Missed opportunities for improving the effectiveness of in vitro fertilization programs in patients with diminished ovarian reserve
Krylova E.I., Pogosyan M.T.
Improving the effectiveness of in vitro fertilization (IVF) programs in patients with diminished ovarian reserve is an essential issue for modern reproductive medicine. One of the options to achieve better treatment results is to determine the most favorable period for the beginning of ovarian stimulation, to modify the protocol of gonadotropin administration and the choice of the day for follicle puncture, taking into account the characteristics of the reproductive system of a woman with diminished ovarian reserve, short follicular phase, and early ovulation. The analysis of literature data shows that the attention of researchers is mainly focused on modification of ovarian stimulation protocols in patients with diminished ovarian reserve and poor response to gonadotropin administration, however, it is necessary to study further the size of the dominant follicle on the day of injecting the ovulation trigger for final oocyte maturation. It is presumed that choosing the most favorable period for ovarian stimulation may be crucial for patients with diminished ovarian reserve. It is useful to define the prognostic criteria for more or less successful IVF cycles, which may include hormonal and ultrasound characteristics of ovarian reserve and their combined effect at the beginning of the follicular phase.
Conclusion: The hidden reserve of increasing the effectiveness of IVF programs in patients with diminished ovarian reserve, poor response to ovarian stimulation and low pregnancy rate may include adaptation of trigger for oocyte maturation to the size of the dominant follicle, which is smaller than usual, as well as a prediction of a more successful IVF cycle on the basis of reliable markers.
Authors’ contributions: Krylova E.I., Pogosyan M.T. – review of the publications on the subject of the article, analysis of the obtained data, writing the text of the article.
Conflicts of interest: The authors declare no possible conflicts of interest.
Funding: The study was conducted without sponsorship.
For citation: Krylova E.I., Pogosyan M.T. Missed opportunities for improving the effectiveness of in vitro fertilization programs in patients with diminished ovarian reserve.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (6): 13-18 (in Russian)
https://dx.doi.org/10.18565/aig.2024.106
Keywords
References
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Received 24.04.2024
Accepted 04.06.2024
About the Authors
Ekaterina I. Krylova, Resident, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology, Perinatology, Ministry of Health of Russia,117997, Russia, Moscow, Ac. Oparin str., 4, kr.katrin00@gmail.com, https://orcid.org/0000-0002-0220-0474
Mariam T. Pogosyan, MD, PhD student, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, mariam-pogosyan@yandex.ru, https://orcid.org/0009-0002-0772-2367