The dissertation presents a new solution to the actual objective of obstetrics and gynecology, namely reproductive medicine, to increase the efficiency of in vitro fertilization cycles (IVF) in women with tubal-peritoneal infertility (TBI). Based on the study of clinical and anamnestic, hormonal, echographic and psychological data, comparative analysis of the results of recombinant follicle-stimulating hormone (rFSH) long and short action and individualized approach to cryoembryotransfer, the method of stimulation of superovulation (SSO) is optimized. frequency of pregnancy and live births, quality of life and pharmacoeconomic efficiency in the cycles of IVF. It was determined that the average term of SSO when using long-acting rFSH is less than when using short-acting rFSH (8.43 ± 0.01 vs. 10.51 ± 0.03 days, p<0.05), and the number of oocytes obtained is higher (17.68 ± 0.51 vs. 14.58 ± 0.25, p <0.05), as well as the number of mature oocytes (14.35 ± 0.24 vs. 10.16 ± 0.19, p <0.05). Analysis of oocyte quality showed that the use of long-acting rFSH allows to obtain more mature oocytes (77.78 % vs. 62.5 %, p<0.05), among which they are only in two thirds of cases (74.15 % vs. 69, 0 %, p<0.05) were of high quality, while in others registered changes in structure and shape (14.13 % vs. 4.68 %, p<0.05), while small oocytes were registered in 2.7 times more often (10.13 % vs. 3.75 %, p<0.05). A significant number of other oocytes obtained were immature, and most of them obtained from patients after long-term rFSH use were stage m1 (80.72 %), while after the introduction of short-acting rFSH their percentage was probably lower (almost 20 %, p <0.05), while extremely immature (stage of germinal vesicles) was more than 2.8 times (9.37 % vs. 3.39 %, p<0.05) and degraded oocytes - 2 times (22.18 % vs. 11.23 %, p<0.05). The number obtained after 120 hours of blastocysts and blastocysts of high quality (AA) after administration of long-acting rFSH was greater (13.67 ± 0.43 vs. 10.29 ± 0.54, p<0.05; 9.42 ± 0.75 vs. 5.17 ± 0.68, respectively, p<0.05). Analysis of quality of life (QOL) of patients with TPI revealed that it is generally quite low, but in the process of treatment there was an improvement in the emotional sphere with the use of long-acting rFSH (from 50.05 ± 2.07 to 58, 43 ± 1.65 points, p <0.05), and when using short-acting rFSH there was a deterioration due to role functioning (56.23 ± 1.57 vs. 67.45 ± 2.19 points, p<0.05 ) and, as a result, the overall assessment of QOL in connection with treatment was probably higher after the use of long-acting rFSH (79.24 ± 1.11 vs. 69.64 ± 1.38 points, p<0.05), and fear , associated with treatment, and clinically expressed anxiety was registered 3.34 times less often and depressive disorders - 1.98 times (p<0.05). The cost of SSO when using long-acting rFSH to obtain one oocyte was lower by 24.15 %; one mature oocyte - by 44.6 %; one blastocyst - by 35.01 %; high quality blastocysts - 53.61 %; one pregnancy - by 32.98 % less and one live birth - by 56.67 %. The use of rFSH and an individualized approach to cryoembryotransfer in women with tubal-peritoneal infertility in in vitro fertilization cycles has increased the effectiveness of treatment: increase the incidence of pregnancy by 15.61 % and live births - by 12.87 %.
