Complex method of preparation for <i>in vitro</i> fertilization of patients with intrauterine synechia

Abstract

BACKGROUND: Intrauterine synechiae (Ascherman syndrome) is one of the fairly common causes of infertility. Despite a large number of clinical studies, there are still no effective methods of both prevention and treatment, which is one of the main causes of reproductive failures. The article discusses the experience of combined preimplantation preparation of patients with uterine factor infertility caused by intrauterine synechia. An assessment of the effectiveness of preparation for the in vitro fertilization procedure, with subendometrial use of platelet-rich autoplasma against the background of surgical, antibacterial and hormone therapy, is given. AIM: Evaluation of the effectiveness of complex preimplantation preparation of patients with uterine factor infertility caused by intrauterine synechia. MATERIALS AND METHODS: Study of the results of preparation for in vitro fertilization with thawed embryos of 30 women with infertility against the background of Asherman’s syndrome. Treatment: surgical (hysteroscopic adhesiolysis), antibiotic therapy (semisynthetic penicillin’s with clavulanic acid), hormonal support (conjugated estradiol valerate and micronized progesterone) and subendometrial administration of platelet-rich autoplasma. The main criterion for the effectiveness of treatment is the onset of biochemical and clinical pregnancy. RESULTS: The method of combined preimplantation preparation of infertile patients with intrauterine synechia showed high efficiency of the in vitro fertilization procedure: the onset of clinical pregnancy in 46.7% of women, live birth in 36.7%. CONCLUSIONS: A comprehensive method of preparation for in vitro fertilization of patients with intrauterine synechiae significantly increases the chances of successful embryo implantation during this procedure.