Ilyin I. Prevention of Ovarian Hyperstimulation Syndrome in in-vitro fertilization treatment.

The dissertation is devoted to improve the efficiency of prevention and forecast of a severe ovary hyperstimulation syndrome (OHHS) - one of the most severe complications of a controlled ovary hyperstimulation in in-vitro fertilization(IVF) treatment of infertility.The results of retro-and prospective clinical and statistical study of 3437 IVF cycles and a mathematical simulation have made it possible to establish the incidence of the development of a severe ovary hyperstimulation in IVF treatment of infertility in Ukraine and reveal the major causes of the syndrome.Diagnostic criteria of prognosis of the development of severe OHSS were determined and an algorithm of the performance of controlled ovary hyperstimulation and a modified method of controlled drift (MCD) was presented.A comparative study of the effect of preoperative infusion of albumine and hydroxyetil starch and that of MCD has shown that better results were obtained with MCD. This method allows to avoid a development of severe OHSS andkeep high pregnancy rate (41.7%) in IVF cycles.The developed method that covers some prognostic and preventing measures was introduced into the health care practice and resulted in 5 times reduction (from 2% to 0.4%) of the incidence of severe OHSS, in the high risk group 7 times reduction was observed.