Efficiency evaluation of the improved treatment and prevention complex in pregnant women after assisted reproductive technologies
DOI:
https://doi.org/10.18370/2309-4117.2021.59.26-31Keywords:
assisted reproductive technologies, β-chorionic gonadotropin, progesterone, cortisol, prolactin, stress-related hormonesAbstract
Study objective: to determine the role and effectiveness of the proposed therapeutic and preventive complex and psychoemotional correction of hormonal disorders in the pregnancy dynamics after assisted reproductive technologies (ART) to improve the antenatal observation and prevention of obstetric and perinatal complications.
Materials and methods. The study included 299 pregnant women: the main group included 249 women whose pregnancy occurred as an ART result; the control group included 50 pregnant women with spontaneous pregnancy. Therapeutic and prophylactic complex for pregnant women after ART included: micronized progesterone, magnesium oxide, folic acid, L-arginine aspartate, ω3-polyunsaturated fatty acids and long-term psychological correction on the eve of the ART program, at 8–10, 16–18 and 28–30 weeks of pregnancy.
Results. There was a significant increase in the β-chorionic gonadotropin (β-hCG) level in women of the study groups in the first trimester of pregnancy against the background of the proposed treatment.
Mean β-HCG value at 7–8 weeks of gestation in the subgroup IA exceeded the subgroup IB by 37% (p <0.05), in subgroup IIA it exceeded the subgroup IIB by 33% (p <0.05). The mean β-hCG value in subgroups IIIA and IIIB did not have a significant difference in the dynamics of the first trimester compared with the control group and among themselves (p >0.05).
Mean progesterone value at 7–8 weeks of gestation in subgroup IA increased by 38% in comparison with pregnant women who received the conventional treatment complex (p <0.05), in subgroup IIA it was 73% higher than in subgroup IIB (p <0.05). There was no significant difference in the progesterone level in subgroups IIIA and IIIB in the dynamics of the first trimester.
The average cortisol value at 23–24 weeks of pregnancy in subgroup IA decreased by 42% (p <0.05), in pregnant women with endocrine infertility against the background of the proposed treatment complex it was 62% less than in subgroup IIB (p <0.05). The average cortisol level in women with a male factor of infertility was 63% lower than in subgroup IIIB against the background of the proposed complex (p <0.05).
Conclusion. Advanced therapy with micronized progesterone in combination with magnesium saturation, L-arginine aspartate, folic acid, ω-3 polyunsaturated fatty acids, as well as long-term psychoemotional correction is appropriate and effective compared to conventional therapy for pregnant women.
References
- Adamov, M.M. “Pregnancy and childbirth after the use of assisted reproduc tive technologies performed in the absence and presence of fallopian tubes.” Women's health 5 (2011): 159–60.
- Ancheva, I.A. “Psychoprophylaxis of stress during pregnancy and childbirth.” Women's health 5.121 (2017): 32–4.
- Buranova, F.B., Fedorova, T.A., Yershova, L.I. “Features of macro- and microreological properties of blood in pregnant women with placental insufficiency after in vitro fertilization.” Obstetrics and gynecology 1 (2012): 88–93.
- Vdovichenko, Y.P., Zhuk, S.I., Shchurevskaya, O.D. Support for pregnancy and childbirth in conditions of social stress. Methodological recommendations. Kyiv (2014): 64 p.
- Geriak, S.M., Kutsenko, A.V., Kutsenko, V.V. “Features of changes in the placenta under the influence of complex therapy with the inclusion of L-arginine aspartate in women with metabolic syndrome.” Tavricheskiy mediko-biologicheskiy vestnik 15.2.1 (2012): 51–5.
- Hovorukha, I.T., Kvashenko, V.P., Akimova, I.K. “Peculiarities of embryonic and early fetal period of development of pregnancy in patients with cured infertility.” Tavricheskiy mediko-biologicheskiy vestnik 14.3.1 (2011): 50–2.
- Hovorukha, I.T. “Reduction of obstetric and perinatal complications in women with restored fertility.” Tavricheskiy mediko-biologicheskiy vestnik 15.2.2 (2012): 64–7.
- Goshovska, A.V., Yasnikovska, S.M., Goshovskyi, V.M. “Diagnostic criteria for hyperandrogenism in miscarriage from a histological point of view.” In: Scientific digest of the Association of Obstetricians and Gynecologists of Ukraine. Kyiv (2012): 120–1.
- Dakhno, F.V., Kaminskiy, V.V., Yuzko, O.M., eds. Assisted reproductive technologies for infertility treatment: a textbook. Kyiv (2011): 338 p.
- Demina, T.N., Voronova, I.I. “Features of the formation of utero – (pre)placental blood flow in pregnant women with the threat of abortion in early pregnancy against the background of hypoprogesteronemia.” In: Scientific digest of the Association of Obstetricians and Gynecologists of Ukraine. Kyiv. Poligraf plus (2013): 117–21.
- Dovzhikova, I.V. “Cortisol during pregnancy (review of literature).” Bull. VSNTS SO RAMN 6.1 (2010): 226–9.
- Zhylka, N.Y., Pitko, V.A., Grishchenko, V.I., et al.; MoH of Ukraine. Modern auxiliary reproductive technologies. Methodological recommendations. Kyiv (2016): 23 p.
- Korchinska, O.A., Ignat, G.V. “Morphometric indicators of placentas in women with placental dysfunction on the background of hyperhomocysteinemia.” Tavricheskiy mediko-biologicheskiy vestnik 15.2.2 (2012): 311.
- Linde, V.A., Pogorelova, T.N., Drucker, N.A. “Role of arginine imbalance in the development of placental insufficiency.” Obstetrics and gynecology 4 (2011): 26–30.
- Menzhinskaya, I.V. “Distribution by subclasses of Immunoglobulin G and pathogenetic activity of autoantibodies to human chorionic gonadotropin in disorders of reproductive function in women.” Obstetrics and gynecology 3 (2011): 32–7.
- Ministry of Health of Ukraine. Order No. 787 of September 09, 2013 “On approval of instructions on the procedure for using assisted reproductive technologies.”
- Ministry of Health of Ukraine. Order No. 417 of July 15, 2011 “Methodological recommendations for providing outpatient obstetric and gynecological care.”
- Ministry of Health of Ukraine. Order No. 579 of November 29, 2004 “On approval of the procedure for sending women for infertility treatment using assisted reproductive technologies for absolute indications for budget funds.”
- Nechaeva, M.A., Berebin, M.A. “Methodology ‘Type of attitude to pregnancy’: development technology, psychometric characteristics.” Bulletin of State University of South Ural 11 (2011): 66–76.
- Tatarchuk, T.F., Kosei, N.V. “Treatment of stress-induced luteal phase insufficiency.” Women's Health 3 (2016): 18–22.
- Chaika, V.K., ed. Fundamentals of reproductive medicine: a practical guide. Donetsk. Lavis (2011): 896 p.
- Barber, D., Mounce, G. “Women's experiences of antenayal services following IVF: a qualitative study. Abstracts of the 29th Annual Meeting of the European Society of Human Reproductionuction and Embriology, 7–10 July 2013, London, United Kingdom.” Human Reproduction 28 Suppl 1 (2013): 57–8.
- Ferraretti, A., Goossens, V., de Mouzon, J., et al. “Assisted reproductive technology in Europe, 2010: results generated from European registers by ESHRE.” Human Reproduction 28 Suppl 1 (2013): 38–9.
- Kalifa, E., Gliozheni, O., Goldstein, H. “Massive vulvar edema in a patient with hyperstimulation ovarian syndrome.” In: Materials of 18th World Congress on Controversies in obstetrics, gynecology & infertility (COGI), October 24–27, 2013, Vienna, Austria. Vienna (2013): 71–5.
- Lowndess Stevenson, E. “Psychological stress in women who have conceived pregnancies via in vitro fertilization.” Human Reproduction 28 Suppl 1 (2013): 20–1.
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