Berestovyi V. Therapeutic and diagnostic criteria for the effectiveness of the use of assisted reproductive technologies in women with unsuccessful implantation

The dissertation is devoted to the study of the peculiarities of the occurrence and course of infertility in women in terms of improving the prediction of the success of embryo implantation during in vitro fertilization and the use of step-by-step, pathogenesis-based algorithm of therapeutic and diagnostic measures. Recurrent implantation failure is an important cause of habitual in vitro fertilization failure. Known diagnostic methods do not always determine the cause of implantation failure, as the etiopathogenetic component of infertility remains unknown. Therefore, the introduction of new methods of infertility treatment and prediction of implantation success would help to establish a set of standardized tests that will allow a preliminary assessment of each patient and determine the approach for treatment in each case. This work aims to determine the features of the pathogenesis of implantation failure based on an in-depth study of immune and molecular mechanisms with the justification of new approaches to therapeutic and diagnostic interventions. Objectives of the study: 1. To determine the structure of gynaecological morbidity among patients with implantation failure. 2. Systematically study the factors that contribute to implant failure. 3. To evaluate the role of molecular antibodies against heat shock proteins, markers of cellular stress of different specificity with the possibility of their accumulation in case of implantation failure. 4. To develop a new concept of the pathogenesis of recurrent unsuccessful implantation based on systemic clinical-immunological-biochemical analysis. 5. To investigate the clinical effectiveness of the proposed step-by-step, pathogenesis-based algorithm of therapeutic and diagnostic measures in patients with failed implantation to reduce the number of cases of recurrent implantation failure.