CLINICAL RESULTS IN WOMEN WITH FERTILITY DUE TO ENDOMETRIOS IN THE PROTOCOLS OF ASSISTED REPRODUCTIVE TECHNOLOGIES

Surgical treatment of ovarian endometriosis remains a controversial issue. Sclerotherapy of endometrioma as a minimally invasive and affordable method proves its effectiveness for this category of patients, confirming it with clinical results in ART protocols. The aim is to study the effectiveness of protocols of controlled ovarian stimulation using protocol pretreatment therapy and sclerotherapy in patients with endometriosis-associated infertility in assisted reproductive technology programs. Materials and methods. 126 women with endometriosis-associated and tubal infertility were examined. The patients were divided into 3 clinical groups. Group 1 – 51 patients with infertility on the background of endometriosis, who, 2 months before the COS protocol with GnRH antagonists, underwent a course of protocol pretreatment therapy with sclerotherapy of the endometrioid cyst. Group 2 consisted of 45 patients with infertility on the background of endometriosis, who had a history of surgical treatment. Group 3 includes 30 women with tubal factor infertility, who were a control group. Depending on the treatment tactics, the clinical results of women of both research groups and the control group in ovulation stimulation protocols in ART programs were analyzed. Results. The mean number of retrieved oocytes from patients with endometriosisassociated infertility who underwent conservative endometrioma treatment, as well as the mean number of mature oocytes (MII), the mean number of immature oocytes (MI), and the mean number of deeply immature oocytes (GV) were actually statistically do not differ from the number of oocytes in the same sorting in the control group of women with tubal factor infertility, but it is statistically significantly different between the women of the experimental groups with endometriosis-associated infertility who underwent conservative and operative treatment of ovarian endometriosis, (p1- 2<0.05 )*. In women who underwent endometrioma cystectomy, the ovulatory reserve significantly decreased due to a decrease in the absolute number of follicles, as well as their quality, which affected the subsequent clinical results of women in ART protocols. Conclusions. The fact of the negative impact of endometriosis on the reproductive system and the woman’s body as a whole is proven by the clinical results of patients. Surgical treatment poses a serious risk to women with low ovulatory reserve. Preservation of the follicular apparatus, preservation of the quality of eggs offered by the method of sclerotherapy and protocol pretreatment therapy can increase the chances of success in women with infertility due to endometriosis in ART programs.