CLINICAL RESULTS OF INFERTILITY TREATMENT IN PATIENTS WITH A COMORBIDITY OF UTERINE LEIOMYOMA AND CHRONIC ENDOMETRITIS WITH OPTIMIZATION OF CRYOPTOCOLS FOR EMBRYO TRANSFER PREPARATION

Abstract

Infertility is a major medical and social issue. In vitro fertilization is an advanced ART technique that helps to successfully cure infertility. Quality preparation for an IVF protocol and the subsequent pregnancy is important and should include treatment of concomitant pathology, evaluation of the condition of the uterine cavity and its optimal preparation in order to prevent reproductive failures and early obstetric losses. This study assessed the effectiveness of optimized cryoprotocols for preparation for embryo transfer in patients with infertility and the comorbid course of uterine leiomyoma and chronic endometritis. We performed clinical examination and comparative analysis of anamnestic data of 100 women with infertility and comorbid uterine leiomyoma and chronic endometritis. The patients were divided into two groups depending on the proposed treatment scheme and the outcomes were compared to a control group. In all groups, stimulation of superovulation was carried out following a short protocol with a GnRH antagonist. We determined that patients with infertility comorbid with uterine leiomyoma and chronic endometritis, when compared to the control group patients, had a history of early menarche, early onset of sexual life, a greater number of sexual partners, a greater incidence of urogenital infections, and of performed intrauterine surgical procedures. The patients in the modified treatment group received a lower mean total dose of gonadotropins, had a shorter duration of stimulation, and fewer days of anti-GnRH administration compared to the traditional treatment group. The patients in the modified treatment group also had a higher frequency of clinical pregnancy and delivery compared to those received conventional treatment. An appropriate anti-inflammatory and antibiotic therapy and comprehensive preparation of the uterine cavity for embryo transfer are key factors in the success of IVF protocols.