Davyd L. Optimization of assisted reproductive technologies in patients over 40 years of age

The thesis is devoted to the new solution of the relevant problem in modern gynecology - reducing the frequency of unsuccessful in vitro fertilization attempts in women over 40 years of age by optimizing and individualizing the ovarian stimulation protocols, using an improved algorithm for treatment and preventive measures. The main reasons for the late implementation of reproductive function are determined, taking into account the somatic and gynecological health conditions in women over 40 years of age. The authors substantiate the algorithm of diagnostic, treatment and preventive measures, depending on the level of ovarian reserve, in the treatment of infertility and the choice of the IVF program and the ovarian stimulation protocol. It has been established that the introduction of the developed complex of diagnostic and treatment measures, and the differentiated approach to the selection of ovarian stimulation protocol, allows to adjust the economic variable of reproductive function restoration in patients with infertility over 40 old. An algorithm for diagnostic measures and an approach to selecting the ovarian stimulation protocol in ART programs for women over 40 years old has been introduced, based on its effectiveness and economic feasibility.