Ефективність програм екстракорпорального запліднення (IVF/ICSI) у пацієнток із прогнозованою слабкою відповіддю яєчників

Abstract

Purpose - to show the effectiveness of in vitro fertilization (IVF) programs in infertile women with a predicted poor ovarian response to stimulation with various gonadotropins and to study the course of pregnancy, childbirth and the condition of their newborns. Materials and methods. The Group І is 75 women, the controlled stimulation of superovulation in which by urinary gonadotropins was performed in the protocol with the use of gonadotropin-releasing hormone antagonist. The Group ІІ (comparison) is 65 women, the stimulation of superovulation in which was carried out according to an analogical scheme with recombinant gonadotropins. Confirmation or exclusion of biochemical pregnancy was carried out by determining the level of total human chorionic gonadotropin in blood serum 14 days after embryo transfer. Data processing was carried out using the Stat Soft Statistica 8.0 software package. Results. The frequency of cancellation of IVF cycle (IVF/ICSI) in the patients of the Group І was reliably lower than among the patients of the Group ІІ: in the Group І it was 2 (2.7%) cases against 8 (12.3%) cases in the Group ІІ (p<0.05). IVF cycle cancellations among the patients of the Group І was reliably lower than among the women of the Group ІІ (OR=0.205; 95% СІ: 0.048-0.87; p<0.05). Embryo transfer procedure was performed for 73 women of the Group І and 57 patients of the Group ІІ. The frequency of pregnancy on the IVF protocol and embryo transfer was 41.1% (30/73) and 36.8% (21/57), respectively. Absence of the further embryo development after implantation (biochemical pregnancy) was registered in 1 (3.3%) woman of the Group І and 1 (4.8%) patient of the Group ІІ. Non-developing pregnancy up to 12 weeks was diagnosed in 2 (6.6%) women of the Group І and 3 (14.2%) patients of the Group ІІ. Pregnancy that occurred after the IVF/ICSI program resulted in childbirth in 24 (32.9%) women out of 73 of the Group І and 13 patients out of 57 (22.8%) of the Group ІІ. Conclusions. In women who underwent the controlled stimulation of superovulation by urinary gonadotropins in the protocol using gonadotropin-releasing hormone antagonist compared to women who underwent the stimulation of superovulation with recombinant gonadotropins according to an analogical scheme, the frequency of pregnancy and completion of pregnancy by childbirth was reliably higher. 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.