Strategy of the endometrium preparation in patients undergoingthe program of assisted reproductive technologies to improve the effectiveness of treatment

Aim. To develop a strategy of improvement of the effectiveness of infertility treatment by preparing endometrium in ART program. Materials and Method. The study was conducted from 01.01.2015 to 31.12.2016 in the Communal Institution "Regional Medical Centre of Human Reproduction" of Zap...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	N.V. Avramenko, D.E. Barkovskiy, E.V. Kabachenko, I.B. Gridina
Formato:	article
Lenguaje:	EN UK
Publicado:	Danylo Halytsky Lviv National Medical University 2018
Materias:	endometrium, assisted reproductive technologies, plasmapheresis, ozone therapy, hormone replacement therapy, granulocyte-macrophage colony-stimulating factor Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/370bf745cd5d4ae3a7393fe80fb4cf1d
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:370bf745cd5d4ae3a7393fe80fb4cf1d
record_format	dspace
spelling	oai:doaj.org-article:370bf745cd5d4ae3a7393fe80fb4cf1d2021-11-10T19:50:04ZStrategy of the endometrium preparation in patients undergoingthe program of assisted reproductive technologies to improve the effectiveness of treatment1029-42442415-330310.25040/aml2018.01.023https://doaj.org/article/370bf745cd5d4ae3a7393fe80fb4cf1d2018-02-01T00:00:00Zhttps://amljournal.com/index.php/journal/article/view/121https://doaj.org/toc/1029-4244https://doaj.org/toc/2415-3303Aim. To develop a strategy of improvement of the effectiveness of infertility treatment by preparing endometrium in ART program. Materials and Method. The study was conducted from 01.01.2015 to 31.12.2016 in the Communal Institution "Regional Medical Centre of Human Reproduction" of Zaporizhzhya Regional Council. It involved 112 patients with 1-2 previous unsuccessful fertilization attempts in ART programs. The diagnostic stage included general examination approaches: extended range of ultrasound exploration; diagnostic hysteroscopy or the Pipelle endometrial biopsy; PCR diagnosis and detection of antisperm antibodies; and additional tests: Hyaluronan binding assay, identification of antibodies to Zonapellucida oocyte and the degree of the sperm DNA fragmentation. Taking into account the identified pathologies, 92 of the 112 patients were divided into four subgroups: I. 23 - with signs of chronic endometritis and cervical antisperm antibodies; II. 12 - with abnormalities of the steroid receptors' expression; III.27 - with endometrium pathology; IV. 30 - with a combination of inflammatory and hyperplastic processes in the endometrium. Twenty patients without any pathology of endometrium were included into the fifth, control group. At the stage of preparation to ART programs, courses of curative plasmapheresis (CP) and ozone therapy were prescribed to all patients. Depending on the indications, additional treatments were administered: HRT, GM-CSF, hCG, and Nicergoline administration. Results and Discussion. By applying an individualized approach, we have developed algorithms for preliminary treatment of endometrium in ART program for each of the selected groups of patients, in addition to CP and ozone therapy: I - complex specific treatment, and also: in case of inflammatory markers' detection - combined oral contraceptives (COCs), and in the presence of ACA - condom therapy; II - COCs or a cycle of HRT, irrigation by HCG, intrauterine administration of G-CSF and drugs improving rheological properties of the blood; III - metabolic and cyclic hormone therapy, irrigation by HCG and intrauterine administration of G-CSF; IV - etiopathogenetic therapy: pharmacological, hormonal therapy, and surgical treatment. According to the results of the clinical work on the comprehensive preparation of endometrium for fertilization in ART programs, clinical pregnancy occurred in: 19 patients (67%) in Group I; 3 patients (25%) in Group ІІ; 10 patients (45%) in Group ІІІ; 19 patients (63 %) in Group IV; and 8 patients (40%) of Group V (control). Conclusions. The implementation of modern techniques and technologies based on the developed strategy of conducting the preparatory stage of the ART program and the optimization of the embryological stage increases the effectiveness of the IVF / ICSI / ET cycles by 15.7% and allows achieving the incidence of clinical pregnancy of 52.7%.N.V. AvramenkoD.E. BarkovskiyE.V. KabachenkoI.B. GridinaDanylo Halytsky Lviv National Medical Universityarticleendometrium, assisted reproductive technologies, plasmapheresis, ozone therapy, hormone replacement therapy, granulocyte-macrophage colony-stimulating factorMedicine (General)R5-920ENUKActa Medica Leopoliensia, Vol 24, Iss 1, Pp 23-31 (2018)
institution	DOAJ
collection	DOAJ
language	EN UK
topic	endometrium, assisted reproductive technologies, plasmapheresis, ozone therapy, hormone replacement therapy, granulocyte-macrophage colony-stimulating factor Medicine (General) R5-920
spellingShingle	endometrium, assisted reproductive technologies, plasmapheresis, ozone therapy, hormone replacement therapy, granulocyte-macrophage colony-stimulating factor Medicine (General) R5-920 N.V. Avramenko D.E. Barkovskiy E.V. Kabachenko I.B. Gridina Strategy of the endometrium preparation in patients undergoingthe program of assisted reproductive technologies to improve the effectiveness of treatment
description	Aim. To develop a strategy of improvement of the effectiveness of infertility treatment by preparing endometrium in ART program. Materials and Method. The study was conducted from 01.01.2015 to 31.12.2016 in the Communal Institution "Regional Medical Centre of Human Reproduction" of Zaporizhzhya Regional Council. It involved 112 patients with 1-2 previous unsuccessful fertilization attempts in ART programs. The diagnostic stage included general examination approaches: extended range of ultrasound exploration; diagnostic hysteroscopy or the Pipelle endometrial biopsy; PCR diagnosis and detection of antisperm antibodies; and additional tests: Hyaluronan binding assay, identification of antibodies to Zonapellucida oocyte and the degree of the sperm DNA fragmentation. Taking into account the identified pathologies, 92 of the 112 patients were divided into four subgroups: I. 23 - with signs of chronic endometritis and cervical antisperm antibodies; II. 12 - with abnormalities of the steroid receptors' expression; III.27 - with endometrium pathology; IV. 30 - with a combination of inflammatory and hyperplastic processes in the endometrium. Twenty patients without any pathology of endometrium were included into the fifth, control group. At the stage of preparation to ART programs, courses of curative plasmapheresis (CP) and ozone therapy were prescribed to all patients. Depending on the indications, additional treatments were administered: HRT, GM-CSF, hCG, and Nicergoline administration. Results and Discussion. By applying an individualized approach, we have developed algorithms for preliminary treatment of endometrium in ART program for each of the selected groups of patients, in addition to CP and ozone therapy: I - complex specific treatment, and also: in case of inflammatory markers' detection - combined oral contraceptives (COCs), and in the presence of ACA - condom therapy; II - COCs or a cycle of HRT, irrigation by HCG, intrauterine administration of G-CSF and drugs improving rheological properties of the blood; III - metabolic and cyclic hormone therapy, irrigation by HCG and intrauterine administration of G-CSF; IV - etiopathogenetic therapy: pharmacological, hormonal therapy, and surgical treatment. According to the results of the clinical work on the comprehensive preparation of endometrium for fertilization in ART programs, clinical pregnancy occurred in: 19 patients (67%) in Group I; 3 patients (25%) in Group ІІ; 10 patients (45%) in Group ІІІ; 19 patients (63 %) in Group IV; and 8 patients (40%) of Group V (control). Conclusions. The implementation of modern techniques and technologies based on the developed strategy of conducting the preparatory stage of the ART program and the optimization of the embryological stage increases the effectiveness of the IVF / ICSI / ET cycles by 15.7% and allows achieving the incidence of clinical pregnancy of 52.7%.
format	article
author	N.V. Avramenko D.E. Barkovskiy E.V. Kabachenko I.B. Gridina
author_facet	N.V. Avramenko D.E. Barkovskiy E.V. Kabachenko I.B. Gridina
author_sort	N.V. Avramenko
title	Strategy of the endometrium preparation in patients undergoingthe program of assisted reproductive technologies to improve the effectiveness of treatment
title_short	Strategy of the endometrium preparation in patients undergoingthe program of assisted reproductive technologies to improve the effectiveness of treatment
title_full	Strategy of the endometrium preparation in patients undergoingthe program of assisted reproductive technologies to improve the effectiveness of treatment
title_fullStr	Strategy of the endometrium preparation in patients undergoingthe program of assisted reproductive technologies to improve the effectiveness of treatment
title_full_unstemmed	Strategy of the endometrium preparation in patients undergoingthe program of assisted reproductive technologies to improve the effectiveness of treatment
title_sort	strategy of the endometrium preparation in patients undergoingthe program of assisted reproductive technologies to improve the effectiveness of treatment
publisher	Danylo Halytsky Lviv National Medical University
publishDate	2018
url	https://doaj.org/article/370bf745cd5d4ae3a7393fe80fb4cf1d
work_keys_str_mv	AT nvavramenko strategyoftheendometriumpreparationinpatientsundergoingtheprogramofassistedreproductivetechnologiestoimprovetheeffectivenessoftreatment AT debarkovskiy strategyoftheendometriumpreparationinpatientsundergoingtheprogramofassistedreproductivetechnologiestoimprovetheeffectivenessoftreatment AT evkabachenko strategyoftheendometriumpreparationinpatientsundergoingtheprogramofassistedreproductivetechnologiestoimprovetheeffectivenessoftreatment AT ibgridina strategyoftheendometriumpreparationinpatientsundergoingtheprogramofassistedreproductivetechnologiestoimprovetheeffectivenessoftreatment
_version_	1718439659551326208

Strategy of the endometrium preparation in patients undergoingthe program of assisted reproductive technologies to improve the effectiveness of treatment

Ejemplares similares