CLINICAL RESULTS IN PATIENTS WITH REDUCED OVARIAN RESERVE IN PROTOCOLS OF ASSISTED REPRODUCTIVE TECHNOLOGIES

Abstract

Introduction. The issues of infertility treatment remain relevant, even in light of significant advances in reproductive medicine. Among the primary factors contributing to reproductive function disorders in women, age stands out prominently. The trend of women delaying pregnancy planning due to their emphasis on social fulfillment and financial stability has been steadily increasing. The aim of this study is to assess the effectiveness of protocols of controlled ovarian stimulation using pre-gravid preparation in patients with reduced ovarian reserve when using assisted reproductive technologies. Participants and methods. This study involved 112 women experiencing infertility due to reduced ovarian reserve and tubal infertility factors. These women underwent a brief ovulation stimulation protocol as part of an assisted reproductive technologies program. The participants were categorized into three groups: the first group comprised 43 women with infertility due to reduced ovarian reserve; prior to controlled ovarian stimulation (COS) and follicular puncture, this group received a combined treatment, which included a vitamin complex containing inositol ("FT500 plus"), a dietary supplement based on alpha-lipoic acid and magnesium ("Pelvidol"), dehydroepiandrosterone (DHEA), and growth hormone ("Zomacton"); the second group consisted of 38 women with infertility associated with reduced ovarian reserve who did not receive any pre-conception preparation; the third group, serving as the control, consisted of 31 women with infertility resulting from tubal factors, and they did not undergo any pre-conception preparation. The clinical outcomes of the women in both research groups and the control group were analyzed based on their treatment tactics within the ovulation stimulation protocols in assisted reproductive technologies programs. Results and discussion. The average number of oocytes obtained from patients with infertility under reduced ovarian reserve who underwent pre-gravid preparation with the medications "FT500 plus" and "Pelvidol" is statistically higher compared to the group of women with reduced ovarian reserve who did not undergo pre-gravid preparation for COS. Clinical results also indicate positive dynamics regarding proper fertilization, blastulation of embryos and subsequent pregnancy in women, who underwent pre-gravid preparation with an inositol-based pharmaceutical "FT500plus" and the dietary supplement "Pelvidol", dehydroepiandrosterone (DHEA) and "Zomacton" (growth hormone).Conclusion. The results of this clinical study demonstrate the effectiveness of pre-conception preparation for patients with reduced ovarian reserve (poor response). This preparation positively impacts the number of oocytes and embryos obtained, the controlled stimulation of oocytes, and the subsequent implantation of the embryo, leading to successful pregnancies.