Features of clinical and anamnestic characteristics of patients with different ovary reserve

Abstract

The objective: conduct a clinical and statistical analysis of anamnestic data in infertile women with a predicted weak response of the ovaries to gonadotropins stimulation. Materials and methods. A prospective study of the clinical and statistical analysis of anamnestic data in infertile women with a predicted weak response of the ovaries to gonadotropins stimulation was carried out on the base of CRT USIR Shupyk National Healthcare University of Ukraine, for the period from 2020–2021. Group I consisted of 55 of reproductive aged women with chronic endometritis and repeated unsuccessful attempts of IVF, and control group consisted of 40 reproductive aged women without impaired fertility. Scope of research: pH-metric of vaginal discharge, assessment of vaginal microbiocenosis by microscopic data of a smear stained by Gram, endometrial biopsy and examination of polymerase chain reaction (PCR) of vaginal discharge culture and cervical canal microflora. Results. According to obtained data, in both groups, primary infertility was 43.6% and 55.5%, secondary – 53.4% and 44.4%, respectively. In both groups, there was a high level of artificial abortions (21.8% and 31.1%) and spontaneous early abortions (14.5% and 13.3%) (p<0.05). Among gynecological pathology, the main place is occupied by chronic inflammatory diseases (56.3% of women in group I and 62.2% in group II) and endometriosis (29.1% in the first group and 26.7% in group II). All women with a predicted weak ovarian response to gonadotropin stimulation had surgical interventions on the pelvic organs in anamnesis; 78.0% (78/100) of cases were performed laparoscopic approach. Analysis of surgical intervention structure in women of both groups revealed high frequency of ovarian resection due to the presence of functional cysts and benign formations (27.0%, 27/100). Conclusions. Thus, the predisposing factors for a «weak» response in IVF programs were an older reproductive age, a high frequency of surgical interventions on the pelvic organs and, as a consequence, a change in the blood supply of the ovarian cortical layer, a decrease in stroma volume and follicular reserve reduction. According to main clinical and anamnestic characteristics, groups were comparable and revealed intergroup differences were statistically insignificant that allows us to compare them with each other in a further study.