USPJEŠNOST MEDICINSKI POTPOMOGNUTE OPLODNJE U PACIJENTICA S ENDOMETRIOZOM

Objectives: This thesis aims to evaluate the implantation rate in patients with endometriosis. Furthermore, its goal is to establish the median of retrived oocytes and embryos, median of total dosage of stimulating hormones as well as to discover the impact of age and serum levels of FSH and AMH on implantation rate. Patients and methods: This retrospective study was carried out at the Department of Gynecology and Obstretrics in University Hospital of Split from January 1st 2016 till July 1st 2018. The data on the protocol type and gonadotropins used in the treatment, number of retrived oocytes, embryos and embriotransfers, serum levels of HCG, FSH and AMH were collected from patients' medical histories and from an ART database at the Institute for Gynecological Endocrinology and Human Reproduction. A total of 28 women, aged 25-47, participated in the study. Patients with endometriosis undergoing assisted reproductive tehnologies were included, while patients with thyroid disease and hyperprolactinemia were excluded from the study. Results: Total implantation rate of IVF/ICSI per ET, FET per ET and AIH in patients with endometriosis was 19.6%, while the implantation rate in infertile patients without endometriosis was 30.1%. The implantation rate of IVF/ICSI method per embriotransfer in patients with endometriosis was 18.8%, while the implantation rate in infertile women without endometriosis was 37.5%. 88 protocols in 28 patients were analysed. Median of retrived oocytes was 2 (1-6; 0-20), median of embryos was 2 (0-2; 0-5), median of gonadotropin ampules was 13.5 (7-23; 0-60) and the median of agonist/antagonist GnRH ampules was 5 (0-7; 0-28). The number of retrived oocytes (P=0.215), ampules of gonadotropin (P=0.828) and ampules of agonist/antagonist GnRH did not have an impact on implantation rate. The number of embryos did have an impact on implantation rate (P=0.033). Age (P=0.521), serum level of FSH (P=0.888) and AMH (P=0.972) did not have an impact on implantation rate. Conclusions: IVF/ICSI is the first choice method of ART in threatening infertility in women with endometriosis. Patients with endometriosis undergoing IVF/ICSI have a lower implantation rate per embriotransfer than other infertile women. The efficacy of ART is lower in women with endometriosis.