Yuzko V. The peculiarities of assisted reproductive technologies in patients with infertility associated with the absence of ovulation

The work presents a theoretical generalization and a new solution to the current task of obstetrics and gynecology, in particular, reproductive medicine - increasing the effectiveness of reproductive function restoring in women with infertility when using ART based on our improved method of preparing patients with infertility, using the preparation melatonin prior to puncture of follicles and sampling oocytes. The significance of determining the level of melatonin in blood of women with infertility during preparation for controlled ovarian stimulation in ART programs has been established. The component of the hormonal profile of blood, the data of the ovulatory reserve, the level of melatonin in follicular fluid, the indicators of number and quality of oocytes, respectively, of embryos, were determined. It has been proven that the inclusion of melatonin in the complex of drug preparation in ART programs contributed to the improvement of the quality of oocytes and embryos and, accordingly, to the improvement of the effectiveness of infertility treatment using ART. New data were obtained on the content of melatonin in blood serum and in follicular fluid in patients with infertility when using ART. The obtained data made it possible to scientifically justify the need to improve the algorithm for preparing women with infertility for controlled ovarian stimulation, follicle puncture and fertilization. Practical significance of the obtained results. For the practical work of obstetricians-gynecologists and reproductive specialists as an algorithm for the preparation of infertile women before and during controlled ovarian stimulation, follicle puncture and oocyte collection, an algorithm is proposed, which includes the administration of a course of melatonin. The results of the study are implemented in the clinical practice of the Medical Center of Infertility Treatment (Chernivtsi), as evidenced by the acts of implementation. The main scientific and theoretical points of the dissertation research are used in the educational process at the Department of Obstetrics and Gynecology of the Bukovinian State Medical University in the training of students, interns and trainee doctors. The dissertation summarizes and solves the scientific and practical task in a new way, which consists in increasing the effectiveness of infertility treatment by optimizing preparation for controlled ovarian stimulation and follicle puncture using melatonin in the protocols of assisted reproductive technologies.