The expediency of mandatory combined endoscopy in increasing of assited reproductive technology efficiency

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Introduction. Evaluation of 168 patients participating in IVF programs was performed depending on the results of combined endoscopic examination and subsequent treatment. The pathology of endometrium was detected in more than half of the cases, while hydrosalpinx was revealed in 20% of the patients, and every tenth patient suffered from endometriosis. The expediency of the approach under the study for preparing the patients for IVF programs has been confirmed. The present study was aimed an evaluation of expediency and efficacy of combined endoscopic examination in preparing for subsequent participation of female patients in IVF programs.

Material and methods. The study involved 168 patients participating in IVF programs in accordance with a standard long-term protocol of ovulation induction from 21st day of 28 days cycle. Depending on ovulation time, volume of preliminary research and correction of detected pathology, the patient population was divided in three groups. Group I consisted of 40 (23,8%) patients, who had undergone a combined endoscopic examination prior to a subsequent IVF cycle. Group II comprised 61 (41,0%) patient with a history of various kinds of endoscopic and surgical treatment directed at correction of the reproductive function. 59 patients from Group III did not have an endoscopic examination.

Results. Besides previous faulty attempts at administering IVF, the indication for performing a combined endoscopic examination (including hysteroscopy and manipulatory laparoscopy) were clinical and ultrasound sings of pathology in endometrium, a suspicion for the presence of hydrosalpinx or genital endometriosis. During endoscopy, hysteroscopy revealed pathology of endometrium in more than half of the patients (65%), hydrosalpinx - in 20% of cases, and external genital endometriosis in every tenth patient (12,5% of cases). Corrected therapy was given and pregravidary preparatory measures were taken considering the revealed pathology. As a result of subsequent IVF procedures, gestation occurred in 37,5%, 30,4% and 30,5% of the patients from Group I, II and III, respectively.

Conclusions. Thus, combined endoscopic examination and subsequent correction of pathology are the mandatory stages in preparing of female patients for participation in the IVF programs in the event of preceding gestational failures and revealing of clinical and paraclinical evidences of gynecological pathology. Implementation of this particular approach promotes for an increase in efficacy of infertility overcoming through administration of supplementary reproductive technologies (IVF).

About the authors

Е. А. Markova

Altai State Medical University; Siberian Institute of Human Reproduction and Genetics

Email: info@eco-vector.com

No. 1 Department of Obstetrics and Gynecology

Russian Federation, Barnaul; Barnaul

Т. A. Kuznetsova

Altai State Medical University; Siberian Institute of Human Reproduction and Genetics

Email: info@eco-vector.com

Siberian Institute of Human Reproduction and Genetics

Russian Federation, Barnaul; Barnaul

V. V. Vostricov

Altai State Medical University; Siberian Institute of Human Reproduction and Genetics

Email: info@eco-vector.com

No. 1 Department of Obstetrics and Gynecology

Russian Federation, Barnaul; Barnaul

S. V. Salfetkina

Altai State Medical University; Siberian Institute of Human Reproduction and Genetics

Author for correspondence.
Email: info@eco-vector.com

No. 1 Department of Obstetrics and Gynecology

Russian Federation, Barnaul; Barnaul

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