COMPLEX THERAPY IN WOMEN WITH ENDOMETRIOSIS-ASSOCIATED INFERTILITY IN ADDITIONAL REPRODUCTIVE TECHNOLOGIES PROGRAMS

Abstract

Endometriosis is a dishormonal, immunodependent disease characterized by benign, focal growth of tissue with the existing epithelial and stromal elements, which are inherent in endometrial in myometry or other organs of genital system and outside it. The main clinical displays of this disease are persistent pain and infertility in 25–50 % of women.

The aim of the study – to improve the method of endometriosis-associated infertility treatment in programs of assisted reproductive technologies with the use of medicine that improve the quality of oocytes.

Materials and Methods. The study involved 94 women of reproductive age, with infertility and histological-confirmed diagnosis of genital endometriosis. The average age of examined women with endometriosis-associated infertility was (31.9±4.0) years. The average body weight of women was (72.2±4.4) kg. The duration of infertility among examined patients amounted from 3 to 10 years with average value (6.2±1.4) year. Primary infertility is found in 63 patients out of 94 (67 %), secondary in 31 patients (3 %). The algorithm of infertility patients treating was carried out according to orders of Healthcare Ministry of Ukraine No. 787 of 09.09.2013 “On Approving the Procedure of Application of Assisted Reproductive Technologies in Ukraine”. Before the ART program data on preliminary examination and treatment of married couples with the further obligatory standard protocol of examination (OSPE) was carried out.

Results and Discussion. The paper shows efficiency of complex therapy by drugs “FT 500 plus” and “Oligodetrym” in women with infertility associated with genital endometriosis before conducting of controlled ovarian stimulation. The patients were further divided into groups, depending on the operative interventions. Stimulation was carried out using a standard "long" protocol with a- GnRH with the use of HCG trigger. Efficiency estimation of treatment quality was carried out with the use of following parameters: total doze of FSH, duration of stimulation, quantity of follicles with diameter more than 17 mm at the moment of introduction trigger of final follicles maturation, the total efficiency coefficient of obtained oocyte-cumulus complexes at TVP, maturity degree of ooocytes, frequency of degenerative changes in oocytes, percentage of fertilization, embryos yield, number of blastocyst.

Conclusions. Application of modified circuits of COS with adjuvant therapy with the purpose of correction of oxidative abnormalities allows to improve the general response of ovaries to stimulation,  also to increase the number of ооocytes, degree of their maturity and quality, the coefficient of fertilization and yield of blastocyst in patients with infertility associated with genital endometriosis.