EFFICACY OF SCLEROTHERAPY AND PRECONCEPTION PREPARATION IN WOMEN WITH INFERTILITY AGAINST ENDOMETRIOSIS
DOI:
https://doi.org/10.11603/bmbr.2706-6290.2020.4.11815Keywords:
endometriosisAbstract
Summary. The debate over the choice of optimal treatment tactics before IVF and the best protocol for superovulation stimulation in women with endometriosis-associated infertility to achieve pregnancy are continuing.
The aim of the study – to analyze the parameters of superovulation induction in women with infertility on the background of endometriosis and to evaluate the effectiveness of the proposed in vitro fertilization protocols.
Materials and Methods. The study included 105 women aged 21 to 40 years with endometriosis-associated infertility. Patients with endometriosis-associated infertility were divided into 3 groups: with unoperated endometrioid cysts, who underwent sclerotherapy and preconception preparation before the COS protocol; with unoperated endometrioid cysts, which were sclerotherapy before the COS protocol, without preconception preparation; in whom a history of surgical treatment of endometrioid cysts was performed and preconception preparation was prescribed before the COS protocol. The drug FT 500 plus for women of group 1 was prescribed in a dosage of 1 sachet – once a day from the 2nd or 3rd day of the cycle for 2 menstrual cycles (the cycle in which sclerotherapy was performed and the next cycle). Vitamin D was prescribed in prophylactic doses of 2000 IU.
Results. The effectiveness of controlled ovarian stimulation in women with endometriosis-associated infertility with the inclusion of sclerotherapy and vitamin complex with inositol and vitamin D3 is evidenced by the number of follicles 13.50 (10.00; 15.00), the number of oocytes 10.50 (8.50); 12.00) of which 85.71 % were mature oocytes of stage M II, blastocyst number 3.00 (2.00; 4.00). When analyzing the number of high-class embryos, it was found that the largest number of them was obtained in patients who underwent sclerotherapy with preconception preparation with a complex vitamin preparation with inositol and vitamin D3.
Conclusions. In women with endometriosis-associated infertility who underwent sclerotherapy and preconception preparation with a vitamin complex with inositol and vitamin D3 before controlled ovarian stimulation, oocyte induction parameters were better, leading to a higher incidence of pregnancies.
References
Giudice LC. Clinical Practice: Endometriosis. N Engl J Med. 2010;362: 2389-98.
Bulun SE. Endometriosis. N Engl J Med. 2009;360(3): 268-79.
Kucheryna NS. Optimization of laparoscopic treatment of patients with ovarian apoplexy. Candidate’s Extended abstract. Kharkiv; 2009. UKrainian.
Practice Committee of the American Society for Reproductive Medicine (ASRM). Endometriosis and Infertility. Fertil Steril. 2006;14:S156–60.
Taylor RN, Lebovic DI. Endometriosis. In: Yen and Jafi' e‘s reproductive endocrinology: physiology and clinical management (6th cdn). Strauss JF, Barbicri R. Eds. New York: Elsevier, 2009.
Coccia ME, Rizzello F, Cammilli F, Bracco GL, Scarselli G. Endometriosis and infertility Surgery and ART: an integrated approach for successful management. Eur J Obstet Gynecol Reprod Biol. 2008;138(1): 54-9. Epub 2008 Feb 20.
Abayomi Ajayi, Victor Ajayi, Ifeoluwa Oyetunji, Oluwafunmilola Biobaku, Happiness Aikhuele, Adedamilola Atiba and Bamgboye M Afolabi. Endometriosis and assisted reproductive technology: A review article. Medical & Clinical Reviews 2017;3(1): 4.
Dunselman GA, Vermeulen N, Becker C, Calhaz-Jorge C, d’Hooghe T, de Bie B, et al. ESHRE guideline: management of women with endometriosis. Hum Reprod. 2014;29: 400-12.
Castellarnau Visus M, Ponce Sebastia J, Carreras Collado R, Cayuela Font E, Garcia Tejedor A. Preliminary results: ethanol sclerotherapy after ltrasoundguided fine needle aspiration without anesthesia in the management of simple ovarian cysts. J Minim Invasive Gynecol 2015;22: 475-82.
Gupta S, Malhotra N, Sharma D. Oxidative stress and its role in female infertility and assisted reproduction: clinical implications. Int J Fertil Steril. 2009;2(4): 47-164.
Tamura H, Takasaki A, Miwa I. Oxidative stress impairs oocyte quality and melatonin protects oocytes from free radical damage and improves fertilization rate. J Pineal Res. 2007;44(3): 280-7.
Agarwal A, Gupta S, Abdel-Razek H. Impact of oxidative stress on gametes and embryos in an ART laboratory. Clin Embryol. 2006;9(3): 5-22.
Shamsuddin AKM, Guang-Yu Yang. "Inositol & its Phosphates: Basic Science to Practical Applications", Bentham Science Publishers; 2015. Avail;able from: https://doi.org/10.2174/97816810800791150101.
Buggio L, Somigliana E, Pizzi MN, Dridi D, Roncella E and Vercellini P: 25 hydroxyvitamin D serum levels and endometriosis: Results of a case control study. Reprod Sci; 2018.
Hamdan M, Dunselman G, Li TC, Cheong Y. The impact of endometrioma on IVF/ICSI outcomes: a systematic review and meta-analysis. Hum Reprod Update 2015;21: 809-25.
Jancar N, Kopitar AN, Ihan A. Effect of apoptosis and reactive oxygen species production in human granulosa cells on oocyte fertilization and blastocyst development. J Assist Reprod Genet. 2007;24(2-3): 91-7.
McKinnon B, Bertschi D, Wotzkow C. Glucose transporter expression in eutopic endometrial tissue and ectopic endometriotic lesions. J Mol Endocrinol. 2014;52(2): 169-79.
Melo AS, Rosa-e-Silva JC, Rosa-e-Silva AC. Unfavorable lipid profile in women with. Fertility and Sterility. 2010;93(7): 2433-6. DOI: 10.1016/j.fertnstert.2009.08.043.
Polak G, Barczyński B, Kwaśniewskn W. Low -density lipoproteins oxidation and endometriosis. Mediators Inflamm. 2013;624540. DOI: 10.1155/2013/624540.
Simi G, Genazzani AR, Obino MER. Inositol and in vitro fertilization with embryo transfer. International Journal of Endocrinology. 2017;(5): 1-5. DOI: 10.1155/2017/5469409.
Surrey ES, Katz-Jaffe M, Kondapalli LV, Gustofson RL, Schoolcraft WB. GnRH agonist administration prior to embryo transfer in freeze-all cycles of patients with endometriosis or aberrant endometrial integrin expression. Reprod Biomed Online. 2017;35(2): 145-51. DOI: 10.1016/j.rbmo.2017.05.004.
The Practice Committee of the American Society for Reproductive Medicine. Endometriosis and infertility: a committee opinion. Fertility and Sterility. 2012;98(3): 591-8. DOI: 10.1016/j.fertnstert.2012.05.031.
Halis G, Arici A, Ann NY. Endometriosis and inflammation in infertility. Acad Sci. Annals of the New York Academy of Sciences. 2004;19(8): 2385. DOI: 10.3390/ijms19082385.
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