OVARIAN RESERVE FOR PATIENTS INCLUDED IN EXTRACORPORAL FERTILIZATION PROGRAMS
Main Article Content
Abstract
Objective – to study the ovarian reserve and to identify the effectiveness of IVF programs in women of different age categories.
Material and methods:. The study included 241 patients from the Department of VRT at the City Clinical Perinatal Center, which inducted superovulation in IVF and PE programs in 2016. All women were divided into 4 age groups. I group up to 30 years were 60 people (25 %), II group 31-35 years – 85 people (35 %), III 36-39 years – 61 people (25 %), IV groups over 40 years – 35 people (15 %). In these groups, the parameters of the ovarian reserve (AMG, the number of antral follicles), the response to stimulation of superovulation (the number of oocytes obtained during transvaginal puncture of follicles) and the effectiveness of IVF programs (biochemical and clinical pregnancy) were analyzed.
Results. In the comparative analysis of the AMH level, the low value (less than 1.0 ng/ml) in the IV group was significantly higher (in 24 women – 69 %) in group I (4 patients – 7 %, p <0.005). In a comparative analysis of the number of antral follicles in the ovaries, their small number (less than 5) was detected in 26 women of the IV group (75 %), versus 4 people (6 %) of the I group (p <0.005). In women less than 5 years after the age of 40, transvaginal puncture was significantly more frequent than in other age groups: 23 women (71 %) – IV group, 11 women (18 %) – I group (p <0.005). Positive results of IVF and PE programs were significantly lower in the IV age group compared to the rest. Clinical pregnancy in group IV was registered in only 3 women (9 %), in group I in 25 patients (41 %).
The conclusion. The age of the woman, the level of AMH, the number of antral follicles can serve as reliable markers in determining the individual ovarian reserve and be taken into account for predicting the effectiveness of the IVF and PE program. With age, the effectiveness of the IVF and PE program is progressively decreasing and reaches a minimum after 40 years.
Keywords
Article Details
Information about financing and conflict of interests
The authors declare that they have no apparent or potential conflicts of interest related to the publication of this article.
This work is licensed under a Creative Commons Attribution 4.0 License.
How to Cite
References
Nazarenko TA, Misheeva NG. Infertility and age: ways to solve the problem. M.: MEDpress-inform, 2010. 208 p. Russian (Назаренко Т.А., Мишеева Н.Г. Бесплодие и возраст: пути решения проблемы. М.: МЕДпресс-информ, 2010. 208 с.)
Bojarskij KJu. The role of ovarian reserve indicators in the treatment of infertility by the method of IVF and ET. V kn.: Lechenie zhenskogo i muzhskogo besplodija, vspomogatel'nye reproduktivnye tehnologii. Pod red. VI Kulakova, BV Leonova, LN Kuz'micheva. M.: MIA, 2005. P. 53-61 Russian (Боярский К.Ю. Роль показателей овариального резерва при лечении бесплодия методом ЭКО и ПЭ /В кн.: Лечение женского и мужского бесплодия, вспомогательные репродуктивные технологии. Под ред. В.И. Кулакова, Б.В. Леонова, Л.Н. Кузьмичева. М.: МИА, 2005. С. 53-61)
Kravchenko EN, Krivchik GV, Makarkina LG i dr. Diagnosis and treatment of infertility. Omsk: Izd-vo «JuNZ», 2012. 89 p. Russian (Кравченко Е.Н., Кривчик Г.В., Макаркина Л.Г. и др. Диагностика и лечение бесплодия. Омск: Изд-во «ЮНЗ», 2012. 89 с.)
Krasnopol'skaja KV, Nazarenko TA. Clinical aspects of infertility treatment in marriage. M.: GEOTAR-Media, 2013. 327 p. Russian (Краснопольская К.В., Назаренко Т.А. Клинические аспекты лечения бесплодия в браке. М.: ГЭОТАР-Медиа, 2013. 327 с.)
Nazarenko TA. Stimulation of ovarian function. 5 izd., dop. i pererab. M.: MEDpress-inform, 2015. 288 p. Russian (Назаренко Т.А. Стимуляция функции яичников. 5-е изд., доп. и перераб. М.: МЕД пресс-информ, 2015. 288 с.)
Volkov NI. Tactics of management of patients with uterine myoma in the clinic of female infertility. V kn.: Besplodnyj brak. Sovremennye podhody k diagnostike i lecheniju: rukovodstvo. Pod red. GI Suhih, TA Nazarenko. 2-e izd. M.: GEOTAR-Media, 2010. P. 438-463. Russian (Волков Н.И. Тактика ведения пациенток с миомой матки в клинике женского бесплодия. В кн.: Бесплодный брак. Современные подходы к диагностике и лечению: руководство. Под ред. Г.И. Сухих, Т.А. Назаренко. 2-е изд. М.: ГЭОТАР-Медиа, 2010. С. 438-463)
Adamjan LV, Kulakov VI, Andreeva EN. Endometriosis. A guide for doctors. Izd. 2-e, pererab. i dop. M.: Medicina, 2006. 416 p. Russian (Адамян Л.В., Кулаков В.И., Андреева Е.Н. Эндометриоз. Руководство для врачей. Изд. 2-е, перераб. и доп. – М.: Медицина, 2006. 416 с.)
Zdanovskij VM, Vitjazeva II. Exodus of pregnancy and childbirth after infertility treatment by assisted reproduction methods. V kn.: Lechenie zhenskogo i muzhskogo besplodija, vspomogatel'nye reproduktivnye tehnologii. Pod red. VI Kulakova, BV Leonova, LN Kuz'micheva. M.: MIA, 2005. P. 487-491. Russian (Здановский В.М., Витязева И.И. Исход беременности и родов после лечения бесплодия методами вспомогательной репродукции. В кн.: Лечение женского и мужского бесплодия, вспомогательные репродуктивные технологии. Под ред. В.И. Кулакова, Б.В. Леонова, Л.Н. Кузьмичева. М.: МИА, 2005. С. 487-491)
Kalugina AS, Krasnopol'skaja KV. The effectiveness of the IVF program in patients with previous ovarian surgery. Obstetrics and Gynecology. 2000; 6: 35-39. Russian (Калугина А.С., Краснопольская К.В. Эффективность программы ЭКО у пациенток с предшествующими оперативными вмешательствами на яичниках //Акушерство и гинекология. 2000. № 6. С. 35-39)