Gradil' O. Ovarian reserve and its hormonal correction using programmes of assisted reproductive technologies.

The study deals with treatment efficiency improvement in female infertility patients with programmes of assisted reproductive technologies (ART) by increasing their ovarian response in cases with a low ovarian reserve by means of hormonal correction of oxidative disorders during controlled ovarian stimulation (COS). On the basis of clinical-immunological investigations, carried out in 96 women, pathogenetical mechanisms of the development of ovarian reserve disorders during use of ART were studied. It is proved that a poor ovarian response develops against a background of oxidative stress in the blood flow and follicular fluid during COS with gonadotropins, hormonal disbalance, dysfunction of the antioxidant system and a poor ovarian reserve. The study scientifically substantiates that the suggested complex scheme of COS, which makes it possible to normalize the work of the antioxidant system and block processes of oxidative stress within short periods of time, demonstrates a high efficiency of ART during treatment of infertility in women with a low ovarian reserve. When ART are used in women with a low ovarian reserve, the complex scheme of COS with melatonin results in improvements in the quality and number of obtained oocytes and the level of development of clinical pregnancies versus the traditional schemes of COS.