Vіsnik Naukovih Doslіdžen' (Jan 2018)
EFFECTIVENESS OF THE USE OF PRE-GLARE PREPARATION IN PATIENTS WITH POLYCYSTIC OVARY SYNDROME IN AUXILIARY REPRODUCTIVE TECHNOLOGIES PROGRAMS IN THE USE OF CONTROLLED OVARIAN STIMULATION PROTOCOLS WITH ANTAGONISTS AND TRIGGER AGONIST
Abstract
Polycystic ovary syndrome (PCOS ) is a polysyndromic disease, often associated with infertility, and is the most common pathology in women of reproductive age, both in Ukraine and abroad. According to literature, PCOS is diagnosed in almost 50 % of women with menstrual and ovulatory functions, and in 40 % of patients suffering from endocrine infertility. The aim of the study – to evaluate the effectiveness of pre-bladder therapy before controlling stimulation of ovulation in IVF protocols in patients with PCOS. Materials and Methods. A randomized clinical trial was conducted among 146 women with a confirmed diagnosis of PCOS and the following characteristics: age 29.8 (25–38) years, BM I – (27.2 ± 4.9) kg / m², AMG -6.3 ng / ml (4.1–11.6 ng / ml). Duration of infertility – from 2 to 19 years on average (6.8±0.5). Primary infertility was in 102 patients (69.9 %), and secondary – in 44 women (30.1 %). The average age of women who started menarche was 14.1 ± 0.3 years, in all women the cycle was not regular, in 118 women (80.8 %) the menstrual cycle lasted from 30 to 150 days. The examination and treatment were conducted in accordance with the order of the Ministry of Health of Ukraine No. 787 dated 09.09.2013. “On approval of the procedure for the use of assisted reproductive technologies in Ukraine” and the Order of the Ministry of Health of Ukraine dated 11/29/2013. No. 1030/102 “On improvment of family planning and reproductive health system care in Ukraine”. Data was collected prior to the DRT program for the preliminary examination and treatment of married couples, followed by mandatory standard protocol of examination (MSPE ). Results and Discussion. The article presents the effectiveness of therapy with the drugs “FT-500 Plus” (inositol, folic acid, glutathione, lutein, zinc, vitamin C, vitamin E, selenium) and vitamin D3 “Aquadetrin” in patients with infertility in polycystic ovary syndrome (PCOD) before controlling stimulation of ovulation (COS ) in the protocol of extracorporal fertilization. Stimulation was carried out at recombinant gonadotrophin of coriophyllotropin-alpha “ELONVA ” for 5–7 days after the protocol, depending on the reaction of the ovaries. When the size of the follicle reached 14–15 mm, the daily GnRH antagonist “Orlgutran” was administered at 0.25 mg. At the 8th day after the introduction of ELONVA , stimulation was continued by recombinant FSH Purreon to the final maturation of the oocytes (3 follicles>17 mm), as a trigger, the releasing hormone “Diferelin” was used as a trigger. The collection of oocytes was carried out 36 hours after the introduction of an ovulation trigger, followed by the embryos vitrification for 5–6 days (stage of blastocyst). Conclusions. The obtained results showed that in patients receiving pregravid therapy, the total factor of the effectiveness of the oocytes obtained, their degree of maturity, the frequency of fertilization, crushing, the output of blastocyst and, respectively, the onset of pregnancy were higher compared to the control group.
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