MODERN CONCEPTS OF TREATMENT OF WOMEN WITH INFERTILITY ON THE BACKGROUND OF UTERINE LEIOMYOMA IN ASSISTED REPRODUCTIVE TECHNOLOGY PROGRAMS
DOI:
https://doi.org/10.11603/1811-2471.2022.v.i2.13146Keywords:
infertility, assisted reproductive technologies, controlled ovarian stimulation, induction of ovulation, in vitro fertilization, sex hormones, hysteroscopy, folliculogenesis, oocytes, alpha-lipoic acid, “FT 500 Plus”Abstract
SUMMARY. The aim – to increase the incidence of pregnancy in women with infertility on the background of leiomyoma using modern concepts of treatment of this pathology.
Materials and Methods. The study included a group of 175 women of childbearing age with uterine fibroids and 32 healthy women with normal menstrual and reproductive function, divided into the following groups: Group I – 137 women with LM, then divided into A1 – 55 women with LM using the proposed treatment complex after laparoscopy and hysteroscopy, A2 – 45 women with LM after hysteroscopy, A3 – 37 women with LM and recommended drug therapy without surgical resection of LM; comparison group B – 38 women with LM and standard treatment.
Results and Discussion. The relative incidence of clinical pregnancies was highest in the first (45.5 %) and second (44.4 %) study groups, exceeding the data of the A3 subgroup and the comparison group. Among clinical pregnancies, the lowest proportion of aborted pregnancies was found in women with uterine leiomyoma after hysteroresectoscopy and treatment and prevention complex (10.0 %), which was lower than the data of the first and third groups by 6.0 % and 20.0 %, respectively, and relative to the comparison group by 11.4 %.
Conclusion. Therefore, the use of the proposed treatment regimen, which includes the introduction of a gonadotropin-releasing hormone agonist, conservative myomectomy or hysteroresectoscopy in women with infertility on the background of uterine leiomyoma and pre-pregnancy training in assisted reproductive technology programs, which includ a vitamin complex with inositol, vitamin D3 and alpha-lipoic acid with magnesium, has the same effect on the frequency of clinical pregnancy, but the frequency of live birth is the highest after conservative myomectomy (84.0 %).
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