CLINICAL AND MORPHOLOGICAL CONTROL OF THE EFFICIENCY OF PREGRAVID TREATMENT WITH DUPHASTON IN WOMEN AFTER NON-DEVELOPING PREGNANCIES

Objective. To test the efficiency of pregravid treatment with duphaston in women after non-developing pregnancies. Subject and methods. Seventy-eight women were examined in two steps. The first step was the postmortem diagnosis of luteal phase defect, a dominant endocrine cause, from uterine cavity scrapes. Then they were on pregravid treatment with 1 duphaston tablet twice on cycle days 16 to 25 for 3 months. The second step involved the concurrent use of a triad of tests: 1) control endometrial aspiration biopsy on cycle day 26; 2) ultrasonographic measurement of the thickness of the endometrium and the diameter of the corpus luteum; 3) determination of blood progesterone concentration. Results. Analysis of these complementary indicators could identify 46 (61.54%) women with the adequate endometrium corresponding to the late secretory phase. Retarded development of the endometrial glands and a weak predecidual reaction around the spiral arterioles were revealed in the remaining 32 (38.46%) women; in them, a course of pregravid treatment with duphaston was additionally prolonged up to 6 months and uterine physiotherapy sessions were carried out to stimulate the receptor apparatus of endometrial cells. Conclusion. The use of the above clinical and morphological triad of signs permitted recommendation with certainty that the married couples should plan their next pregnancy, as confirmed by 90% good outcomes.

non-developing pregnancy, pregravid treatment, endometrium, dihydrogesterone