Assessment of underlying causes in patients with implantation fails in ivf cycles

Abstract

The article presents an analysis of literature data and the results of own retrospective studies of the incidence of cases of lag in the development of the endometrium in women with unsuccessful attempts to treat infertility of tubal peritoneal genesis using auxiliary reproductive technologies (ART). Clinico-anamnestic factors that negatively affect the state of the endometrium and are associated with the risk of an unsuccessful attempt at treatment have been revealed.The objective: to retrospectively analyze the cases of unsuccessful attempts to treat tubal peritoneal infertility in order to elucidate the frequency and extent of the development of the endometrium in the proliferative phase of the cycle in ART programs, as well as clinical and anamnestic factors negatively affecting the endometrium.Materials and methods. A retrospective analysis of 838 attempts to treat infertility of tubal-peritoneal genesis by ART methods was carried out. The criteria for selecting patients in the study were: 1) the reproductive age from 20 to 40 years; 2) normogonadotropicity; 3) absence or complete obstruction of the existing fallopian tubes; 4) absence of endometriosis, hyperprolactinemia, diabetes mellitus and other endocrine disorders; 5) absence of pathology of the uterus body; 6) normospermia in men. The embryological protocol indicates that embryos are of satisfactory quality, the number of embryos is two or more.Results. In cycles of infertility treatment of tubal peritoneal genesis by ART methods, the lag in the development of the endometrium (of varying severity) is 1/3 of the total number of cycles performed. Hypoplasia of the endometrium, found on the 7th day of the stimulation cycle, persists throughout the proliferative phase before the administration of hCG in 100% of patients. In patients with a marked lag in the development of the endometrium compared with women with normal and moderate retardation, intrauterine manipulation and their complications from anamnesis are significantly more frequent.Conclusion. The results of the study clearly demonstrate the need to analyze the effectiveness of the use of conventional methods for correcting deviations in the development of pregravid endometrium in cycles of treatment with assisted reproductive technologies (ART) and the impact of various degrees of lag in the development of pregravid endometrium on the clinical consequences of ART-infertility programs of tubal peritoneal genesis and their optimization.