Ефективність прегравідарної підготовки в пацієнток після невдалих спроб допоміжних репродуктивних технологій на тлі хронічного ендометриту

Abstract

Purpose - to evaluate the effectiveness of the complex preconception preparation in patients after unsuccessful attempts at assisted reproductive technologies (ART) against the background of chronic endometritis. Materials and methods. At the stage of pregnancy planning, we conducted complex preconceptional training for 55 women of reproductive age with chronic endometritis and repeated unsuccessful attempts at ART. These women represented the first main group of the study. The group II (comparison) - 40 women of reproductive age with chronic endometritis and repeated unsuccessful attempts at ART, who did not use the preconception training developed by us. Results. The percentage of pregnancy by determining the level of human chorionic gonadotropin for embryo transfer was 47.2% (26 cases) in the group I versus 34.5% (19 cases) in the group II (p<0.05). In the group I women, such complications of pregnancy as the threat of termination of the first half of pregnancy, the threat of premature birth, preeclampsia, placental dysfunction and the syndrome of fetal growth retardation and gestational anemia were significantly lower compared to women in the group II. Term delivery was observed in 21 (86.0%) of women of the group I, while in pregnant women without preconception preparation, the frequency of delivery on time did not exceed 11 (64.7%), (p<0.05). Caesarean section in both groups, performed in almost half of the examined pregnant women (10 (40.0%) versus 9 (52.9%), respectively, p<0.05), varied significantly depending on the indications for caesarean section. In a planned manner, caesarean section was performed in 9 (90.0%) of cases of pregnant women in the group I and 4 (44.4%) of cases in the group II (p<0.05). Of the 28 newborns from mothers of the group I, full-term children were 23 (92.0%) and 5 (8.0%) were premature, of which 3 were born at gestational times of 33-36 weeks and one of the twins at 28-32 weeks. In the group II, term babies were 14 (70.0%) cases, and 6 (30.0%) cases were premature and all of them were twins: the first twins were born at 24-27 weeks, the second twins were born at 28-32 weeks and the third twin was born at 33-36 weeks (p<0.05). Conclusions. The complex pregravid training in patients after unsuccessful attempts of ART against the background of chronic endometritis had a positive effect on the onset of pregnancy, a favorable course of pregnancy, childbirth in the postpartum period and the condition of newborns in this group of patients. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the author.