G.R. ABRAMYAN

Republican Institute of Reproductive Health, Perinatology, Obstetrics and Gynecology of the Republic of Armenia, 6/2 Markaryana Str., Erevan, the Republic of Armenia, 0078 

Abramyan G.R. ― Cand. Med. Sc., Associate Professor of the Department of Obstetrics and Gynecology №2, tel. (+37410) 34-18-83, e-mail: rirhpog@gmail.com 

The article presents the results of a study of 354 patients suffering from the infertility at ART who had mutation of thrombophilia genes polymorphism, level of homocysteine AFA. It is demonstrated that the genetic and acquired defects of a hemostasis system in the absence of correction promote failures of IVF. Application of the antithrombotic drugs (low molecular heparin and aspirin), by preparation and during IVF, allows to reduce the number of failures of pregnancy at ART and to increase the efficiency.

Key words: in vitro fertilization (IVF), pregnancy, thrombophilia, failures of IVF, antiphospholipid antibodies, genetic thrombophilia, hyperhomocysteinemia.

REFERENCES

1. Vorob’eva O.A., Korsak V.S. History and basic principles of IVF technology. Probl. reprod, 1997, no. 1, pp. 46-50 (in Russ.).
2. Kitaev E.M. From the history of IVF in Russia. Part I. Probl. reprod, 2002, no. 4, pp. 5-12 (in Russ.).
3. Kulakov V.I., Leonov B.V. Ekstrakorporal’noe oplodotvorenie i ego novye napravleniya v lechenii zhenskogo i muzhskogo besplodiya (teoreticheskie i prakticheskie podkhody): rukovodstvo dlya vrachey. 2-e izd., dop.[ In Vitro Fertilization and its new directions in the treatment of male and female infertility (theoretical and practical approaches): A Guide for Physicians. 2nd ed., Ext]. Moscow: MIA, 2004. 782 p.
4. Dzhamolova N.G., Makatsariya A.D. Gipergomotsisteinemiya i folatdefitsitnye sostoyaniya [Hyperhomocysteinemia and folatdefitsitnye state]. Rossiyskiy forum “Mat’ i ditya”, 6-y: Materialy. Moscow, 2004. P. 69.
5. Momot A.P., Lydina I.V., Borisova O.G. et al. Probl. reprod, 2012, 6 (18), pp. 47-55 (in Russ.).
6. Vartanyan E.V., Okhtyrskaya T.A., Yavorovskaya K.A. et al. Probl. reprod, 2010, 2, pp. 53-57 (in Russ.).
7. Nyboe Andersen A., Goossens V., Bhattacharya S. end The European IVF-monitoring (EIM) Consortium, for the European.
8. Society of Human Reproduction and Embryology (ESHRE). Hum. Reprod, 2009, 6 (24), pp. 1267-1287.
9. Momot A.P. Problemy reproduktsii, 2014, 3-4 (20-21), pp. 24-26 (in Russ.).
10. Di Nisio M., Rutjes A.W., Ferrante N. et al. Thrombophilia and outcomes of assisted reproduct ion technologies: a systematic review and metaanalysis. Blood, 2011, 118, 10, pp. 2670-2678.
11. Inge M.W., Ebish M.S.,Chris M.G. et al. Review of the role of the plasminogen activator system and vascular endothelial growth factor in subfertility. Fertil Steril, 2008, 90, 6, pp. 2340-2350.
12. Middeldorp S. Pregnancy failure and heritable thrombophilia. Semin Hematol, 2007, 44, pp. 93-97.
13. Ramsay M. Normal hematological changes during pregnancy and the puerperium. The Obstetric Hematology Manual. New York: Cambridge University Press, 2010. Pp. 3-12.
14. Sa-Ra Lee, Eun-Joo Park, Sung-Hoon Kim et al. Influence of antiphospholipid antibodies on pregnancy outcome in women undergoing in vitro fertilization and embryo transfer. Am. J. Reprod. Immunol, 2007, 57, pp. 34-39.
15. Dzhandzhgava Zh.G. Klinicheskoe znachenie vyyavleniya trombofilii u patsientok s besplodiem i neudachami EKO: dis. … kand. med. nauk [The clinical significance of detection of thrombophilia in women with infertility and IVF failures. Dis. of PhD med. sciences]. Moscow, 2005. 120 p.
16. Pilipenko M.A. Znachenie trombofilii v formirovanii rannikh embrionicheskikh poter’ pri provedenii ekstrakorporal’nogo oplodotvoreniya i perenosa embrionov: avtoref. dis. … kand. med. nauk [Meaning of thrombophilia in the formation of early embrionicheskih losses during in vitro fertilization and embryo transfer. Synopsis of dis. of PhD med. sciences]. Omsk, 2009. 135 p.
17. Amirova A.A., Nazarenko T.A., Mishieva N.G. Probl. reprod, 2010, 1, pp. 68-74.
18. Bitsadze V.O. et al. Trombofiliya kak vazhneyshee zveno patogeneza oslozhneniy beremennosti [Thrombophilia as the most important link in the pathogenesis of complications of pregnancy]. Moscow, 2012.
19. Sidel’nikova V.M. Privychnaya poterya beremennosti [The usual pregnancy loss]. Triala-Kh, 2002.
20. Michaeleen Doucleff IVF Baby Boom: Births From Fertility Procedures Hit New High, available at: https://www.ivfschool.ru/news/deti_eko_v_ssha.html
21. Bitsadze V.O., Makatsariya A.D., Khizroeva D.Kh. et al. Thrombophilia as the most important link in the pathogenesis of complications of pregnancy. Prakticheskaya meditsina, 2012, no. 5 (60), pp. 22-29 (in Russ.).
22. Okhtyrskaya T.A., Yavorovskaya K.A., Shurshalina A.V., Nazarenko T.A. Implant loss in IVF: the role of hereditary and acquired thrombophilia (review). Probl. reprod, 2010, 2, pp. 53-57 (in Russ.).
23. Brenner B. Haemostatic changes in pregnancy. Thromb Res, 2004, no. 5-6 (114), pp. 409-414.
24. Choi J.W., Pai S.H. Tissue plasminogen activator levels change with plasma fibrinogen concentrations during pregnancy. Ann. Hematol, 2002, no. 11 (81), pp. 611-615.
25. Makatsariya A.D., Bitsadze V.O. Trombofilii i protivotromboticheskaya terapiya v akusherskoy praktike [Thrombophilia and antithrombotic therapy in obstetric practice]. Moscow: Triada-Kh, 2003. 904 p.
26. Bulent Berker, Cemil Kaya, Rusen Aytac, Hakan Satiroglu Homocystein concentrations in follicular fluid are associated with poor oocyte and embryo qualiti es in polycystic ovary syndrome patients undergoing assisted reproduction. Hum. Reprod, 2009, 24. Pp. 2293-2302.
27. Khizroeva D.Kh. Patogenez i profilaktika raznoobraznykh klinicheskikh proyavleniy antifosfolipidnogo sindroma v akusherskoy praktike: dis. … dokt. med. nauk [Pathogenesis and prevention of a variety of clinical manifestations of antiphospholipid syndrome in obstetric practice. Dis. of Dr med. sciences]. Moscow, 2014.