Missed opportunities for improving the effectiveness of in vitro fertilization programs in patients with diminished ovarian reserve

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Дәйексөз келтіру

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Аннотация

Improving the effectiveness of in vitro fertilization (IVF) programs in patients with diminished ovarian reserve is an essential issue for modern reproductive medicine. One of the options to achieve better treatment results is to determine the most favorable period for the beginning of ovarian stimulation, to modify the protocol of gonadotropin administration and the choice of the day for follicle puncture, taking into account the characteristics of the reproductive system of a woman with diminished ovarian reserve, short follicular phase, and early ovulation. The analysis of literature data shows that the attention of researchers is mainly focused on modification of ovarian stimulation protocols in patients with diminished ovarian reserve and poor response to gonadotropin administration, however, it is necessary to study further the size of the dominant follicle on the day of injecting the ovulation trigger for final oocyte maturation. It is presumed that choosing the most favorable period for ovarian stimulation may be crucial for patients with diminished ovarian reserve. It is useful to define the prognostic criteria for more or less successful IVF cycles, which may include hormonal and ultrasound characteristics of ovarian reserve and their combined effect at the beginning of the follicular phase.

Conclusion: The hidden reserve of increasing the effectiveness of IVF programs in patients with diminished ovarian reserve, poor response to ovarian stimulation and low pregnancy rate may include adaptation of trigger for oocyte maturation to the size of the dominant follicle, which is smaller than usual, as well as a prediction of a more successful IVF cycle on the basis of reliable markers.

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Авторлар туралы

Ekaterina Krylova

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

Хат алмасуға жауапты Автор.
Email: kr.katrin00@gmail.com
ORCID iD: 0000-0002-0220-0474

Resident

Ресей, Moscow

Mariam Pogosyan

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

Email: mariam-pogosyan@yandex.ru
ORCID iD: 0009-0002-0772-2367

MD, PhD student

Ресей, Moscow

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