THE CLINICAL AND DIAGNOSTIC VALUE OF VASCULAR ENDO-THELIAL GROWTH FACTOR ON IVF ATTEMPS

Objective. To study the serum levels of vascular endothelial growth factor (VEGF) in women included into an IVF program and to define its clinical value. Subjects and methods. Eighty-six women aged 28 to 43 years (mean age 35.5±7.5 years) who had a history of failed IVF were examined. The patients made up the following clinical groups: 1) 44 patients with infertility of unclear genesis, including 34 patients with grade 1 infertility (21 had IVF failures) and 10 with grade 2 infertility and IVF failures; 2) 27 women who had become pregnant after IVF, 24 of them had a history of IVF failures; 3) 15 healthy nonpregnant women. The investigators performed small pelvic ultrasonography, examined for them sexually transmitted infections, determined hormonal and hemostatic states, made a molecular genetic analysis of risk factors for thrombophilia, immunological and genetic (karyotype determination in married couples) studies, identified a marker of local hemostasis of VEGF on 20 to 24 days of their menstrual cycle, and estimated VEGF concentrations in pg/ml by enzyme immunoassay, by applying a kit of commercial reagents (eBioscience Human FEFF-A, Austria). Results. Elevated serum VEGF levels in the women included into the IVF program may be a major predisposing factor for failed IVF attempts. An algorithm for the management of these patients was compiled. The IVF preparation program involved corrective therapy with vitamin B groups, folates, and anticoagulants. Conclusion. Thirty-eight (44.1%) women with a history of failed IVF became pregnant due to the performed therapy.

angiogenesis, angiogenic factors, vascular endothelial growth factor