EFFECTIVENESS OF A MODIFIED INFERTILITY TREATMENT APPROACH FOR IN VITRO FERTILIZATION PROTOCOLS IN WOMEN WITH POLYCYSTIC OVARIAN SYNDROME AND CHRONIC ENDOMETRITIS
DOI:
https://doi.org/10.11603/24116-4944.2021.2.12888Keywords:
oocytes, embryo implantation, chronic endometritis, PCOSAbstract
The aim of the study – to analyze the effect of a modified treatment regimen of in vitro fertilization protocols on the quality of oocytes, embryo implantation and pregnancy in women with infertility against the background of polycystic ovary syndrome and chronic endometritis.
Materials and Methods. The study involved 105 women with endocrine infertility against the background of PCOS and CE, who were divided into two treatment groups, depending on the cause of infertility and treatment approach, as well as 35 women with infertility due to male causes, who comprised the control group. The patients in this study were evaluated for oocyte quality and embryo implantation.
Results and Discussion. Analysis of the treatment outcomes in patients with infertility against the background of PCOS and CE showed that the initial dose of rFSG and the duration of administration of “Orgalutran” anti-GnRH were significantly higher in the group with standard treatment. Following the modified treatment scheme for PCOS and CE, the number of follicles, derived oocytes and MII was significantly higher than in the comparison group. The patients with comorbid PCOS and CE who completed the the modified treatment scheme had a significantly higher number of normal fertilized cells (2.30 times), unfertilized oocytes (3.12 times), 1PN abnormally fertilized oocytes (3.05 times), 3PN abnormally fertilized oocytes (2.38 times), blastocyst yield (1.94 times) and the number of high quality cells (2.17 times) relative to the comparison group. In the cases of successful clinical pregnancies, there was also a high frequency of childbirth (41.94 %); this rate was comparable to the same metric of the comparison group, while term births predominated over premature ones.
Conclusions. In patients with PCOS and CE, the use of standard anti-inflammatory therapy as a part of our modified scheme, which includes pre-pregnancy treatment with inositol and alpha-lipoic acid, PRP therapy of the uterine cavity and lipofundin infusion on the day of embryo transfer, helps to increase the frequency of clinical pregnancies, reduce frequency of aborted pregnancies and increase frequency of term deliveries.
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