Assessment of underlying causes in patients with implantation fails in ivf cycles

The article presents an analysis of literature data and the results of own retrospective studies of the incidence of cases of lag in the development of the endometrium in women with unsuccessful attempts to treat infertility of tubal peritoneal genesis using auxiliary reproductive technologies (ART). Clinico-anamnestic factors that negatively affect the state of the endometrium and are associated with the risk of an unsuccessful attempt at treatment have been revealed. The objective: to retrospectively analyze the cases of unsuccessful attempts to treat tubal peritoneal infertility in order to elucidate the frequency and extent of the development of the endometrium in the proliferative phase of the cycle in ART programs, as well as clinical and anamnestic factors negatively affecting the endometrium.

and methods. A retrospective analysis of 838 attempts to treat infertility of tubal-peritoneal genesis by ART methods was carried out. The criteria for selecting patients in the study were: 1) the reproductive age from 20 to 40 years; 2) normogonadotropicity; 3) absence or complete obstruction of the existing fallopian tubes; 4) absence of endometriosis, hyperprolactinemia, diabetes mellitus and other endocrine disorders; 5) absence of pathology of the uterus body; 6) normospermia in men. The embryological protocol indicates that embryos are of satisfactory quality, the number of embryos is two or more. Results. In cycles of infertility treatment of tubal peritoneal genesis by ART methods, the lag in the development of the endometrium (of varying severity) is 1/3 of the total number of cycles performed. Hypoplasia of the endometrium, found on the 7th day of the stimulation cycle, persists throughout the proliferative phase before the administration of hCG in 100% of patients. In patients with a marked lag in the development of the endometrium compared with women with normal and moderate retardation, intrauterine manipulation and their complications from anamnesis are significantly more frequent. Conclusion. The results of the study clearly demonstrate the need to analyze the effectiveness of the use of conventional methods for correcting deviations in the development of pregravid endometrium in cycles of treatment with assisted reproductive technologies (ART) and the impact of various degrees of lag in the development of pregravid endometrium on the clinical consequences of ART-infertility programs of tubal peritoneal genesis and their optimization.##plugins.themes.bootstrap3.article.details## This work is licensed under a Creative Commons Attribution 4.0 International License. Authors retain the copyright and grant the journal the first publication of original scientific articles under the Creative Commons Attribution 4.0 International License, which allows others to distribute work with acknowledgment of authorship and first publication in this journal.

Алиева К.У., Кузьмичев Л.Н., Смольникова В.Ю. [и др.]. Современные подходы к подготовке эндометрия у пациенток с ранее безуспешными попытками программы экстракорпорального оплодотворения // Акушерство и гинекология. – 2008. – 5:39–43. Головченко Ю.И., Трещинская М.А. Обзор современных представлений об эндотелиальной дисфункции // Consilium medicum Ukraina. – 2008. – 1:38–40. Гюльмамедова И.Д., Ильина О.И., Носенко Е.Н. [та ін.]. Особенности формирования эндометриальных пиноподий при поддержке лютеиновой фазы вагинальным микронизированным прогестероном // Жіночий лікар. – 2010. – 5:18–23. Гюльмамедова И.Д. Проблемы имплантации в программе IVF. Новости медицинской фармации // Гинекология. – 2008. – 253:17–27. Самойлова А.В., Кострова Е.В., Любовцева Л.А. Рецепторный статус эндометрия у женщин с бесплодием / Репродуктивные технологии сегодня и завтра: материалы XVIII ежегодной международной конференции РАРЧ. – 2008, Sept. – 52–53. Сеидова Л.А., Яворская К.А. Паракринные регуляторы имплантации // Проблемы репродукции. – 2010. – 3:7–10. Судома И.А., Задорожная Т.Д., Берестовой О.А. Эндометриальные натуральные киллеры у пациенток с неудачами имплантации в циклах экстракорпорального оплодотворения // Здоровье женщины. – 2004. – 17(1):82–86. Чайка В.К., Чайка А.В., Носенко Е.Н. [и др.]. Рецептивность эндометрия у пациенток с бесплодием. – Донецк: Ноулидж, 2011. – 243 с. Сhen M.J., Yang J.H., Peng F.H. et al. 2006. Extended estrogen administration for women with thin endometrium in frozenthawed in-vitro fertilization program. J Ass Reprod Genet. 23:337–342. https://doi.org/10.1007/s10815-006-9053-1 Bourgain C. Devroey Р. 2007. Histologic and functional aspects of the endometrium in the implantatory phase. Gynecol. Obstet. Invest. 64(3):131–133. https://doi.org/10.1159/000101735 Chennazhi K.P., Nayak N.R. 2009. Regulation of angiogenesis in the primate endometrium: vascular endothelial growth factor. Semin. Reprod. Med. 27(1):80–89. https://doi.org/10.1055/s-0028-1108012 Garcia Velasco J. Auto-immunity and/or thrombophilia as causes for recurrent implantation failure: myth or reality? / J. Garcia Velasco // Instituto Valenciano de Infertilidad, Reproductive Endocrinology and Infertility, Madrid, Spain, 2012. Granot I. Gnainsky Y., Dekel N. 2012. Endometrial inflammation and effect on implantation improvement and pregnancy outcome. Reproduction. 44:61. https://doi.org/10.1530/REP-12-0217 Huang S.Y., Wang C.J., Soong Y.K. et al. 2011. Site-specific endometrial injury improves implantation and pregnancy in patients with repeated implantation failures. Reproductive Biology and Endocrinology. 9:140. https://doi.org/10.1186/1477-7827-9-140 Li T.C. Evidence¬based management of the couple with recurrent implantation failure / T.C. Li // ESHRE. – 2012. Macklon N. Laboratory: The embryo-endometrial interface – role in implantation/developmental success / N. Macklon // The contribution of the endometrium University of Southampton, Academic Unit of Human Health and Development Mailpoint. European Society of Human Reproduction and Embryology: 29th Annual Meeting. Paramedical invited session. – London, United Kingdom, 7–10 July 2013 Singh N., Bahadur A., Mittal S. et al. 2011. Predictive value of endometrial thickness, pattern and sub-endometrial blood flows on the day of hCG by 2D doppler in in-vitro fertilization cycles: A prospective clinical study from a tertiary care unit. J Hum Reprod Sci. 4:29–33. https://doi.org/10.4103/0974-1208.82357 Wynn R.M. 1977. Ultrastructural development of the human decidua. Biology of the Uterus. New York. 341–376.