THE ASSESSMENT OF THE ROLE OF HEMODYNAMIC SUPPORT IN THE GENESIS OF TUBAL-PERITONEAL INFERTILITY IN WOMEN WITH OBESITY TREATMENT BY REPRODUCTIVE TECHNOLOGIES
DOI:
https://doi.org/10.11603/24116-4944.2017.1.7582Keywords:
tubal-peritoneal infertility, obesity, internal uterine vascularization, follicular reserve, reproduction technologies, invitro fertilization.Abstract
The aim of the study – to study a hemodynamic support of uterus and estimate a state follicular reserve in women with a tubal-peritoneal infertility and the 1–2 degree of obesity like the important predictors of the successful pregnancy rate after the invitro fertilisation programes.
Materials and Methods. When conducted prospective study we examined 40 patients with tubal-peritoneal form of infertility and obesity (BMI 30–35). The control group consisted of 30 women with tubal-peritoneal factor infertility and BMI 20–25 kg / m2 in the programs of assisted reproductive technologies. Before turning patients into programs vitro fertilization (IVF) on the 2nd – 3rd of the menstrual cycle day women underwent ultrasound with Doppler mapping of the uterine vessels.
Results and Discussion. It was studied the intrauterine vascularization and the state of the follicular reserve in 40 women with tubal-peritoneal form of infertility with obesity. It was revealed that in patients of this group had decrease of intensity by intrauterine vascularization due to endometrial perfusion parameters. (OR 5.25, 95 % CI [1.80 – 15.35], p = 0.002). In 25.0 % of patients enrolled in the IVF programs was limited follicular reserve (OR 4.11, 95 % CI [1.10 – 15.29], p = 0.035). Symptoms, which were founded, may be independent of cofactors for infertility, which can reduce the chances of the possibility of pregnancy in the IVF programs.
Conclusions. Cofactors of the infertility, except of the main factor, could be not diagnosed before diseases of the endometrium (22.0 %), hydrosalpings, polycystic ovarian structure (10.0 %), the limited ovarian reserved. Besides a decline of the intrauterine vascularisation by the doplerometric indices of endometrial perfusion was diagnosed in the patients with obesity.
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