Медико-социальные особенности акушерско-гинекологического профиля женщин, преодолевших бесплодие с помощью ВРТ.

Abstract

To increase the birth rate, in addition to increasing the availability of ART, their high effectiveness is necessary. The effectiveness of providing this type of medical care is influenced by a significant number of medical, social and organizational factors. Achieving a positive result during IVF largely depends on the obstetric history of the expectant mother. Purpose. To determine the medical and social characteristics of the obstetric and gynecological profile of patients at the Center for Reproduction and Family Planning who had a positive result in the treatment of infertility using IVF. Materials and methods. Using a specially developed statistical form “Questionnaire for medical and social examination of women suffering from infertility,” an anonymous survey was conducted of 398 women whose pregnancy resulted from the IVF procedure. The significance of differences in indicators was assessed using Student’s t-test. Differences were considered significant at p<0,05. Statistical data processing was carried out using the MS Office‑2016 and StatSoft-Statistica 10.0 software packages. Results. With an average age of onset of sexual activity of 18,82± years, sexual debut before 18 years of age was observed in 32,7% of patients. Most often, for the first time, women sought medical help for infertility within 2–5 years after the start of regular sexual activity (65,4%) (m=3,38±0,17 years) to obstetrician-gynecologists at antenatal clinics and planning centers families (83,0%). Despite the fact that the average age of initial diagnosis of infertility was 28,86±0,34 years, 38,2% of women were diagnosed with infertility after 30 years of age, and 55.3% of all requests for medical help for problems with conception came from private medical organizations. In most cases, before being referred for IVF, women underwent treatment at antenatal clinics and family planning centers (91,3%). The obstetric and gynecological profile of women who have overcome infertility with the help of ART is characterized by: a history of negative IVF results (50.4%), absence of children before this pregnancy (87,0%), low detection of gynecological diseases in childhood (13,1%) and the presence of abortions (27,1%). 38,9% of patients who had a history of pregnancy terminations had two or more abortions (m=1,61±0,03 abortions). In the study group, a high frequency of abortions for medical reasons and spontaneous terminations of pregnancy was revealed (31,5% and 24,1%, respectively). Conclusion. The established obstetric and gynecological profile of women who have overcome infertility with the help of ART has revealed a significant number of medical and social risk factors, which makes it possible to develop organizational measures aimed at improving the provision of medical care to this group of women.