The study was conducted using retrospective and prospective methods of information collection during 2020-2023.
Prospective cohort study on the basis of a limited liability company (LLC) “Rodynne Dzherelo” and included 123 women with infertility who who have undergone in vitro fertilization (IVF): average age 34.4 years, with a range of 26 to 45 years. Of all those examined, 93 patients had repeated unsuccessful implantation attempts and were divided into three study groups: Group 1 - patients who were treated using genetically untested embryos according to the standard fixed protocol for preparing the endometrium for transfer, Group 2 - patients who were treated using euploid embryos after preimplantation genetic screening standard fixed endometrial preparation protocol; Group 3 - patients who were treated with euploid embryos after preimplantation genetic screening and determination of the implantation window with subsequent modification of the stimulation protocol for endometrial preparation, in accordance with the result of the endometrial study. The remaining 30 control group (CG) patients had their first in vitro fertilization (IVF) attempt, which was performed using genetically untested embryos, according to the standard fixed endometrial preparation protocol.
The scientific novelty of the results obtained is that the author:
- In-depth scientific knowledge on the peculiarities of understanding the structure of the causes of repeated unsuccessful attempts at implantation, namely the assessment of the embryonic factor and factors from the female body, including the endometrium, as an implantation medium.
- New scientific data have been obtained on the role of the implantation window within the framework of the assisted reproductive technology (ART) program, or rather in vitro fertilization.
- The nature of morphofunctional changes of endometrial epitheliocytes in the middle luteal phase of the menstrual cycle and their correlation with the potential for embryo implantation have been determined.
- The effectiveness of various embryo transfer strategies in the IVF cycle for women with a displaced implantation window has been investigated.
- A model for predicting live birth in women with repeated unsuccessful attempts at implantation with a sensitivity of 95.9% has been developed.
The practical significance of the results obtained is that:
- The effectiveness of determining the implantation window was evaluated to optimize the diagnosis of the causes and treatment of repeated unsuccessful attempts of embryotransfer.
- The identity of the effectiveness of strategies, such as double asynchronous transfer of embryos in the endometrial preparation cycle to the embryotransfer, and transfer of embryos to the optimal day of progestin support in accordance with the results of the implantation window study, has been established.
- A matrix of correlations of anthropometric and anamnestic characteristics, infertility factors, hormonal hemostasis indicators, markers of antiphospholipid syndrome (API), autoimmune diseases, organic pathology of the uterus, including endometrium, partner's spermogram indicators, previous anamnestic attempts with efficacy indicators of IVF treatment and anthropometric indicators of born children, which can be useful for planning infertility treatment tactics using ART methods.
- A model for predicting live birth for patients with repeated failed implantation attempts (RIF) has been formed, which can be useful in practice.
