The role of minimally invasive intrauterine interventions in increasing the effectiveness 0of IVF programs
- Authors: Kozachenko I.F.1, Arakelyan A.S.1, Smolnikova V.Y.1, Adamyan L.V.1
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Affiliations:
- Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
- Issue: No 9 (2020)
- Pages: 97-104
- Section: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/329547
- DOI: https://doi.org/10.18565/aig.2020.9.97-104
- ID: 329547
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Abstract
Objective. To determine intrauterine pathologies in infertile women preparing for IVF and to evaluate the significance of minimally invasive intrauterine interventions in relation to the effectiveness of subsequent IVF programs. Materials and methods. Hysteroscopy and morphological examination of the endometrium were performed in 600 infertile patients of reproductive age. The analysis of clinical data and the results of restoration of reproductive function were conducted in 351 patients, who were divided into the following groups: group 1 (n=140) included patients with chronic endometritis, group 2 (n=116) consisted of women with endometrial hyperplastic processes, group 3 (n=95) included patients with intrauterine pathology (fibroids, septum, synechiae, adenomyosis). Results. Normal morphological structure of the endometrium was detected in 36% of the examined patients, benign endometrial pathology in 42.7%, atypical hyperplasia and endometrial cancer in 5.5%, and intrauterine pathology in 15.9% of patients. The average duration of infertility was 5.8 (0.6) years. All patients had a history of intrauterine interventions: one intrauterine intervention was in 27.8%, two intrauterine interventions were in 46.6%, and three or more intrauterine interventions were in 25.6% of cases. The results of restoration of reproductive function were evaluated within one year after undergoing complex treatment of assisted reproductive technology (ART) cycles. Pregnancy occurred in 62% of women. Pregnancy resulted in childbirth in 51% of cases. Conclusion. Intrauterine pathology was observed in 58.5% of infertile women. Surgical and subsequent conservative treatment of intrauterine pathology contributed to a reduction in pregnancy losses, as well as an increase in the frequency of pregnancies that ended in childbirth. The risk factors for repeated ART failures in patients with intrauterine pathology are the maternal age over 35 years, the presence of chronic salpingoophoritis, endometriosis and chronic endometritis, as well as the previous history of three or more different intrauterine interventions.
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About the authors
Irena F. Kozachenko
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
Email: i_kozachenko@oparina4.ru
Ph. D., leading researcher of the Gynecological Department
Alek S. Arakelyan
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
Email: A_arakelyan@oparina4.ru
Ph. D., doctor of the Gynecological Department
Veronika Yu. Smolnikova
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
Email: v_smolnikova@oparina4.ru
MD, leading researcher of the Department of assisted reproductive technologies in infertility treatment
Leila V. Adamyan
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
Email: Adamyanleila@gmail.com
MD, Professor, academician of the Russian Academy of Sciences, Head of the Gynecological Department, Deputy Scientific Director
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