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Результаты программ вспомогательных репродуктивных технологий у пациенток с «тонким» эндометрием
Результаты программ вспомогательных репродуктивных технологий у пациенток с «тонким» эндометрием
Абдурахманова Н.Ф., Гвоздева А.Д., Зиганшина М.М., Долгушина Н.В. Результаты программ вспомогательных репродуктивных технологий у пациенток с «тонким» эндометрием. Гинекология. 2019; 21 (1): 23–27. DOI: 10.26442/20795696.2019.1.190232
DOI: 10.26442/20795696.2019.1.190232
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DOI: 10.26442/20795696.2019.1.190232
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Аннотация
Актуальность. Эффективность программ вспомогательных репродуктивных технологий (ВРТ) достаточно высока, но у пар с повторными неудачными попытками программ ВРТ вероятность наступления беременности прогрессивно снижается с каждой последующей попыткой. Эндометрий недостаточной толщины является частой причиной снижения возможности наступления беременности. Однако данные о прогностической ценности этого значения в программах ВРТ противоречивы. Ряд исследователей не находят корреляции между толщиной эндометрия и исходами программ ВРТ. Другие исследователи выявили статистически значимую зависимость между толщиной эндометрия и частотой наступления беременности в циклах ВРТ.
Цель. Оценить влияние «тонкого» эндометрия на частоту наступления беременности в программах ВРТ.
Материалы и методы. В проспективное исследование были включены 154 пары, обратившиеся для лечения бесплодия в программах ВРТ. Пациентки были стратифицированы на группы в зависимости от наступления беременности: 1-я группа (n=43) – беременность наступила, 2-я группа (n=111) – беременность не наступила. Далее была выявлена пороговая толщина эндометрия по данным ультразвукового исследования, которая влияла на наступление беременности, и сформированы дополнительные две группы: 3-я группа (n=85) – пациентки с «тонким» эндометрием, 4-я группа (n=69) – пациентки с нормальной толщиной эндометрия.
Результаты. Пороговый уровень толщины эндометрия, при котором вероятность наступления беременности, а также достоверность модели и площадь под кривой (AUC) были максимальными, составил 8,0 мм (AUC=86,7%, чувствительность – 97,7%, специфичность – 75,7%). Скорректированное отношение шансов наступления беременности в зависимости от толщины эндометрия с учетом полученных бластоцист отличного качества составило 9,1 (95% доверительный интервал 4,3–19,3). Факторами, оказывающими влияние на толщину эндометрия, были полипы эндометрия с полипэктомией и самопроизвольные выкидыши в анамнезе, что, несомненно, связано с воспалительным генезом поражения эндометрия.
Выводы. «Тонкий» эндометрий играет негативную роль в программах ВРТ, снижая вероятность наступления беременности в 9,1 раза.
Ключевые слова: бесплодие, вспомогательные репродуктивные технологии, «тонкий» эндометрий, толщина эндометрия, хронический эндометрит.
Aim. To evaluate an effect of “thin” endometrium on pregnancy rate in ART programs.
Materials and methods. 154 couples who applied for infertility treatment in ART programs were included in this prospective study. The patients were stratified into groups depending on whether a pregnancy to occur: Group 1 (n=43) – pregnancy occurred and Group 2 (n=111) – pregnancy did not occur. Then the endometrial thickness threshold determining pregnancy occurrence was identified by ultrasound and two additional groups were formed: Group 3 (n=85) – patients with “thin” endometrium, Group 4 (n=69) – patients with normal endometrial thickness.
Results. The endometrial thickness threshold at which pregnancy probability, as well as the model and area under the curve (AUC) reliability were maximum, was 8.0 mm (AUC=86.7%, sensitivity – 97.7%, specificity – 75.7%). The adjusted odds ratio of pregnancy occurrence depending on endometrial thickness given the excellent quality blastocysts obtained, was 9.1 (95% confidence interval 4.3–19.3). Factors affecting endometrial thickness were endometrial polyps with polypectomy and spontaneous miscarriages in anamnesis that was undoubtedly associated with an inflammatory genesis of endometrial damage
Conclusions. "Thin" endometrium plays a negative role in ART programs reducing pregnancy likelihood by 9.1 times.
Key words: infertility, assisted reproductive technologies, “thin” endometrium, endometrial thickness, chronic endometritis.
Цель. Оценить влияние «тонкого» эндометрия на частоту наступления беременности в программах ВРТ.
Материалы и методы. В проспективное исследование были включены 154 пары, обратившиеся для лечения бесплодия в программах ВРТ. Пациентки были стратифицированы на группы в зависимости от наступления беременности: 1-я группа (n=43) – беременность наступила, 2-я группа (n=111) – беременность не наступила. Далее была выявлена пороговая толщина эндометрия по данным ультразвукового исследования, которая влияла на наступление беременности, и сформированы дополнительные две группы: 3-я группа (n=85) – пациентки с «тонким» эндометрием, 4-я группа (n=69) – пациентки с нормальной толщиной эндометрия.
Результаты. Пороговый уровень толщины эндометрия, при котором вероятность наступления беременности, а также достоверность модели и площадь под кривой (AUC) были максимальными, составил 8,0 мм (AUC=86,7%, чувствительность – 97,7%, специфичность – 75,7%). Скорректированное отношение шансов наступления беременности в зависимости от толщины эндометрия с учетом полученных бластоцист отличного качества составило 9,1 (95% доверительный интервал 4,3–19,3). Факторами, оказывающими влияние на толщину эндометрия, были полипы эндометрия с полипэктомией и самопроизвольные выкидыши в анамнезе, что, несомненно, связано с воспалительным генезом поражения эндометрия.
Выводы. «Тонкий» эндометрий играет негативную роль в программах ВРТ, снижая вероятность наступления беременности в 9,1 раза.
Ключевые слова: бесплодие, вспомогательные репродуктивные технологии, «тонкий» эндометрий, толщина эндометрия, хронический эндометрит.
________________________________________________
Aim. To evaluate an effect of “thin” endometrium on pregnancy rate in ART programs.
Materials and methods. 154 couples who applied for infertility treatment in ART programs were included in this prospective study. The patients were stratified into groups depending on whether a pregnancy to occur: Group 1 (n=43) – pregnancy occurred and Group 2 (n=111) – pregnancy did not occur. Then the endometrial thickness threshold determining pregnancy occurrence was identified by ultrasound and two additional groups were formed: Group 3 (n=85) – patients with “thin” endometrium, Group 4 (n=69) – patients with normal endometrial thickness.
Results. The endometrial thickness threshold at which pregnancy probability, as well as the model and area under the curve (AUC) reliability were maximum, was 8.0 mm (AUC=86.7%, sensitivity – 97.7%, specificity – 75.7%). The adjusted odds ratio of pregnancy occurrence depending on endometrial thickness given the excellent quality blastocysts obtained, was 9.1 (95% confidence interval 4.3–19.3). Factors affecting endometrial thickness were endometrial polyps with polypectomy and spontaneous miscarriages in anamnesis that was undoubtedly associated with an inflammatory genesis of endometrial damage
Conclusions. "Thin" endometrium plays a negative role in ART programs reducing pregnancy likelihood by 9.1 times.
Key words: infertility, assisted reproductive technologies, “thin” endometrium, endometrial thickness, chronic endometritis.
Полный текст
Список литературы
1. Kumbak B, Erden HF, Tosun S et al. Outcome of assisted reproduction treatment in patients with endometrial thickness less than 7 mm. Reprod Biomed Online 2009; 18 (1): 79–84.
2. Zhang T, Li Z, Ren X et al. Endometrial thickness as a predictor of the reproductive outcomes in fresh and frozen embryo transfer cycles: A retrospective cohort study of 1512 IVF cycles with morphologically good-quality blastocyst. Medicine (Baltimore) 2018; 97 (4): e9689. DOI: 10.1097/MD.0000000000009689
3. Liu KE, Hartman M, Hartman A et al. The impact of a thin endometrial lining on fresh and frozen-thaw IVF outcomes: an analysis of over 40 000 embryo transfers. Hum Reprod 2018; 33 (10): 1883–8. DOI: 10.1093/humrep/dey281
4. Gonen Y, Casper RF, Jacobson W, Blankier J. Endometrial thickness and growth during ovarian stimulation: a possible predictor of implantation in in vitro fertilization. Fertil Steril 1989; 52 (3): 446–50.
5. Oliveira JB, Baruffi RL, Mauri AL et al. Endometrial ultrasonography as a predictor of pregnancy in an in-vitro fertilization programme after ovarian stimulation and gonadotrophin-releasing hormone and gonadotrophins. Hum Reprod 1997; 12 (11): 2515–8.
6. Khalifa E, Brzyski RG, Oehninger S et al. Sonographic appearance of the endometrium: the predictive value for the outcome of in-vitro fertilization in stimulated cycles. Hum Reprod 1992; 7 (5): 677–80.
7. Serafini P, Batzofin J, Nelson J, Olive D. Sonographic uterine predictors of pregnancy in women undergoing ovulation induction for assisted reproductive treatments. Fertil Steril 1994; 62 (4): 815–22.
8. Weiss NS, van Vliet MN, Limpens J et al. Endometrial thickness in women undergoing IUI with ovarian stimulation. How thick is too thin?
A systematic review and meta-analysis. Hum Reprod 2017; 32 (5): 1009–18. DOI: 10.1093/humrep/dex035
9. Sher G, Herbert C, Maassarani G, Jacobs MH. Assessment of the late proliferative phase endometrium by ultrasonography in patients undergoing in-vitro fertilization and embryo transfer (IVF/ET). Hum Reprod 1991; 6 (2): 232–7.
10. Check JH, Lurie D, Dietterich C et al. Adverse effect of a homogeneous hyperechogenic endometrial sonographic pattern, despite adequate endometrial thickness on pregnancy rates following in-vitro fertilization. Hum Reprod 1993; 8 (8): 1293–6.
11. Приказ Минздрава России №107н от 30 августа 2013 г. «О порядке использования вспомогательных репродуктивных технологий, противопоказаниях и ограничениях к их применению». https: //www.rosminzdrav.ru/documents/6787-Prikaz-Minzdrava-Rossii-107n-.
[Prikaz Minzdrava Rossii №107n ot 30 avgusta 2013 g. "O poriadke ispol'zovaniia vspomogatel'nykh reproduktivnykh tekhnologii, protivopokazaniiakh i ogranicheniiakh k ikh primeneniiu". https: //www.rosminzdrav.ru/documents/6787-Prikaz-Minzdrava-Rossii-107n- (in Russian).]
12. Gardner DK, Schoolcraft WB. Culture and transfer of human blastocysts. Curr Opin Obstet Gynecol 1999; 11 (3): 307–11.
13. Fatemi HM, Popovic-Todorovic B, Ameryckx L et al. In vitro fertilization pregnancy in a patient with proven chronic endometritis. Fertil Steril 2009; 91 (4): 1293.e9–1293.e11. DOI:10.1016/j.fertnstert.2008.12.050.
14. Noyes N, Liu HC, Sultan K et al. Endometrial thickness appears to be a significant factor in embryo implantation in in-vitro fertilization. Hum Reprod 1995;10 (4): 919–22.
15. Rinaldi L, Lisi F, Floccari A et al. Endometrial thickness as a predictor of pregnancy after in-vitro fertilization but not after intracytoplasmic sperm injection. Hum Reprod 1996; 11 (7): 1538–41.
16. Weissman A, Gotlieb L, Casper RF. The detrimental effect of increased endometrial thickness on implantation and pregnancy rates and outcome in an in vitro fertilization program. Fertil Steril 1999; 71 (1): 147–9.
17. Bassil S. Changes in endometrial thickness, width, length and pattern in predicting pregnancy outcome during ovarian stimulation in in vitro fertilization. Ultrasound Obstet Gynecol 2001; 18 (3): 258. DOI: 10.1046/j.1469-0705.2001.00502.x
18. Kovacs P, Matyas S, Boda K, Kaali SG. The effect of endometrial thickness on IVF/ICSI outcome. Hum Reprod 2003; 18 (11): 2337–41.
19. Dain L, Bider D, Levron J et al. Thin endometrium in donor oocyte recipients: enigma or obstacle for implantation? Fertil Steril 2013; 100 (5): 1289–1295.e2. DOI: 10.1016/j.fertnstert.2013.07.1966
20. Miwa I, Tamura H, Takasaki A et al. Pathophysiologic features of “thin” endometrium. Fertil Steril 2009; 91 (4): 998–1004. DOI: 10.1016/j.fertnstert.2008.01.029
21. Takasaki A, Tamura H, Taketani T et al. A pilot study to prevent a thin endometrium in patients undergoing clomiphene citrate treatment.
J Ovarian Res Bio Med Central 2013; 6 (1): 94. DOI: 10.1186/1757-2215-6-94
22. Esmailzadeh S, Faramarzi M. Endometrial thickness and pregnancy outcome after intrauterine insemination. Fertil Steril 2007; 88 (2): 432–7. DOI: 10.1016/j.fertnstert.2006.12.010
23. Sharara FI, Lim J, McClamrock HD. Endometrial pattern on the day of oocyte retrieval is more predictive of implantation success than the pattern or thickness on the day of hCG administration. J Assist Reprod Genet 1999; 16 (10): 523–8.
24. Sereepapong W, Suwajanakorn S, Triratanachat S et al. Effects of clomiphene citrate on the endometrium of regularly cycling women. Fertil Steril 2000; 73: 287–91.
25. Isaacs JD, Wells CS, Williams DB et al. Endometrial thickness is a valid monitoring parameter in cycles of ovulation induction with menotropins alone. Fertil Steril 1996; 65 (2): 262–6.
26. Kuć P, Kuczyńska A, Topczewska M et al. The dynamics of endometrial growth and the triple layer appearance in three different controlled ovarian hyperstimulation protocols and their influence on IVF outcomes. Gynecol Endocrinol 2011; 27 (11): 867–73. DOI: 10.3109/09513590.2010.540602
27. Apparao KBC, Lovely LP, Gui Y et al. Elevated endometrial androgen receptor expression in women with polycystic ovarian syndrome. Biol Reprod 2002; 66 (2): 297–304.
28. O’Donnell RL, Warner P, Lee RJ et al. Physiological sex steroid replacement in premature ovarian failure: randomized crossover trial of effect on uterine volume, endometrial thickness and blood flow, compared with a standard regimen. Hum Reprod 2012; 27 (4): 1130–8. DOI: 10.1093/humrep/des004
2. Zhang T, Li Z, Ren X et al. Endometrial thickness as a predictor of the reproductive outcomes in fresh and frozen embryo transfer cycles: A retrospective cohort study of 1512 IVF cycles with morphologically good-quality blastocyst. Medicine (Baltimore) 2018; 97 (4): e9689. DOI: 10.1097/MD.0000000000009689
3. Liu KE, Hartman M, Hartman A et al. The impact of a thin endometrial lining on fresh and frozen-thaw IVF outcomes: an analysis of over 40 000 embryo transfers. Hum Reprod 2018; 33 (10): 1883–8. DOI: 10.1093/humrep/dey281
4. Gonen Y, Casper RF, Jacobson W, Blankier J. Endometrial thickness and growth during ovarian stimulation: a possible predictor of implantation in in vitro fertilization. Fertil Steril 1989; 52 (3): 446–50.
5. Oliveira JB, Baruffi RL, Mauri AL et al. Endometrial ultrasonography as a predictor of pregnancy in an in-vitro fertilization programme after ovarian stimulation and gonadotrophin-releasing hormone and gonadotrophins. Hum Reprod 1997; 12 (11): 2515–8.
6. Khalifa E, Brzyski RG, Oehninger S et al. Sonographic appearance of the endometrium: the predictive value for the outcome of in-vitro fertilization in stimulated cycles. Hum Reprod 1992; 7 (5): 677–80.
7. Serafini P, Batzofin J, Nelson J, Olive D. Sonographic uterine predictors of pregnancy in women undergoing ovulation induction for assisted reproductive treatments. Fertil Steril 1994; 62 (4): 815–22.
8. Weiss NS, van Vliet MN, Limpens J et al. Endometrial thickness in women undergoing IUI with ovarian stimulation. How thick is too thin?
A systematic review and meta-analysis. Hum Reprod 2017; 32 (5): 1009–18. DOI: 10.1093/humrep/dex035
9. Sher G, Herbert C, Maassarani G, Jacobs MH. Assessment of the late proliferative phase endometrium by ultrasonography in patients undergoing in-vitro fertilization and embryo transfer (IVF/ET). Hum Reprod 1991; 6 (2): 232–7.
10. Check JH, Lurie D, Dietterich C et al. Adverse effect of a homogeneous hyperechogenic endometrial sonographic pattern, despite adequate endometrial thickness on pregnancy rates following in-vitro fertilization. Hum Reprod 1993; 8 (8): 1293–6.
11. Prikaz Minzdrava Rossii №107n ot 30 avgusta 2013 g. "O poriadke ispol'zovaniia vspomogatel'nykh reproduktivnykh tekhnologii, protivopokazaniiakh i ogranicheniiakh k ikh primeneniiu". https: //www.rosminzdrav.ru/documents/6787-Prikaz-Minzdrava-Rossii-107n- (in Russian).
12. Gardner DK, Schoolcraft WB. Culture and transfer of human blastocysts. Curr Opin Obstet Gynecol 1999; 11 (3): 307–11.
13. Fatemi HM, Popovic-Todorovic B, Ameryckx L et al. In vitro fertilization pregnancy in a patient with proven chronic endometritis. Fertil Steril 2009; 91 (4): 1293.e9–1293.e11. DOI:10.1016/j.fertnstert.2008.12.050.
14. Noyes N, Liu HC, Sultan K et al. Endometrial thickness appears to be a significant factor in embryo implantation in in-vitro fertilization. Hum Reprod 1995;10 (4): 919–22.
15. Rinaldi L, Lisi F, Floccari A et al. Endometrial thickness as a predictor of pregnancy after in-vitro fertilization but not after intracytoplasmic sperm injection. Hum Reprod 1996; 11 (7): 1538–41.
16. Weissman A, Gotlieb L, Casper RF. The detrimental effect of increased endometrial thickness on implantation and pregnancy rates and outcome in an in vitro fertilization program. Fertil Steril 1999; 71 (1): 147–9.
17. Bassil S. Changes in endometrial thickness, width, length and pattern in predicting pregnancy outcome during ovarian stimulation in in vitro fertilization. Ultrasound Obstet Gynecol 2001; 18 (3): 258. DOI: 10.1046/j.1469-0705.2001.00502.x
18. Kovacs P, Matyas S, Boda K, Kaali SG. The effect of endometrial thickness on IVF/ICSI outcome. Hum Reprod 2003; 18 (11): 2337–41.
19. Dain L, Bider D, Levron J et al. Thin endometrium in donor oocyte recipients: enigma or obstacle for implantation? Fertil Steril 2013; 100 (5): 1289–1295.e2. DOI: 10.1016/j.fertnstert.2013.07.1966
20. Miwa I, Tamura H, Takasaki A et al. Pathophysiologic features of “thin” endometrium. Fertil Steril 2009; 91 (4): 998–1004. DOI: 10.1016/j.fertnstert.2008.01.029
21. Takasaki A, Tamura H, Taketani T et al. A pilot study to prevent a thin endometrium in patients undergoing clomiphene citrate treatment.
J Ovarian Res Bio Med Central 2013; 6 (1): 94. DOI: 10.1186/1757-2215-6-94
22. Esmailzadeh S, Faramarzi M. Endometrial thickness and pregnancy outcome after intrauterine insemination. Fertil Steril 2007; 88 (2): 432–7. DOI: 10.1016/j.fertnstert.2006.12.010
23. Sharara FI, Lim J, McClamrock HD. Endometrial pattern on the day of oocyte retrieval is more predictive of implantation success than the pattern or thickness on the day of hCG administration. J Assist Reprod Genet 1999; 16 (10): 523–8.
24. Sereepapong W, Suwajanakorn S, Triratanachat S et al. Effects of clomiphene citrate on the endometrium of regularly cycling women. Fertil Steril 2000; 73: 287–91.
25. Isaacs JD, Wells CS, Williams DB et al. Endometrial thickness is a valid monitoring parameter in cycles of ovulation induction with menotropins alone. Fertil Steril 1996; 65 (2): 262–6.
26. Kuć P, Kuczyńska A, Topczewska M et al. The dynamics of endometrial growth and the triple layer appearance in three different controlled ovarian hyperstimulation protocols and their influence on IVF outcomes. Gynecol Endocrinol 2011; 27 (11): 867–73. DOI: 10.3109/09513590.2010.540602
27. Apparao KBC, Lovely LP, Gui Y et al. Elevated endometrial androgen receptor expression in women with polycystic ovarian syndrome. Biol Reprod 2002; 66 (2): 297–304.
28. O’Donnell RL, Warner P, Lee RJ et al. Physiological sex steroid replacement in premature ovarian failure: randomized crossover trial of effect on uterine volume, endometrial thickness and blood flow, compared with a standard regimen. Hum Reprod 2012; 27 (4): 1130–8. DOI: 10.1093/humrep/des004
2. Zhang T, Li Z, Ren X et al. Endometrial thickness as a predictor of the reproductive outcomes in fresh and frozen embryo transfer cycles: A retrospective cohort study of 1512 IVF cycles with morphologically good-quality blastocyst. Medicine (Baltimore) 2018; 97 (4): e9689. DOI: 10.1097/MD.0000000000009689
3. Liu KE, Hartman M, Hartman A et al. The impact of a thin endometrial lining on fresh and frozen-thaw IVF outcomes: an analysis of over 40 000 embryo transfers. Hum Reprod 2018; 33 (10): 1883–8. DOI: 10.1093/humrep/dey281
4. Gonen Y, Casper RF, Jacobson W, Blankier J. Endometrial thickness and growth during ovarian stimulation: a possible predictor of implantation in in vitro fertilization. Fertil Steril 1989; 52 (3): 446–50.
5. Oliveira JB, Baruffi RL, Mauri AL et al. Endometrial ultrasonography as a predictor of pregnancy in an in-vitro fertilization programme after ovarian stimulation and gonadotrophin-releasing hormone and gonadotrophins. Hum Reprod 1997; 12 (11): 2515–8.
6. Khalifa E, Brzyski RG, Oehninger S et al. Sonographic appearance of the endometrium: the predictive value for the outcome of in-vitro fertilization in stimulated cycles. Hum Reprod 1992; 7 (5): 677–80.
7. Serafini P, Batzofin J, Nelson J, Olive D. Sonographic uterine predictors of pregnancy in women undergoing ovulation induction for assisted reproductive treatments. Fertil Steril 1994; 62 (4): 815–22.
8. Weiss NS, van Vliet MN, Limpens J et al. Endometrial thickness in women undergoing IUI with ovarian stimulation. How thick is too thin?
A systematic review and meta-analysis. Hum Reprod 2017; 32 (5): 1009–18. DOI: 10.1093/humrep/dex035
9. Sher G, Herbert C, Maassarani G, Jacobs MH. Assessment of the late proliferative phase endometrium by ultrasonography in patients undergoing in-vitro fertilization and embryo transfer (IVF/ET). Hum Reprod 1991; 6 (2): 232–7.
10. Check JH, Lurie D, Dietterich C et al. Adverse effect of a homogeneous hyperechogenic endometrial sonographic pattern, despite adequate endometrial thickness on pregnancy rates following in-vitro fertilization. Hum Reprod 1993; 8 (8): 1293–6.
11. Приказ Минздрава России №107н от 30 августа 2013 г. «О порядке использования вспомогательных репродуктивных технологий, противопоказаниях и ограничениях к их применению». https: //www.rosminzdrav.ru/documents/6787-Prikaz-Minzdrava-Rossii-107n-.
[Prikaz Minzdrava Rossii №107n ot 30 avgusta 2013 g. "O poriadke ispol'zovaniia vspomogatel'nykh reproduktivnykh tekhnologii, protivopokazaniiakh i ogranicheniiakh k ikh primeneniiu". https: //www.rosminzdrav.ru/documents/6787-Prikaz-Minzdrava-Rossii-107n- (in Russian).]
12. Gardner DK, Schoolcraft WB. Culture and transfer of human blastocysts. Curr Opin Obstet Gynecol 1999; 11 (3): 307–11.
13. Fatemi HM, Popovic-Todorovic B, Ameryckx L et al. In vitro fertilization pregnancy in a patient with proven chronic endometritis. Fertil Steril 2009; 91 (4): 1293.e9–1293.e11. DOI:10.1016/j.fertnstert.2008.12.050.
14. Noyes N, Liu HC, Sultan K et al. Endometrial thickness appears to be a significant factor in embryo implantation in in-vitro fertilization. Hum Reprod 1995;10 (4): 919–22.
15. Rinaldi L, Lisi F, Floccari A et al. Endometrial thickness as a predictor of pregnancy after in-vitro fertilization but not after intracytoplasmic sperm injection. Hum Reprod 1996; 11 (7): 1538–41.
16. Weissman A, Gotlieb L, Casper RF. The detrimental effect of increased endometrial thickness on implantation and pregnancy rates and outcome in an in vitro fertilization program. Fertil Steril 1999; 71 (1): 147–9.
17. Bassil S. Changes in endometrial thickness, width, length and pattern in predicting pregnancy outcome during ovarian stimulation in in vitro fertilization. Ultrasound Obstet Gynecol 2001; 18 (3): 258. DOI: 10.1046/j.1469-0705.2001.00502.x
18. Kovacs P, Matyas S, Boda K, Kaali SG. The effect of endometrial thickness on IVF/ICSI outcome. Hum Reprod 2003; 18 (11): 2337–41.
19. Dain L, Bider D, Levron J et al. Thin endometrium in donor oocyte recipients: enigma or obstacle for implantation? Fertil Steril 2013; 100 (5): 1289–1295.e2. DOI: 10.1016/j.fertnstert.2013.07.1966
20. Miwa I, Tamura H, Takasaki A et al. Pathophysiologic features of “thin” endometrium. Fertil Steril 2009; 91 (4): 998–1004. DOI: 10.1016/j.fertnstert.2008.01.029
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20. Miwa I, Tamura H, Takasaki A et al. Pathophysiologic features of “thin” endometrium. Fertil Steril 2009; 91 (4): 998–1004. DOI: 10.1016/j.fertnstert.2008.01.029
21. Takasaki A, Tamura H, Taketani T et al. A pilot study to prevent a thin endometrium in patients undergoing clomiphene citrate treatment.
J Ovarian Res Bio Med Central 2013; 6 (1): 94. DOI: 10.1186/1757-2215-6-94
22. Esmailzadeh S, Faramarzi M. Endometrial thickness and pregnancy outcome after intrauterine insemination. Fertil Steril 2007; 88 (2): 432–7. DOI: 10.1016/j.fertnstert.2006.12.010
23. Sharara FI, Lim J, McClamrock HD. Endometrial pattern on the day of oocyte retrieval is more predictive of implantation success than the pattern or thickness on the day of hCG administration. J Assist Reprod Genet 1999; 16 (10): 523–8.
24. Sereepapong W, Suwajanakorn S, Triratanachat S et al. Effects of clomiphene citrate on the endometrium of regularly cycling women. Fertil Steril 2000; 73: 287–91.
25. Isaacs JD, Wells CS, Williams DB et al. Endometrial thickness is a valid monitoring parameter in cycles of ovulation induction with menotropins alone. Fertil Steril 1996; 65 (2): 262–6.
26. Kuć P, Kuczyńska A, Topczewska M et al. The dynamics of endometrial growth and the triple layer appearance in three different controlled ovarian hyperstimulation protocols and their influence on IVF outcomes. Gynecol Endocrinol 2011; 27 (11): 867–73. DOI: 10.3109/09513590.2010.540602
27. Apparao KBC, Lovely LP, Gui Y et al. Elevated endometrial androgen receptor expression in women with polycystic ovarian syndrome. Biol Reprod 2002; 66 (2): 297–304.
28. O’Donnell RL, Warner P, Lee RJ et al. Physiological sex steroid replacement in premature ovarian failure: randomized crossover trial of effect on uterine volume, endometrial thickness and blood flow, compared with a standard regimen. Hum Reprod 2012; 27 (4): 1130–8. DOI: 10.1093/humrep/des004
Авторы
Н.Ф.Абдурахманова*1, А.Д.Гвоздева2, М.М.Зиганшина1, Н.В.Долгушина1
1. ФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. акад. В.И.Кулакова» Минздрава России. 117997, Россия, Москва, ул. Академика Опарина, д. 4;
2. ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России. 121552, Россия, Москва, ул. 3-я Черепковская, д. 15А
*abd.nigora@yandex.ru
1. V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation. 4, Akademika Oparina st., Moscow, 117997, Russian Federation;
2. National Medical Research Center for Cardiology of the Ministry of Health of the Russian Federation. 15a, 3-ia Cherepkovskaia st., Moscow, 121552, Russian Federation
*abd.nigora@yandex.ru
1. ФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. акад. В.И.Кулакова» Минздрава России. 117997, Россия, Москва, ул. Академика Опарина, д. 4;
2. ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России. 121552, Россия, Москва, ул. 3-я Черепковская, д. 15А
*abd.nigora@yandex.ru
________________________________________________
1. V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation. 4, Akademika Oparina st., Moscow, 117997, Russian Federation;
2. National Medical Research Center for Cardiology of the Ministry of Health of the Russian Federation. 15a, 3-ia Cherepkovskaia st., Moscow, 121552, Russian Federation
*abd.nigora@yandex.ru
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