Ectopic pregnancy and acute appendicitis during intrauterine pregnancy after in vitro fertilization

The paper presents a clinical case of the Patient T., 34years old, who underwent the treatment in the Department of ART of the Regional Perinatal Center for tubal peritoneal infertility for seven years. In the anamnesis: one spontaneous uterine pregnancy, culminating in medical abortion for up to 12 weeks, treatment for chronic salpingo-oophoritis, tubectomy on the right side for a progressing ectopic pregnancy. The patient denied the presence of Chlamydia infection in the anamnesis. Studies on sexually transmitted infections before the 1VF program were negative. During laparoscopic tubectomy, no endometriotic foci were found. There were four programs of ART in anamnesis: in 2009, 2012, 2014,2016. During the fourth ART program in 2016, two embryos were transferred to the uterine cavity, resulting in a uterine pregnancy in combination with an ectopic pregnancy diagnosed in the ultrasound study at 4 to 5 weeks of gestation, in the absence of clinical symptoms. The patient underwent emergency laparoscopic tubectomy on the left, the course of the postoperative period proceeded without complications. Later, in the period of uterine pregnancy of 7-8 weeks, with a clinical picture of acute appendicitis, the woman was hospitalized in the surgical department where she underwent laparoscopic appendectomy. Later the pregnancy proceeded without complications, at 39 weeks the planned cesarean section was performed, a girl weighing 3480 grams, 51 cm long with an Apgar score of 9-10 points was extracted on the operation. The course of the early postoperative period without complications, the patient was discharged with the child on the 4th day

RISK FACTORS AND CRITERIA FOR PREDICTION OF OVARIAN HYPERSTIMULATION SYNDROME

Ovarian hyperstimulation syndrome (OHSS) is the most frequent and dangerous complication of IVF programmers. Evaluation of OHSS risk factors allows to perform differentiated, approaches to controlled ovarian stimulation. This article presents the results of OHSS risk factors analysis in 775 IVF cycles. It was found that young age (< 35 years), PCOS, tubal factor of infertility and low BMI (< 25 kg/m2) are the significant risk factors for OHSS

ESTIMATION OF EFFICIENCY OF A TECHNIQUE OF TRANSVAGINAL PUNCTURES OF OVARIES WITH WASHING OF FOLLICLES IN IVF CYCLES

«Poor» ovarian response in standard IVF protocols leads to the difficulty or even impossibility of ensuring the stage of transfer of embryos. A technique of transvaginal puncture with washing of follicles by buffer solution is performed in patients with «poor» ovarian response. This article presents the analysis of TVP in 495 IVF initiated treatment cycles. A smaller number of mature oocytes and embryos are received in the process of controlled ovarian hyperstimulation in patients with washing of follicles, however, the possibility of pregnancy is comparable to the overall IVF results

ESTIMATION OF EFFICIENCY OF FROZEN-THAWED EMBRYOS TRANSFERS IN IVF CYCLES

Cryo-embryos transfer is less expensive and less aggressive method in compare with repeated ovarian stimulation and transfer of «fresh» embryos. The article presents the analysis of influence of various factors on the efficiency of cryo-embryo transfers in 118 IVF cycles. The main success criteria is the quality of thawed embryos

Analysis of the efficiency of IFV techniques (ICSI, PICSI) in the assisted reproductive technology programs

The male factor is the cause of infertility in 40 % of cases. This study is dedicated to the efficiency assessment of ICSI and PICSI techniques and the determination of indications of these methods. There are some relative indicationsfor ICSI in clinical practice: advanced reproductive age of patients, a small number of obtained oocytes, prolonged infertility, repeated attempts of in vitro fertilization. However, normal sperm values are registered in 71.3 % of cases. PICSI method is more preferable at high level of DNA fragmentation and associated changes in sperm indicators. Nevertheless, the pregnancy rate after these methods was comparable - 19.3 % and 19.7 % respectively. The results indicate that the ICSI and PICSI methods do not have a negative impact on the quality of the embryos and do not increase the pregnancy rate