Pretreatment before in vitro fertilization and its effectiveness in patients with diffuse adenomyosis


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Aim. To conduct preparatory treatment before in vitro fertilization (IVF) program and to assess its effectiveness in patients with various stages of adenomyosis. Materials and methods. The study included 198patients with infertility and ineffective past IVF attempts. They were examined and diagnosed with adenomyosis, that could be a possible cause of implantation failure in previous attempts of IVF. 128 patients were randomly divided into three groups. As a preparatory treatment before IVF program, the patients received adenomyosis treatment with GnRH-a, COC and Dienogest in a continuous mode for 3 months. 70patients did not undergo preparatory treatment before IVF program. Results. Stage I adenomyosis had no impact on the effectiveness of the IVF program and did not require pretreatment. At stages II-III adenomyosis, preparatory treatment may increase the conception rate. However, the incidence of pregnancy in women with stage III adenomyosis remains low, and this severe stage of adenomyosis is characterized as the uterine factor of infertility. Conclusion. Stage I adenomyosis is not the cause of infertility or IVF failures, and does not require pre-treatment. At stages II-III adenomyosis pre-treatment improves the effectiveness of IVF programs.

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作者简介

Artem Aksenenko

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

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

Alexandr Gus

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

Email: a_gus@oparina4.ru
Dr. Med. Sci., Professor, Head of the Department Ultrasound Diagnostic Imaging

Nona Mishieva

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

Email: nondoc555@mail.ru
PhD, Senior Researcher of the 1st Gynecology Department

Daria Senina

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

Email: seninadashal995@gmail.ru
clinical resident

参考

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