Оптимизация тактики ведения беременных с эндокринным фактором бесплодия: особенности клинического течения беременности после ВРТ и исходы родов

Abstract

Study Objective: To optimize pregnancy management and improve delivery outcomes in women with infertility of endocrine origin after the use of assisted reproductive technologies (ART). Study Design: This was an analytical prospective study. Materials and Methods: One hundred and twenty patients with singleton pregnancy were observed: 74 women with infertility of endocrine origin who had undergone in vitro fertilization (IVF) (Group I) and 46 women who became pregnant spontaneously (Group II). The main group (Group I) was divided into subgroup IA (n = 44), in which a comprehensive approach to pregnancy was applied (obstetric pessary and micronized progesterone), and subgroup IB (n = 30) consisting of patients for whom micronized progesterone alone was used. Study Results: Groups I and II differed significantly in miscarriage risk rates: 60.8% and 30.4%, respectively. This complication was most often observed in subgroup IB (80.0%), 2.6 times more often than in Group II (χ2 = 5.700; p = 0,029). There were also statistically significant differences between the groups in the rate of preterm delivery (PD), which was 5.6 times higher in the main group than in the control group (24.3% vs. 4.3%, χ2 = 4.915; p = 0.027). The greatest difference from the control group (9.3 times higher rate) was observed in subgroup IB (χ2 = 10.156; p = 0.004). Conclusion: A comprehensive approach makes it possible to prolong pregnancy, reduce rates of PD by a factor of 2.9 and achieve full-term pregnancies in 86.4% of cases. Keywords: pregnancy, IVF, ART, obstetric complications, perinatal outcomes, Arabin pessary.