Evaluation of the influence of clinical risk factors on the performance of extracorporal fertilization programs

V V Likhacheva,S V Shramko,A E Vlasenko,L G Bazhenova,A G Markdorf

doi:10.20538/1682-0363-2018-2-49-59

Abstract

Purpose of the study. To assess the influence of main clinical risk factors on the effectiveness of the in vitro fertilization (IVF) program.Materials and methods. The study included 3,969 IVF programs conducted in the “Medica” clinic of the “Mother and Child” group of companies in Novokuznetsk for 2010–2015. The inclusion criterion was the availability of information on the results of the procedure conducted.Results.The structure of the considered risk factors was identified, their key features were identified: the majority of women who underwent IVF procedure were under the age of 34, inclusive, more than half of all procedures were performed at the first attempt. The main causes of female infertility were: tubal factor, including those associated with chronic endometritis, polycystic ovary syndrome, external genital endometriosis and adenomyosis. In a number of cases, as a concomitant gynecological disease, uterine fibroids have been extirpated, which is not the main cause of infertility, but the presence of which can influence the effectiveness of IVF programs. Statistically significantly more often, fibroids were found in adenomyosis and tubal factors associated with chronic endometritis. A quantitative assessment of the degree of influence of the considered risk factors on the effectiveness of IVF programs was considered, and the influence of both individual factors and their combination was considered.Conclusion.The main factors statistically significantly increasing the risk of a negative outcome of the program are: the age of a woman over 30; repeated attempt at the age of up to 30 years inclusive (in comparison with the first attempt); tubular factor associated with chronic endometritis; presence of uterine fibroids in the tubular factor associated with chronic endometritis; The presence of fibroids in the tubular factor, complicated by adenomyosis.

Highlights

The structure of the considered risk factors was identified, their key features were identified: the majority of women who underwent in vitro fertilization (IVF) procedure were under the age of 34, inclusive, more than half of all procedures were performed at the first attempt
The main causes of female infertility were: tubal factor, including those associated with chronic endometritis, polycystic ovary syndrome, external genital endometriosis and adenomyosis
In a number of cases, as a concomitant gynecological disease, uterine fibroids have been extirpated, which is not the main cause of infertility, but the presence of which can influence the effectiveness of IVF programs

Summary

Methods

Частота отрицательного результата ЭКО в зависимости от наличия или отсутствия миомы матки при различных причинах бесплодия представлена в табл. 7. Частота отрицательного результата ЭКО при наличии или отсутствии миомы для различных причин бесплодия за период 2010–2015 гг. Наличие миомы любой локализации статистически значимо увеличивает вероятность отрицательного исхода у женщин с трубным фактором бесплодия, ассоциированном с хроническим эндометритом или аденомиозом. 8 представлена частота отрицательного исхода программы ЭКО при трубном бесплодии, ассоциированном с хроническим эндометритом, и трубном бесплодии в сочетании с аденомиозом с учетом наличия или отсутствия миомы. Но при сочетании трубного фактора, аденомиоза и миомы риск отрицательного исхода программы статистически значимо выше по сравнению с суммарным риском для остальных причин бесплодия. For citation: Likhacheva V.V., Markdorf A.G., Bazhenova L.G., Vlasenko A.E., Shramko S.V. Evaluation of the influence of clinical risk factors on the performance of extracorporal fertilization programs. Likhacheva V.V.1, Markdorf A.G.2, Bazhenova L.G.1, Vlasenko A.E.1, Shramko S.V.1

Results

Conclusion

CONFLICT OF INTEREST