod red. Kulakova VI, Leonova BV. M, Meditsinskoe informatsionnoe agentstvo:782.

10. Nazarenko TA. (2014). Sovremennyie metodyi induktsii ovulyatsii v lechenii besplodiya (posobie dlya vrachey akusher-ginekologov): 11.

11. Smetnik VP, Tumilovich LG. (1999). Neoperativnaya ginekologiya. Rukovodstvo dlya vrachey. M, Med. Inform. Agentstvo:592.

12. Daya S, Gunby J, Hughes EG, Collins JA, Sagle MA. (1995). Follicle-stimulating hormone versus human menopausal gonadotropin for in vitro fertilization cycles: a metaanalysis. Fertil. Steril. 64 (2): 347–354. https://doi.org/10.1016/S0015-0282(16)57734-6

13. Stanton PG, Robertson DM, Burgon PG et al. (1992). Isolation and physicochemical characterization of human follicle-stimulating hormone isоforms. Endocrinology 139: 2820–2832. https://doi.org/10.1210/endo.130.5.1572295; PMid:1572295

14. Hazout A, Pouly JL, Buvat J et al. (1998). A prospective, randomized, multicentre study comparing low dose versus conventional dose GnRH agonist in a long protocol using recombinant human ® follicle stimulating hormone (Gonal-F) in women undergoing in-vitro fertilization. 14th Annual Meeting of the European Society of Human Reproduction and Embryology, Gothenburg, Sweden, 21–24 June 1998: 45–49.

15. Kornilov NV, Mihaylik GV, Krapivina EG i dr. (1999). Sravnenie chetyireh protokolov preparatov gonadotropinov dlya kontroliruemoy ovarialnoy giperstimulyatsii v programmah EKO i EKO/IKSI. Problemy reproduktsii 5;5: 56–61.

16. Stanton PG, Robertson DM, Burgon PG et al. (1992). Isolation and physicochemical characterization of human follicle-stimulating hormone isоforms. Endocrinology 139: 2820–2832. https://doi.org/10.1210/endo.130.5.1572295; PMid:1572295

17. Kalibianakis et al. (2008). Corifollitropin alfa Dose-finding Study Group. Hum Reprod. 23: 2484–2492. https://doi.org/10.1093/humrep/den288; PMid:18684735

18. Fares FA, Suganuma N, K. Nishimori et al. (1992). Design of a long-acting follitropin agonist by fusing the Cterminal sequence of the chorionic gonadotropin beta subunit to the follitropin beta subunit. Proc Natl Acad Sci USA. 89 (10): 4304–4308. https://doi.org/10.1073/pnas.89.10.4304; PMid:1374895 PMCid:PMC49070

19. ELONVA (corifollitropin alfa) summary of product characteristics. (2010). N.V. Organon, a subsidiary of Merck & Co., Inc., Whitehouse Station, NJ. USA.

20. Ablyaeva ESh, Bendusov IA. (2016). Korifollitropin alfa. Effektivnost, bezopasnost i komfortnost dlya vracha i patsienta. Meditsinskiy sonet. 2: 42–48.

21. Kuleshova DA, Melehova NYu, Gustovarova TA i dr. (2016). Primenenie korifollitropina alfa v programmah vspomogatelnyih reproduktivnyih tehnologiy u zhenschin starshe 40 let. Ginekologiya 18;6: 20–23.

22. Strelko GV. (2018). Meditsinskie preimuschestva kontrolirovannoy stimulyatsii yaichnikov s ispolzovaniem antagonistov gonadotropin-rilizing-gormona i korifollitropina alfa v klinike EKO u plohih otvetchikov. Zdorove zhenschinyi 3 (129): 39–45.

23. Andreeva MG, Syirkasheva AG, Dolgushina NV, Kalinina EA. (2016). Vliyanie raznyih protokolov ovarialnoy stimulyatsii na embriologicheskie harakteristiki i effektivnost programm vspomogatelnyih reproduktivnyih tehnologiy. Ginekologiya 18;1:79–82.

24. Cota AMM, Petersen CG, Mauri AL, Silva LFI. (2012). GnRH agonist versus GnRH antagonist in assisted reproduction cycles : oocyte morphology. Reprod Biol Endocrinol. 10: 33. https://doi.org/10.1186/1477-7827-10-33; PMid:22540993 PMCid:PMC3464873

25. Fensore S, Di Marzio M, Tiboni GM. (2015). Corifollitropin alfa compared to daily FSH in controlled ovarian stimulation for in vitro fertilization: a meta-analysis. J Ovarian Res. 8:33. https://doi.org/10.1186/s13048-015-0160-4; PMid:26036214 PMCid:PMC4465305