EFFECTIVENESS OF IVF IN TREATING INFERTILITY IN PATIENTS WITH INTERNAL ENDOMETRIOSIS (ADENOMYOSIS)


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Abstract

Objective. To evaluate the effectiveness of IVF treatment in patients with various stages of adenomyosis. Materials and methods. The study included 128 infertile patients after IVF failures; the patients were diagnosed with adenomyosis which was considered one of possible causes of implantation failure in previous IVF attempts. The patients were randomly divided into two groups. The patients of the first group underwent ovarian stimulation with GnRH-antagonists. The patients of the second group received IVF treatment using GnRH-agonist long protocol. Results. The presence of adenomyosis and its stage do not affect the functional activity of the ovaries. Indicators of the ovarian reserve, parameters of folliculogenesis and embryogenesis in IVF programs are influenced by the state of the ovarian reserve and the woman’s age, but not by the presence of adenomyosis. The use of GnRH-antagonist protocols and GnRH-agonist long protocols in ovarian stimulation showed the same effectiveness in patients with internal endometriosis. Conclusion. Pregnancy rate in IVF programs and reproductive losses can be affected by the stage of adenomyosis, which makes it possible to consider moderate-severe and severe stages of adenomyosis as the uterine factor infertility characterized by impaired implantation in the endometrium.

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About the authors

Artem A. AKSENENKO

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: a_axenenko@oparina4.ru
gynecologist of the 1st Gynecology Department Moscow, Russia

Muminat Kh. IBRAGIMOVA

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: m_ibragimova@oparina4.ru
Ph.D., gynecologist of the 1st Gynecology Department Moscow, Russia

Alla A. GAVISOVA

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: gavialla@yandex.ru
Ph.D., Senior Researcher of the 1st Gynecology Department Moscow, Russia

Nona G. MISHIEVA

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: nondoc555@mail.ru
PhD, Senior researcher of 1st gynecology department Moscow, Russia

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